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FAQ On Individual Exchange

How were the final plans selected?

The plans approved for Covered California were selected after a thorough examination of numerous factors, including access to quality care, affordability, and a good mix of doctors and hospitals available in each plan. Sometimes, carriers were required to add more options for consumers in order to be approved by the state.

Have the plans for the Small Employer Health Options Been Released?

The final plans for SHOP are expected to be released in early June.

Are the plans eligible to raise their rates?

Under Covered California, plans cannot lower or raise the rates, unless the regulator determines that current rates are unreasonable. If a company wants to change their rates, they would have to go through the state regulator. Covered California is committed to making affordable and accessible care a reality for the entire state.

Do the new plans match up well with contracts of providers who tend to serve lower-income populations?

Covered California conducted an exhaustive evaluation of how the current healthcare plans would mesh with providers who tend to serve this important population. As making coverage available and affordable for all was a critical component of Covered California, plans were often expanded to include connections with these Essential Community Providers.

How will I know what providers are available?

Each plan was required to have a good mix of doctors and hospitals available for patient care, which resulted in the final selection of the 13 providers and their plans. In July, you can expect to see the complete list of available providers.

Is a variety of plan choice available for all Californians?

In highly populated areas of the state, six health plans will be offered. Throughout the rest of the state, an average of 4 health plans will be available, although patients will generally be able to choose between at least 2 or 3 health plans. Covered California recognizes that choice is an important component in selecting a healthcare plan.

How many doctors and hospitals are currently included in the approved plans?

The final plans authorized by Covered California make available thousands of doctors and over 300 of the state’s hospitals. Each plan will have its own networks, which is why it’s so important to carefully review the plan you are considering. It might help narrow down your choices by talking with a health insurance agent. Choosing a plan is important, and making an informed choice is critical.