Buying a Plan on Your Own
Health coverage you buy yourself is called individual coverage. Laws that regulate individual plans are different from the laws that regulate group plans.
New rules affect individual health plans
Plans are no longer allowed to refuse to cover you or charge higher premiums because you have a pre-existing condition or are pregnant.
An insurance marketplace called Covered California opened October 1, 2013, to help people find individual health plans and get tax credits to help pay premiums.
Applying for insurance on your own
- You will have to apply for an individual plan during an enrollment period. This can be during:
- The annual open enrollment period, or
- A special enrollment period after certain life changes, such as the birth of a baby, marriage, loss of coverage through a job, or another qualifying event
- You can apply for Medi-Cal any time of the year.
- Make sure you fill out the application form completely and honestly.
- Plans cannot require you to fill out a health assessment or medical questionnaire before you enroll.
- Plans cannot deny you or charge you a higher premium because of your health status or history.
Moving from a group plan to an individual plan
- You may qualify for a special enrollment period to buy a new plan if you are losing your coverage through your job or another group plan.
- You have a limited time to buy a new plan during a special enrollment period after the triggering event. Be sure to apply and pay your premium before the deadline.
- If you are losing group coverage through your job, you also may have the option to buy the same plan. Ask your group plan about COBRA/Cal-COBRA and HIPAA. Or, ask your current plan if you can convert to individual coverage. Make sure you ask about the application deadlines.
Buying an individual plan
- You can buy a health plan through Covered California, a new insurance marketplace. For more information visit www.coveredca.com or call 1-800-300-1506.
- Covered California is the only place where you can get tax credits to help pay your premium.
- You can get it help applying through Covered California's customer service center or from a certified enrollment counselor.
- You can also get help applying from an insurance agent who is certified to help with Covered California enrollment.
- You can buy a plan outside of Covered California. If you get insurance outside of Covered California, you will not qualify for tax credits for premium assistance. To find insurance options, you can do any of the following:
- Contact an insurance agent or broker for help.
- Search through an insurance broker's website.
- Contact an insurance company or health plan directly.