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Home > Complaint Data Reports > State Service Center Profiles > Profile-Covered CA

Consumer Assistance at Covered California

Covered California is the state's health insurance marketplace where you can apply for health plans. You may also qualify for tax credits to help pay your insurance premiums. Open enrollment is over for 2018, but you may still be able to enroll if you have a qualifying life event. Qualifying events include the loss of health coverage through a job, the birth of a child, or other life-changing events. If you are eligible for Medi-Cal, you can sign up at any time of the year.

The following table outlines information the department reported to OPA about its consumer assistance service center.

Covered California Service Center
Website www.coveredca.com
Main Phone Number 1-800-300-1506
TTY/TDD 1-800-889-4500
Other Phone Numbers  Arabic  1-800-826-6317
Հայերեն (Armenian)  1-800-996-1009
中文 (Chinese) 1-800-300-1533
Farsi  1-800-921-8879
Hmoob (Hmong)  1-800-771-2156
Khmer  1-800-906-8528
한국어 (Korean)  1-800-738-9116
Lao  1-800-357-7976
Spanish 1-800-300-0213
ру́сский (Russian)  1-800-778-7695
Tagalog 1-800-983-8816
Tiếng Việt (Vietnamese) 1-800-652-9528
Hours of Operation Monday-Friday, 8:00 a.m. - 6:00 p.m.
(except state holidays)

 

Complaints Reported for 2016

State Fair Hearings conducted by the Department of Social Services are an avenue for Covered California applicants to address complaints. The following table outlines State Fair Hearings reported by Covered California for OPA's annual Complaint Data Report.

2016 Covered California State Fair Hearings
(conducted by the Department of Social Services)
Website www.coveredca.com/members/file-an-appeal-or-complaint/
Most Common Reasons for Fair Hearings
  1. Denial of coverage (66%)
  2. Eligibility determination issues (20%)
  3. Cancellation (15%)
Most Common Results from the Fair Hearing
  1. Complaint withdrawn (41%)
  2. Compromise settlement or resolution (21%)
  3. No Action Required (19%)
  4. Covered California Position Overturned (15%)
  5. Covered California position upheld (4%)
Average Number of Days the Fair Hearing Process Took in 2016 66 days
Minimum number of days: 0
Maximum number of days: 262

  • There is a faster review process for complainants with an urgent health issue.

Find complaint information from prior years

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