As you probably already know, the Affordable Care Act established open, state-run health insurance exchanges. Here in California, those who are not covered by employer-provided health insurance can opt to purchase insurance via Covered California. Depending upon your income and family size, you might even be eligible for help with the cost of your premiums.
But what if you’re covered by health insurance through your employer, but the premiums are too high for you? Are you able to log into Covered California, select a plan, and receive help with the premiums?
That depends. In general, if you opt out of your employer’s health insurance plan, you can’t receive subsidies to cover the cost of the health insurance plan you select through Covered California. But there is one exception to this rule: If your employer-provided health insurance fails the “affordability test”, then you can apply for, and receive, help with your premiums through Covered California.
According to the IRS, a health insurance plan is “affordable” if the employee’s share of the cost amounts to less than 9.5 percent of their income. If your premiums fall above this threshold, then you can opt out of your employee plan and shop for a new one, and apply for subsidies, on the Covered California exchange.
Additionally, keep in mind that some families have difficulty affording dependent coverage for their children. But you can log into Covered California and apply for health insurance through Medi-Cal, which covers low income children. Approval is based upon income and family size.
Remember that you can always call our office if you have questions about health insurance or affording your premiums. There are many different types of health insurance plans on the market, and often we find that our customers just need a little guidance to find a policy that suits their needs and budget.