Find answers to some common questions about L.A. Care Covered ™.
Choosing a health plan can be confusing.
Here are some of our frequently asked questions. You can also call us at 1.855.270.2327 (TTY 711) and we’ll be happy to help you.
When is Open Enrollment?
Open Enrollment for coverage in 2023 is currently closed. Open Enrollment normally runs from November 1st through the following January 31st.
When will my new coverage start?
Your coverage will begin the first day of the month after you complete the enrollment process.
How do I know how much my premium will be?
You can use our Get a Quote tool or call us at 1.855.270.2327 (TTY 711) to get an estimate. The premium rate depends on things like your annual income, household size, age and ZIP code.
You'll see your final premium when you fill out the application with the required details.
Is there any financial assistance to help pay for health coverage?
The Inflation Reduction Act and state legislation provide expanded financial help resulting in premiums as low as $0 per month depending on your income. L.A. Care also has the most affordable plans across all metal levels in Los Angeles County.
An estimated 93% of our members qualify for a subsidy.
Please contact us at 1.855.270.2327 (TTY 711) about financial help.
How long does it take to enroll?
It depends on whether you enroll as an individual or as a family. Expect to spend an average of 40 minutes to completely fill out your application.
Save time and prepare by gathering Social Security numbers, birth dates, legal status documents and current income information for yourself and family members who need to be covered.
What happens after I sign up?
After you have made your first payment to Covered California™, L.A. Care will mail you a Member ID card and a New Member Welcome Kit.
What if I already have coverage?
People in the individual market could be eligible to switch to Covered California. You may be eligible to save hundreds of dollars every month and keep your same plan.
What if I enroll and my doctor doesn’t accept this health plan?
Call us at 1.855.270.2327 (TTY 711) and a representative can assist you with finding a new provider close to where you live or work.
What happens if I don’t purchase health coverage?
Having health coverage is now the law. Those who are uninsured may face a tax penalty up to:
- $800 per adult (and $400 per child under 18) or,
- 2.5% of annual household income, whichever is greater.
What should I know about the Inflation Reduction Act of 2022?
On August 16, 2022, President Biden signed the Inflation Reduction Act of 2022. For the purposes of health insurance and subsidies, this new law continues the expanded subsidy amounts originally provided by the American Rescue Plan of 2021. These subsidies will now continue through the end of 2025 ensuring that no family will be required to pay more than 8.5% of their household income for the second lowest cost silver plan in their region.
What should I know about the American Rescue Plan of 2021-2022?
On March 11, 2021, President Biden signed the American Rescue Plan Act of 2021. The new law provides a temporary boost in the amount of premium assistance (government tax credits) available and removes the “cliff” that makes people ineligible for subsidies if their income exceeds 400% of the Federal Poverty Level (FPL) for 2021 and 2022. Members who qualify will not have to pay more than 8.5% of their household income for the second lowest cost silver plan in their region.
Federal premium assistance (subsidy) is only available for medical plans purchased through Covered California. Members who purchased their L.A. Care Covered plan through Covered California and didn’t qualify for a subsidy previously, may now qualify. Members who already obtained a subsidy through Covered California may be eligible for additional subsidies to help with the cost of their health plan premiums.
How are subsidies calculated?
The results from the pricing tool are based on the information you provide. If you decide to apply for a plan through Covered California, then Covered California will determine your eligibility and actual subsidy amount, based on the information you enter in your application.
The Advance Premium Tax Credits (also referred to as Premium Subsidies) are based on your income. Under the American Rescue Plan, through 2022, your monthly premium is capped between 0% and 8.5% of your annual income. The cap is based on the price of the second lowest priced Silver plan in your geographic region.
The amount of monthly Subsidy that you receive will be calculated on the amount of premium for the second lowest priced Silver plan that exceeds the cap percentage for which you qualify, spread across 12 months.
What is Advanced Premium Tax Credit?
Advanced Premium Tax Credit (APTC), also called a subsidy, is federally funded financial assistance for health plan premiums. For those who are eligible, it sets a limit on how much one pays based on a percentage of their annual income.
The amount of premium assistance that one can qualify for depends on age, household income and size, and the cost of affordable health care coverage in their region. Premium assistance is only available for medical plans purchased through Covered California.
A simple way to find out if you qualify is by using our subsidy calculator*. If you learn that you may be eligible, you may contact an insurance agent or LA Care directly at 1.866.579.6246 (TTY 711) between 8AM and 8PM.
*The results from this tool are estimates based on the information you provided. If you decide to apply for a plan through Covered California, then Covered California will determine your eligibility and actual subsidy amount based on the information you enter in your application.
What is Special Enrollment?
If you have experienced a qualifying life event you may be eligible to enroll with L.A. Care outside of Open Enrollment through the Special Enrollment Period.
Qualifying life events include:
- You lost or will soon lose your health insurance
- You permanently moved to/within California
- You had a baby or adopted a child
- You got married or entered into domestic partnership
- You returned from active duty military service
- Released from jail or prison
- You gained citizenship/lawful presence
- You are a Federally Recognized American Indian/Alaska Native
- You lost your job or income
For more information about Special Enrollment, call our Enrollment Support Specialist department at 1.855.222.4239 for free and confidential one-on-one assistance.