If you have coverage through Covered California, your plan will most likely renew on its own for next year. That is convenient. It is also the reason many households start the year in a plan that no longer fits, paying a premium based on information that is out of date.
Open enrollment is the one time each year you can take a fresh look without needing a qualifying life event.
The Dates
Covered California open enrollment begins November 1. Covered California begins sending renewal notices in October, and you can review and update your information then. To have new coverage start January 1, you generally need to enroll or make changes by December 31. Open enrollment runs through January 31, but if you enroll or make changes after December 31, your coverage generally will not start January 1.
Outside of open enrollment, you can generally only change plans if you have a qualifying life event, such as losing other coverage, moving, marrying, or having a baby.
Your Income Estimate Drives Your Premium
Financial help through Covered California is based on your household’s estimated income for the coming year — not last year’s tax return and not what you earned when you first enrolled.
That estimate matters in both directions. If your income is estimated too low, you may receive more financial help than you qualify for, which can mean paying some of it back at tax time. If your income is estimated too high, you may be paying more each month than you need to.
Anyone who changed jobs, started a business, retired, or saw their hours change this year should update their estimate before renewing. The amount of financial help available can also change from one year to the next, so last year’s figure is not a reliable guide.
Auto-Renewal Is a Convenience, Not a Review
When your coverage auto-renews, Covered California generally keeps you in the same plan, or the closest available plan if yours is discontinued. What auto-renewal does not do is check whether that plan still suits you.
It also may not keep your financial help in place. Covered California generally needs you to confirm or update your household and income information before financial help is applied for the coming year. If you do nothing, your coverage could renew without it, and the first bill of the year could reflect the full, unsubsidized premium.
Premiums change every year. Carrier networks change. A doctor you rely on may leave a network, or a plan in your area may now offer a better match for how you actually use care. None of that is reflected automatically.
A few minutes confirming your information and comparing next year’s options is usually enough to keep your financial help in place and confirm your plan still makes sense — or to catch that it does not.
What to Gather Now
Before November 1, pull together:
- A realistic income estimate for next year for everyone in your tax household
- Your current plan name and the premium you pay after financial help
- A list of the doctors, specialists, and hospitals you use
- A list of your regular prescriptions
- Any household changes this year — a new dependent, a move, someone gaining or losing job-based coverage
- Any notice from Covered California asking you to confirm or update your information
With those in hand, a review takes very little time.
A Familiar Scenario
A household’s income dropped when one spouse moved to part-time work in the spring. Nobody updated Covered California, and the plan auto-renewed on the old estimate. The household spent another year paying more each month than necessary.
A change of a few minutes in November would have caught it.
We’re Here To Help!
As a certified Covered California agent, we can review your renewal, update your information, and compare next year’s plans with you. Our help is available at no additional cost to you. Reach out before December 31 so any changes are in place for January 1.
This article is general information about Covered California open enrollment. Eligibility for financial help, premiums, and plan availability depend on your individual circumstances and are determined by Covered California. It is not tax advice; questions about reconciling financial help on your tax return should be directed to your tax advisor.