Health insurance coverage while unemployed in California is easy, the costs are less than expected and the filing process simple. Coveredca.com is a website used to determine how much a federal subsidy can be received while unemployed that illustrates the sliding scale used by the health insurance providers participating in California’s new health insurance exchange.
To determine eligibility for a subsidy (premium assistance) and a lower price, plug in the number of people for household, estimate income based on earnings received for 2013, zip code, age and number of dependents 18 years or younger at:
For those employed through the first and second quarters of 2013 and unemployed the rest of that year, calculate income based on earnings while employed and add the amount received for unemployment benefits per week multiplied by the number of weeks. Due to an exhaustion of unemployment funds in the coffers for the state of California, no extension funds have been remitted after 26 weeks of unemployment for the majority of unemployed workers. Medi-Cal is an option.
There are four health care plans to choose from: bronze, enhanced silver, gold and platinum. However, only the enhanced silver plan is used to apply a low cost sliding scale for federal subsidy premium assistance. The differences in monthly premium costs for each insurance provider under the enhanced silver plan are based on negotiations between the provider and the state of California.
Single and unemployed non-smokers with incomes of $22,980 - $28,725 (including unemployment benefits) in 2013 fall between the 200 percent – 250 percent federal poverty level and qualify for the enhanced silver plan consisting of a monthly premium of $121 - $193. The monthly tax credit of $263 remains the same for each insurance provider. All premiums are negotiable and based upon the ability to pay. This enhanced silver plan provides 73 percent of the health care costs and the remaining 27 percent in out of pocket costs. Only emergency room co-pays, 20 percent of hospital stays, and preferred drug copays after $250 drug deductibles are met contribute toward the $1500 medical deductible.
A link requesting more information requires filling out a “Get Contacted” online form by phone or email. A phone call is recommended for finding a preferred physician on the md lists as there is a minimal difference in monthly premiums between HMO and PPO coverage.