Covered California, the New “Health Insurance Marketplace”

What is Covered California?

Covered California, often referred as the California Health Benefit Exchange, is the state’s new “health insurance marketplace” and was created as part of the Affordable Care Act.  Starting in January 2014, most people will be required to have health insurance.  Health center patients who are citizens or legal permanent residents (LPRs) with income levels above 138% of the Federal Poverty Level (FPL) will be able to shop for, compare and enroll in private health insurance plans offered by Covered California with a single, streamlined application process starting in October 2013.

Who is eligible?

Citizens and legal permanent residents with annual household incomes above 138% and up to 400% FPL.





How will health center patients enroll?

Starting in October 2013, individuals can enroll in health plans through a web portal called the California Health Eligibility, Enrollment and Retention System (CalHEERS), in-person assisters (IPAs) & navigators who are trained and certified by Covered California, by mailing in applications, or by calling a regional Covered California service center.  Coverage takes effect in January 2014.

How does this affect health centers?

More patients will have private health plan coverage through Covered California, HealthPAC HCCI patients are included in this group. Other patients who are citizens and LPRs with incomes above 138% FPL will also be required to purchase insurance under the Affordable Care Act’s mandate that all individuals have coverage  Covered California qualified health plans will need to contract with health centers to be a part of the provider network.  Health centers will need to educate the community about Covered California because initially, patients and even staff will be confused about the changes.

Where can I find more information about Covered California?

Covered California just launched a new informational website for consumers, visit  To see an example of what the consumer website will look like, visit and click on the “Find Insurance Options Now” tab.

If you have any questions, please contact Khae Saetern at, Project Coordinator, Policy & Planning at the Alameda Health Consortium.