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    A Primer on How to Shop for Health Insurance on California’s Individual Market during Open Enrollment

    By R. Ruth Linden, Ph.D.–

    For many of us, reviewing our health insurance coverage or selecting a new plan inspires dread. How to select the right plan or anticipate unexpected healthcare needs eight months down the road? Would an HMO, such as Kaiser, be the best choice? If purchasing health insurance paralyzes you with fear, be assured that help awaits. You don’t have to go at it alone, but you do need to act soon.

    Enrollment Deadlines

    As if health insurance weren’t already complex enough, this year, there are various open enrollment deadlines to keep in mind. For Medicare beneficiaries, the open enrollment deadline for original Medicare and Medicare Advantage plans, Supplements (Medigap plans), and Part D prescription drug coverage is today: December 7.

    If you are currently on original Medicare with a Part D plan, it is advisable to use the tool at to check whether your current drug plan provides the most cost-effective coverage. (See Plans change their drug formularies every year and fiercely compete for new members by lowering their rates. Your insurance agent or a health advocate can show you how to use this simple tool that can save you hundreds of dollars.

    For those who purchase coverage through an insurance agent or directly from an insurance plan, the (re)enrollment deadline is December 15.

    For those who purchase their health plans on the state exchange, Covered California, there are several different deadlines depending on when you enroll. Coverage through Covered California is available to any individual California resident or family at all income levels needing insurance. For those whose anticipated 2018 income will fall between 138% of the Federal Poverty Level or FPL (approximately $16,643 for a single individual) and 400% of the FPL (approximately $48,240 for a single individual), a tax credit in the form of a subsidy or premium assistance may be available.

    Covered California Enrollment Deadlines

      Date of Enrollment                Coverage Begins

    Before December 15, 2017 January 1, 2018
    December 15–31, 2017 February 1, 2018
    January 1–15, 2018 February 1, 2018
    January 16–31, 2018 March 1, 2018


    If you are currently a Medi-Cal recipient, or would like to apply for Medi-Cal, there are no formal deadlines. You may apply whenever you wish, either through Covered California or your county human services agency. Contact information for your local human services agency may be found here:

    Finally, if your health insurance coverage is provided by your employer, check with your workplace benefits department for information about deadlines and enrollment support.

    There is one exception to these deadlines, known as a qualifying life event or special enrollment. Consumers who experience a qualifying life event may enroll in a Covered California plan outside of open enrollment. Examples of qualifying events include, but are not limited to:

    • a consumer who loses existing health coverage;
    • a Covered California enrollee who experiences a significant income change that renders them newly eligible or ineligible for help paying for insurance;
    • a consumer who turns 26 years old and is no longer eligible to stay on a parent’s plan;
    • a consumer who moves to California from another state, or relocates to a new region within California that allows them to gain access to new Covered California health insurance plans (this also applies to individuals who are released from jail or prison);
    • entering into a marriage;
    • becoming a citizen, a national, or becoming lawfully present (where the individual was not previously lawfully present).

    Anthem Blue Cross Subscribers

    For 2018, Anthem Blue Cross has withdrawn from 16 of California’s 19 healthcare regions. Going forward, Anthem will offer Affordable Care Act (aka Obamacare) plans only in Santa Clara County, five Central Valley counties, and 22 Northern California counties. Members in San Francisco, Alameda, Contra Costa, Santa Cruz, Monterey County and elsewhere must select a new insurance provider. This affects about 153,000 Covered California consumers. On the bright side, more than 84 percent of doctors contracted by Anthem are also available through another health plan.

    Free and Confidential Enrollment Assistance:

    • Contact an independent health advocate for assistance. Note: Health advocacy is a fee-based service.

    If you have questions about how health advocacy can help you to access the best possible healthcare, please email me at or call me at 415-776-5901.

    Ruth Linden, Ph.D. is the Founder and President of Tree of Life Health Advocates in San Francisco. She works with adults with complex illnesses—individuals with multiple, chronic conditions who may have been failed by the healthcare system. Dr. Linden has expertise in breast cancer, long-term care, clinical trials, and the end of life.