I’m self-employed and not eligible for any subsidies. Is it possible to buy health insurance in California without going through Covered California? If so, would there be any advantages or disadvantages to doing it that way?
Yes, you can buy insurance directly from an insurance company without using Covered California.
However, marketplace plans are ACA-compliant, meaning they cover preventive care, don’t deny coverage based on pre-existing conditions, and meet minimum essential coverage standards. If you buy outside of Covered California, some plans might not offer the same protections.
Private plans can sometimes be even more expensive than marketplace plans. If you find a super cheap plan, read the fine print carefully—it might not cover much. Also, you don’t need to qualify for a subsidy to use Covered California. Anyone can buy through it.
If you buy insurance outside of Covered California, make sure it meets state requirements. Otherwise, you could owe a tax penalty for not having qualifying coverage.
Covered California offers some cost advantages. For example, I’m 40, and a private Kaiser plan costs me $600 per month. Through Covered California, I qualify for a $150 discount, so I only pay $450.
If you don’t qualify for subsidies, you’ll pay the full price, but you may be able to deduct health insurance costs on your taxes.
@Reilly
In my case, my income didn’t affect the premiums at all. When I compared prices on Covered California and directly on Blue Shield’s website, they were exactly the same. So I think it depends on your situation.
@Reilly
Do you know if Canadian citizens moving to California for school can qualify for any discounts on Covered California?
Uma said:
@Reilly
Do you know if Canadian citizens moving to California for school can qualify for any discounts on Covered California?
When I was in grad school in the U.S., my university offered a student health plan, and it was the easiest and most affordable option. I’d recommend checking with your school’s registrar to see if they have something similar.
One benefit of buying through Covered California, even if you don’t get a subsidy, is that all the plans are ACA-compliant.
If you buy insurance outside of the marketplace, you have to be careful. Some private plans don’t offer the same coverage or protections. If you decide to go that route, work with a reputable insurance agent who understands the plans and can help you find one that meets ACA requirements.