Switching to CoveredCA for 2025…how should I plan for coverage?

Individual/Marketplace Insurance Forum
1

I’m pretty new to navigating health insurance, so I’m hoping for some advice here.

I’ve been on a Blue Shield PPO plan for the past few years with my family’s help, but due to rising rates and my job converting me to full-time soon, I’m thinking of switching to CoveredCA. My employer’s health plan won’t start for two months, and I heard I might lose it if my hours drop back to part-time this summer (possibly with a return to full-time in the fall).

So my main questions are: How should I calculate my income for CoveredCA in this situation? Should I skip my employer’s plan and stick with CoveredCA for the year, or is it better to switch back and forth? Any advice would be appreciated!

2

If you lose your coverage when you go part-time, COBRA is an option, but it can be pricey. If you switch to CoveredCA instead, you’d start with a new deductible and out-of-pocket maximum, which could get expensive if you’re seeing doctors regularly. If it’s just a short gap, COBRA might be worth considering, but for a longer period, CoveredCA with subsidies might make more sense.

3

Estimate your total 2025 income a little higher on your CoveredCA application so you’re not stuck paying back any tax credits later. Once you’re eligible for health coverage at work, report it to CoveredCA. Most of the time, it’s better to use the employer plan when available. If you lose that plan later on, you’ll have a Special Enrollment option to get back on CoveredCA instead of going with COBRA.

4

Thanks for the details! Here were some ideas I was considering:

  1. Re-enroll with Blue Shield to have coverage until my employer plan kicks in, then cancel Blue Shield.
  2. Enroll with CoveredCA for 2025 and skip the employer plan entirely.
  3. Enroll with CoveredCA, then switch to the employer plan when it starts, and go back to CoveredCA if I lose employer benefits.

So, I think option 3 sounds like it might be the way to go. And by “report to them,” you mean report to CoveredCA, right?

5

@Ellery
Yes, exactly. Call CoveredCA to let them know about any coverage changes ahead of time. If your employer plan starts April 1, cancel your CoveredCA plan effective March 31. They can’t back-date, so you’ll want to avoid overlapping coverage.