Open Enrollment

California residents can apply during open enrollment. It is the time of year reserved for you to make changes to your benefit selection, or apply for health coverage, if you are not insured. It usually starts in November and ends in January of the following year.

Special Enrollment

You can still apply for health insurance outside the open enrollment period if you experience a qualifying life.

Qualifying life events for special enrollment, application must be received within 60 days (about 2 months) after a qualifying event:

1. Loss of health coverage
2. Having a baby or adopting a child
3. Changes in residence
4. Change in marital status

What is the difference between HMO, EPO, and PPO?

HMO EPO PPO
Primary Care Physician (PCP) required? Yes No No
Referral to see a specialist.  Yes No No
Network limitations Only within 15-30 Miles or residence Limitation of radius from residential address No limitations
Out-of-Network coverage? No No Partial (highly recommended to choose an in-network provider)
Flexibility Low Medium High

What is the difference between the health plan metal tiers?

Choose the level of coverage that fits you the most.

Bronze Silver Gold Platinum
Monthly Cost
$ $$ $$$ $$$$
Percent of cost Coverage 60% 70% 80% 90%
Consider this tier if you… Lower medical needs.
Lower premium, higher out-of-pocket.
Average medical needs.
Lower monthly premium, higher out-of-pocket.
Higher medical needs. Higher premium, no deductible Often medical needs; highest premium, lowest out-of-pocket.
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