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Help with Covered California

• Coverage Levels: Most health insurance plans newly sold to individuals and small businesses must now be classified into one of four levels of coverage: Bronze, Silver, Gold, or Platinum. Additionally, a minimum coverage plan is available for those who are younger than 30 or can provide certification that they are without affordable coverage or are experiencing hardship.
• Essential Health Benefits: All health insurance plans offered in the individual and small-group markets must provide a comprehensive package of items and services known as essential health benefits. These benefits fall into ten categories and include services such as prescription drugs, mental health care, and emergency services.
• Dental Coverage: All Covered California health insurance plans provide embedded pediatric dental coverage. This means that dental insurance for children is included in the price of all health plans purchased through the exchange.

  Additionally, Covered California now offers supplemental dental coverage for adults through optional family dental plans.  Most embedded pediatric dental plans are dental HMOs (DHMOs), and it can be challenging to find dentists who will accept these embedded plans. As a health insurance agent, I have heard more criticisms about DHMOs than praise. The criticism goes back over a decade and comes from dentists, social activists, and patients. Even people who say they like their plans often comment on the difficulty of getting appointments and the distance they need to travel for specific procedures. Other concerns include materials used and reimbursement rates. Therefore, you may want to consider only dental PPO plans and adding your children to your dental plan if you purchase it through Covered California.

• Vision Coverage: Covered California offers consumers a pathway to quality vision care. Vision care benefits for children are included in all health plans purchased through the exchange. While vision care for adults is not offered in Covered California health plans, Covered California collaborates with certain vision insurance companies to provide vision coverage directly to consumers.