Applications to Covered CA On and Off Exchange Health Plans. Provider Search Update.

(The following information does not apply to you if you are on an employer group plan or on Medicare.)

There appears to be a great deal of confusion as to where to submit an application and the role of an agent.
Much of the confusion stem from the failure of the CoveredCA media advertising to mention that in addition to the Covered California Exchange, there is also a whole marketplace of health plans and insurance carriers available to consumers OUTSIDE of the Covered CA Exchange (Off-Exchange). The major difference is that you may only apply for a subsidy INSIDE the CoveredCA Exchange (On-Exchange). But if you don’t qualify or need a subsidy, you may apply outside where all the same plans are also available at the same rates, plus additional carriers and plan choices.

In addition, the Covered CA advertising also fails to mention that agents (Certified Insurance Agents) like myself are available to help consumers to quote, evaluate and apply to BOTH On and Off Exchange plans. And that there are no fees for our services. And no difference in premium. And that we offer free ongoing service.

(A) To apply to a plan INSIDE the Covered CA Exchange (On-Exchange):
You must go to www.coveredca.com to apply. Please designate me as your agent (look for “Find Help Near You”). Step by Step instructions for applying:
https://www.dropbox.com/s/9pas1gmsycqdrfx/Application%20Screenshots%20CovCA.docx

(B) To apply to a plan OUTSIDE the Exchange (Off-Exchange), please use the following links to apply:

Anthem Blue Cross (Deadline Dec. 23rd): https://brokerportal.anthem.com/ehb/web/bkr/acc/agentconnect/PHILIPLEE_1

Blue Shield (Deadline Dec. 15th):
https://www.blueshieldca.com/bsca/ApplyNow?xyz=I%2Bc68ZizpmLi

Health Net (Deadline Dec. 15th):
https://www.healthnet.com/portal/consumer/ca/getYourQuote.ndo?region=CA&a=10952

Kaiser: (Deadline Dec. 15th):
https://smu.kaiserpermanente.org/expressweb/ClearWorkspace.action?nextAction=/user/URLDecryptAction.action&refID=7o830apvbn8eyriuut5qmukks0hfomvhibykqt7emn1yam3vpqwgnp5t815gww

Note: If you miss the Dec. 15th deadline, you may still apply for a non-subsidized health plan through Covered CA. The only difference is that you will need to provide income and immigration information (to be shared by several Government agencies) even though you are not requesting a tax subsidy.

Provider Search

Anthem Blue Cross revised Provider Search
Go to www.anthem.com/CA
RHS under “Useful Tools”, click Find a Doctor.
On LHS Choose Doctor or Hospital #1
#2 Type Name of Doctor or Hospital
#3 Enter radius in miles and zip code.
#4 Enter State and Plan Type or network.
1. Plan Network for Covered CA Exchange:
a. Pathway X HMO Individual via Exchange
b. Pathway X PPO Individual via Exchange
c. Pathway X EPO Individual via Exchange
2. Plan Network for Non-Exchange:
a. Pathway HMO Individual
b. Pathway PPO Individual
c. Pathway EPO Individual

Blue Shield of CA Provider Finder
https://www.blueshieldca.com/fap/app/search.html
(Be sure to “Select a Plan” first before you search.)

Health Net Provider Finder
https://www.healthnet.com/portal/provider/providerSearch.do?region=CA

We offer one stop shopping and can help you with all of these plans. Please call us at 925-284-2000 if you encounter any problems in this application process. We are prepared to help you.
Thank you for reading.
Phil Lee
www.health-insurance.com
www.HealthPlanTalk.com
925-284-2000

About Phil Lee
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Lee Health Insurance Services | Healthcare Insurance Agency, Individual Health Insurance, Family Health Plans, Group Medical Insurance, Small Business Health Insurance, Whole & Term Life Insurance, Dental Insurance, Health Care Reform Assistance, Covered California Insurance Exchange Plans, Medicare Supplement Insurance, Medicare Advantage, Medigap Plans, Anthem Blue Cross, Kaiser Permanente, Blue Shield of CA, Health Net, Cigna, Aetna, Contra Costa County CA, Pleasant Hill, Danville, Concord, Berkeley, Martinez, Albany, Oakland, San Ramon, Alameda, Santa Clara, Campbell, Milpitas, Cupertino, Sunnyvale, Saratoga, Fremont, Palo Alto, Newark | 935 Moraga Road, Suite 240, Lafayette CA 94549 (925) 284-2000 or Toll-Free, (800) 286-7445