Covered California has recently announced its health plans and preliminary rates for the 2025 coverage year. These changes are expected to significantly impact every Californian. The year 2025 will bring about new beginnings for Covered California, with innovative plans and preliminary rates that will shape the health insurance landscape. At Skyline Benefit, we are committed to guiding you through this 2025 Covered California Changes and assisting you in finding the best health insurance options based on your needs.
Key 2025 Covered California Changes
What Are the Rate Changes?
Covered California announced a preliminary weighted average rate increase of 7.9% for 2025. This increase is due to various factors, including:
- Rising Healthcare Use: More people are using healthcare services.
- Increased Pharmacy Costs: The cost of prescription drugs continues to climb.
- Rising Cost of Care: Overall healthcare costs are increasing.
- Labor Shortages: Shortages in healthcare staff can drive up costs.
- Other Industry Issues: Various other challenges are impacting the healthcare industry.
Despite these issues, Covered California has kept the yearly average rate increase over the past five years to just 5%.
How Will Financial Assistance and Support Work?
Governor Newsom and the California Legislature have increased the amount of state funds available for the enhanced cost-sharing reduction (CSR) program. This program aims to eliminate deductibles and lower the cost of care for over a million Californians. In 2025:
- Enhanced Support: Californians with incomes above 200% of the federal poverty level will be eligible for enhanced Silver 73 plans with no deductibles and reduced out-of-pocket costs. Those below 200% will continue to receive higher levels of support.
- Expanded Eligibility: More people will qualify for this program, thanks to additional state funding.
- Federal Subsidies: Continued enhanced federal subsidies through the Inflation Reduction Act will provide more assistance to pay for health insurance.
Who Will Benefit from Zero-Premium Plans?
Nearly 25% of current enrollees are estimated to have a $0 premium in 2025, up from 20% in 2024. This increase is a testament to the robust financial support available through Covered California, ensuring more individuals can access affordable health coverage.
What’s New for DACA Recipients?
Starting November 1, 2024, the Affordable Care Act will make coverage available to Deferred Action for Childhood Arrivals (DACA) recipients. This expansion will allow approximately 40,000 DACA recipients in California to enroll in health plans through Covered California.
Increased Competition and Consumer Choice
In 2025, Californians will benefit from increased competition among health carriers, with 12 providers offering insurance across the state. This ensures that all Californians will have at least two choices, with 92% able to choose from three or more carriers and 85% having four or more options.
How Will the Rate Change Affect Your Premiums?
Even though the average rate is increasing by 7.9%, this doesn’t mean everyone will pay exactly 7.9% more. Your premium might go up, stay the same, or even decrease slightly, depending on:
- The specific plan you choose
- Where you live
- Your income and eligibility for financial help
What Does This Mean for Covered California Enrollees?
- Improved Coverage: The rate increase helps fund better coverage, including eliminating deductibles for many plans and lowering out-of-pocket costs.
- Market Stability: A moderate rate increase supports the stability of the healthcare market, ensuring insurers can cover rising costs and continue offering comprehensive plans.
- More Options: With 12 health carriers providing insurance across the state, 92% of Californians will have three or more carriers to choose from, and 85% will have four or more options.
- Regional Changes: Kaiser Permanente will cover 55% of enrollees in Monterey County as Valley Health Plan exits the region.
When Can You Enroll?
Open Enrollment Period:
- Starts on November 1, 2024, and runs through January 31, 2025. This is the best time to sign up for coverage for the entire 2025 year.
Special Enrollment Period:
- Available for those experiencing qualifying life events, like losing health coverage, getting married, or having a baby. DACA recipients can also enroll starting November 1, 2024, and their coverage can begin as early as December 1, 2024.
How Skyline Benefit Can Help?
At Skyline Benefit, we understand the complexities of navigating health insurance options. We aim to simplify this process, ensuring you find the best coverage at the most affordable rates. Whether you’re exploring options for the first time or reviewing your current plan, our experts are here to provide personalized assistance and support.
Need help applying for 2025 Covered California Open Enrollment?
Skyline Benefit is a certified insurance agency with Covered California. Act now and get the premium subsidy and coverage that you deserve.
Our agents can review your medical needs and budget, and tailor your health insurance options during Covered California Open Enrollment.
Call us now at (714) 888-5112