FAQs

1. How to Qualify for Covered California Health Insurance

Covered California is California’s health insurance marketplace, designed to help residents find affordable health plans. You may qualify based on income, household size, and legal residency status.

To qualify, you must:

Live in California
Be a U.S. citizen, national, or lawfully present immigrant
Not be eligible for Medicare or Medi-Cal (though some can qualify for dual coverage)

Tip: Many households qualify for subsidies to lower monthly premiums. Reach out to a certified agent (like us!) to find out what programs you’re eligible for.

2. How to Report Life Changes to Covered California

Did you move, lose your job, or have a baby? You must report major life changes to Covered California within 30 days — or risk losing benefits or facing incorrect charges.

Common changes to report:

New address or household move
Change in income or job status
Birth, adoption, or loss of a dependent
Marriage or divorce
Gaining other insurance coverage

We can help: Don’t wait on hold! Let Peace & Grace Insurance update your account quickly and correctly.

3. Understanding Your Covered California Health Plan

Your Covered California plan includes essential health benefits — but do you know what they are?

All plans cover:

Preventive care (checkups, screenings, vaccines)
Emergency services and hospital stays
Prescription drugs
Mental health and substance use services
Pediatric care, maternity, lab work, and more

Need help understanding your copays, deductibles, or network? We’ll explain your plan in plain English.

4. Key Health Insurance Terms Everyone Should Know

Navigating Covered California is easier when you know the basics. Here are 5 terms every member should understand:

Premium: What you pay monthly to stay enrolled
Deductible: What you pay before insurance starts covering more expensive services
Copay: A flat fee for services (like $40 for a doctor visit)
Coinsurance: Your share of a bill (e.g., 20%) after you meet your deductible
Out-of-Pocket Max: The most you’ll pay in a year before insurance covers 100%

Still confused? Let’s walk through your plan together.

5. Covered California vs. Direct-to-Carrier Plans: What’s the Difference?

You can apply for health coverage through Covered California or directly through carriers like Anthem, Blue Shield, or Kaiser. What’s the difference?

Covered CA offers:

Premium tax credits based on your income
Medi-Cal eligibility screening
A single platform to compare plans
Certified agent support at no extra cost

Direct enrollment offers:

Same plans, but without subsidy options
May be useful for those over-income or undocumented

Let us help you choose the best route based on your household and budget.

6. Is There a Penalty for Not Having Health Insurance in California?

Yes — in California, there is still a state-mandated penalty if you go without health insurance.

If you don’t have coverage for more than 3 months and don’t qualify for an exemption, the penalty when filing your state taxes can be $900 or more per adult (and $450 per child).

Exceptions may apply if:

You had a short gap in coverage
Your income was too low
You experienced hardship (like eviction or illness)

Tip: Even a low-cost Covered California plan can save you from paying a much larger penalty. Let us help you avoid it.

7. Why Do Some People Have to Pay Covered California Subsidies Back at Tax Time?

When you enroll in a Covered California plan, you may receive premium subsidies (also called Advanced Premium Tax Credits) based on your estimated income.

If your actual income turns out higher than what you reported, the IRS may require you to repay some or all of those credits when you file your federal taxes.

Common reasons people owe:

Getting a raise or second job mid-year
Going from part-time to full-time work
Not reporting income changes within 30 days

How to avoid it:
Keep your income updated throughout the year, and work with a certified agent who can guide you through adjustments in real time.

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Dental & Vision HMO link https://www.deltadentalins.com/shopping/delta/get-a-quote?issuerCode=DELTA&brokerId=191949

PPO link https://enrollment.ncd.com/589037

VISION link https://enrollment.ncd.com/589037

1. Why You Shouldn’t Wait to Buy Dental Insurance

Most people wait until a tooth hurts to buy dental insurance — but by then, it’s often too late.

Here’s why:

Many plans have waiting periods (up to 12–24 months) for major procedures like root canals, crowns, and implants
Some only cover a small percentage in the first year
Emergencies cost more without coverage

Plan ahead: Enroll when you don’t need dental care so it’s there when you do.

View PPO Dental Plans
View HMO Dental Plans

2. What Does Vision Insurance Really Cover?

Vision insurance helps reduce the cost of routine eye care and eyewear. Most plans cover:

Annual eye exams
Prescription glasses and lenses
Contact lenses
Discounts on LASIK or specialty services

Even if your vision is good now, having insurance can help with preventive care and reduce out-of-pocket costs for glasses or contacts.

Explore Vision Plans

3. PPO vs. HMO: Which Dental Plan Is Right for You?

Choosing between a PPO and an HMO dental plan? Here’s a quick guide:

FeaturePPOHMO

Choose dentist	Yes, any licensed dentist	Must use in-network dentists only
Referrals	Not needed	Usually required
Premiums	Higher	Lower
Waiting Period	Often applies for major services	Usually less or none