www.coveredca.com
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https://www.coveredca.com/?utm_source=SFMC&utm_medium=email&utm_campaign=C1-SEP-AF-2022&utm_content=&sfmc_id=30009372&utm_...
Submission: On March 24 via api from US — Scanned from DE
Submission: On March 24 via api from US — Scanned from DE
Form analysis 5 forms found in the DOM
/site-search.html
<form class="form-inline my-2 my-lg-0 py-3 px-3 d-lg-none nav-site-search-form" action="/site-search.html">
<div class="position-relative w-100">
<div class="row">
<div class="col-12">
<div class="input-group d-flex align-items-start w-100">
<input type="hidden" class="d-none" name="index" value="1">
<input class="form-control nav-site-search-form__input nav-site-search-form__input--mobile" placeholder="Search" aria-label="Search" name="query" type="text">
<button class="btn border-left-0 border-radius-0 border-raidus-top-right-1 border-raidus-bottom-right-1 px-2 p-0 d-flex align-items-center border-gray-light" style="height: 40px;right: -1px" type="submit">
<i class="material-icons text-primary">search</i>
</button>
</div>
</div>
<div class="col-12 nav-site-search-form__invalid-feedback nav-site-search-form__invalid-feedback--red d-none" id="nav-site-search-input-invalid-feedback">
</div>
</div>
</div>
</form>/site-search.html
<form action="/site-search.html" class="flex-grow-1 nav-site-search-form" id="site-search-form-nav">
<div class="form-group mb-0">
<div class="row">
<div class="col-10 col-md-11">
<div class="input-group">
<div class="input-group-prepend">
<button type="submit" class="form-control btn btn-white btn-primary-on-hover h-100 d-flex align-items-center border border-right-0" style="left: -1px">
<i class="material-icons color-primary">search</i>
</button>
</div>
<label for="site-search-input-nav" class="sr-only" style="top:1000px;">Search</label>
<input type="text" class="form-control nav-site-search-form__input nav-site-search-form__input--desktop" style="border-top-right-radius: 50rem; border-bottom-right-radius: 50rem;" id="site-search-input-nav" name="query"
placeholder="Search CoveredCA.com">
<input type="hidden" class="d-none" id="site-search-index-nav" name="index" value="1">
</div>
</div>
<div class="col-2 col-md-1">
<div class="d-flex h-100 align-items-center">
<button class="bg-transparent border-0 p-0 search-active-toggle" type="button" style="height: 24px;"><i class="w-24px color-white material-icons">close</i></button>
</div>
</div>
<div class="col-12 nav-site-search-form__invalid-feedback nav-site-search-form__invalid-feedback--white d-none" id="nav-site-search-input-invalid-feedback">
</div>
</div>
</div>
</form><form id="calculator-form" class="subsidy-calculator__form py-3 px-3 px-md-0" autocomplete="off">
<!-- Calculator API Error Message -->
<div id="subsidy-calculator__calculate-error-message" class="row mr-0 d-none">
<div class="col">
<div class="alert alert-danger text-center"> We are experiencing technical difficulties. Please try again later. </div>
</div>
</div>
<!-- Household Income, Zip and County -->
<div class="row mr-0 align-items-end">
<!-- Household Income -->
<div class="col-md-4 py-3">
<div id="household-income-component-01">
<div class="household-income-component">
<!-- HouseholdIncome Label -->
<div class="mb-2">
<label class="household-income-component__label font-weight-bold d-inline m-0" for="subsidy-calculator__household-income"> Household Income </label>
<span id="calculator-tooltip--household-income" data-toggle="tooltip" title="" class="font-18px text-primary cursor-pointer d-inline material-icons-outlined subsidy-calculator__tooltip-trigger" tabindex="0"
data-template="<div class="tooltip subsidy-calculator__tooltip" role="tooltip"><div class="arrow"></div><div class="tooltip-inner"></div></div>"
data-original-title="Household income refers to the estimated combined income of all family members for the year you plan to have coverage."> info </span>
</div>
<!-- HouseholdIncome Input -->
<div class="d-flex">
<input id="subsidy-calculator__household-income" class="household-income-component__input subsidy-calculator__input subsidy-calculator__input-income order-2" placeholder="28,000" type="text">
<div class="input-group-prepend order-1">
<span class="subsidy-calculator__dollar-sign">$</span>
</div>
</div>
<!-- HouseholdIncome Invalid Feedback -->
<div id="subsidy-calculator__household-income-invalid-feedback" class="household-income-component__invalid-feedback invalid-feedback"> Please enter a number </div>
</div>
</div>
</div>
<!-- ZIP -->
<div class="col-6 col-md-4 py-3">
<div id="zip-component-01">
<!-- ZIP Code Component -->
<div class="zip-code-component">
<!-- Label -->
<label class="font-weight-bold zip-code-component__label" for="subsidy-calculator__zip-code">ZIP Code</label> <br>
<!-- Input Group -->
<div class="d-flex">
<!-- Input -->
<input id="subsidy-calculator__zip-code" class="zip-code-component__input subsidy-calculator__input" placeholder="95834" type="text">
<!-- Location Button -->
<div class="input-group-append">
<span class="input-group-text icon-styles subsidy-calculator__form-control">
<button class="subsidy-calculator__flat-button gtm-calculator-geolocation zip-code-component__location-button" type="button">
<span class="sr-only">location</span>
<svg class="subsidy-calculator__icon-primary" focusable="false" viewBox="0 0 24 24" aria-hidden="true">
<path
d="M12 8c-2.21 0-4 1.79-4 4s1.79 4 4 4 4-1.79 4-4-1.79-4-4-4zm8.94 3c-.46-4.17-3.77-7.48-7.94-7.94V1h-2v2.06C6.83 3.52 3.52 6.83 3.06 11H1v2h2.06c.46 4.17 3.77 7.48 7.94 7.94V23h2v-2.06c4.17-.46 7.48-3.77 7.94-7.94H23v-2h-2.06zM12 19c-3.87 0-7-3.13-7-7s3.13-7 7-7 7 3.13 7 7-3.13 7-7 7z">
</path>
</svg>
</button>
</span>
</div>
</div>
<!-- Invalid Feedback -->
<div class="zip-code-component__invalid-feedback invalid-feedback"> Please enter a valid ZIP code </div>
</div>
</div>
</div>
<!-- County -->
<div class="col-6 col-md-4 py-3">
<div id="county-01" class="d-none">
<div class="county-component">
<label class="county-component__label font-weight-bold" for="subsidy-calculator__county">County</label> <br>
<select id="subsidy-calculator__county" class="county-component__input subsidy-calculator__select">
<option value="Sacramento">Sacramento</option>
</select>
</div>
</div>
</div>
</div>
<!-- Household Size, How many need coverage, coverage year-->
<div class="row mr-0 align-items-end">
<div id="household-size" class="col-6 col-md-4 py-3">
<div class="household-size-component subsidy-calculator__household-size">
<div class="mb-2">
<label class="household-size-component__label font-weight-bold d-inline m-0" for="subsidy-calculator__household-size"> Household Size </label>
<span id="calculator-tooltip--household-size" data-toggle="tooltip" data-placement="right" title="" class="font-18px text-primary cursor-pointer material-icons-outlined subsidy-calculator__tooltip-trigger" tabindex="0"
data-template="<div class="tooltip subsidy-calculator__tooltip" role="tooltip"><div class="arrow"></div><div class="tooltip-inner"></div></div>"
data-original-title="Include only the tax filer and any spouse or dependents (even if they aren’t applying for insurance)."> info </span>
</div>
<select id="subsidy-calculator__household-size" class="subsidy-calculator__select household-size-component__input">
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
</select>
<div role="alert">
<div id="subsidy-calculator__household-size-invalid-feedback" class="invalid-feedback household-size-component__invalid-feedback"> Household size must be the same or more than how many need coverage. </div>
</div>
</div>
</div>
<div id="need-coverage" class="col-6 col-md-4 py-3">
<div class="need-coverage-component">
<label class="need-coverage-component__label font-weight-bold" for="subsidy-calculator__need-coverage">How many need coverage?</label> <br>
<select id="subsidy-calculator__need-coverage" class="need-coverage-component__input subsidy-calculator__select">
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
</select>
<div role="alert">
<div id="subsidy-calculator__need-coverage-invalid-feedback" class="need-coverage-component__invalid-feedback invalid-feedback"> Cannot be more than the household size </div>
</div>
</div>
</div>
<div id="coverage-year" class="col-12 col-md-4 py-3" style="display: none;">
<div class="coverage-year-component">
<div class="mb-2">
<label class="coverage-year-component__label font-weight-bold d-inline m-0" for="subsidy-calculator__coverage-year"> When do you want to start coverage? </label>
</div>
<select disabled="" id="subsidy-calculator__coverage-year" class="coverage-year-component__input subsidy-calculator__select">
<option value="2022">Next year (2022)</option>
<option value="2021">This year (2021)</option>
</select>
<div class="coverage-year-component__invalid-feedback invalid-feedback" role="alert"> Please enter a coverage year </div>
</div>
<script>
const now = new Date();
if (now.getFullYear() > 2021) document.getElementById('coverage-year').style.display = 'none';
</script>
</div>
</div>
<!-- Age of members needing coverage -->
<div class="row">
<div id="ages" class="col-12">
<div class="ages-component pt-4">
<div class="mb-2">
<span class="ages-component__label d-inline-block font-weight-bold pr-2"> Age of People Needing Coverage <span id="calculator-tooltip--member-ages" data-toggle="tooltip" data-placement="right" title=""
class="font-18px text-primary cursor-pointer material-icons-outlined subsidy-calculator__tooltip-trigger" tabindex="0"
data-template="<div class="tooltip subsidy-calculator__tooltip" role="tooltip"><div class="arrow"></div><div class="tooltip-inner"></div></div>"
data-original-title="If under one year old, enter "1". Enter the age you and your household members will be on Jan. 1, 2022."> info </span>
</span>
<span id="member-age-label" class="d-none">Age of People Needing Coverage</span>
</div>
<!-- Household Member Ages Input Container -->
<div id="household-members" class="ages-component__ages-container d-flex flex-wrap m-0 w-100">
<div class="household-member-age mr-2"><label for="dynamic-age-input-1" class="font-weight-bold sr-only"><br> Age of People Needing Coverage<br> <br> info<br> <br> </label><input type="number" id="dynamic-age-input-1"
class="subsidy-calculator__household-member-age subsidy-calculator__input ages-component__age-input mr-2" placeholder="45"></div>
</div>
<div role="alert">
<div id="household-members-invalid-feedback" class="ages-component__invalid-feedback invalid-feedback"> Please enter a valid age for each person. </div>
</div>
</div>
</div>
</div>
<!-- UIB -->
<div class="row mr-0 align-items-end pt-4">
<div id="received-unemployment-benefits" class="col-md-8">
<div class="uib-component d-none">
<div class="font-weight-bold mb-2"> Received unemployment benefits in 2021? <span id="calculator-tooltip--uib" data-toggle="tooltip" data-placement="right" title=""
class="font-18px text-primary cursor-pointer ml-2 material-icons-outlined subsidy-calculator__tooltip-trigger" tabindex="0"
data-template="<div class="tooltip subsidy-calculator__tooltip" role="tooltip"><div class="arrow"></div><div class="tooltip-inner"></div></div>"
data-original-title="If yes, your household likely qualifies for Silver 94 plans with lower deductibles, copays, and coinsurance — all for as low as $1 per person."> info </span>
</div>
<div class="d-inline-block pr-5 radio-container">
<label for="yes-unemployment">Yes <input class="uib-component__yes-radio" type="radio" id="yes-unemployment" name="unemployment-benefits" value="yes">
<span class="custom-radio"></span>
</label><br>
</div>
<div class="d-inline-block radio-container">
<label for="no-unemployment">No <input class="uib-component__no-radio" type="radio" id="no-unemployment" name="unemployment-benefits" value="no" checked="">
<span class="custom-radio"></span>
</label><br>
</div>
<div id="received-unemployment-benefits--info" class="subsidy-calculator__uib-info d-none">
</div>
</div>
</div>
</div>
<!-- Calculate Button -->
<div class="row mr-0 mt-auto pt-4">
<div class="col-12 d-md-flex justify-content-md-end pr-md-5 py-3">
<div id="calculate">
<a href="#results-container" id="calculate-desktop" class="subsidy-calculator__calculate-button btn btn-primary px-0 px-lg-5 d-none d-sm-block gtm-calculator-calculate disabled">Calculate</a>
<a href="#results-container" id="calculate-mobile" class="subsidy-calculator__calculate-btn-mobile btn btn-primary px-5 d-block d-sm-none w-75 mx-auto gtm-calculator-calculate disabled">Calculate</a>
</div>
</div>
</div>
</form><form class="sign-up__form subscription w-100" id="footer-subscribe">
<input type="hidden" name="StateSubsidy" value="true">
<input type="hidden" name="Source" value="footer">
<div class="row mx-0">
<div class="col-12">
<div class="form-group w-90 mx-auto">
<label class="text-dark m-0 pl-3" for="Name">First Name</label>
<input type="text" id="Name" name="Name" class="form-control form-control-sm border border-dark rounded-pill" placeholder="e.g. John">
</div>
</div>
<div class="col-6 ml-2">
<div class="form-group w-90 mx-auto">
<label class="text-dark m-0 pl-3" for="Zip">ZIP Code</label>
<input type="text" id="Zip" name="ZipCode" class="form-control form-control-sm border border-dark rounded-pill" placeholder="12345">
</div>
</div>
<div class="col-12">
<div class="form-group w-90 mx-auto mb-0">
<label class="text-dark m-0 pl-3" for="EmailAddress">Email*</label>
<input type="email" id="EmailAddress" name="EmailAddress" class="form-control form-control-sm border border-dark rounded-pill" placeholder="youremail@example.com" required="">
</div>
</div>
<div class="col-12">
<div class="w-90 mx-auto">
<span class="font-size-12px pl-3">* required</span>
</div>
</div>
<div class="col">
<button type="submit" id="gtm-sign-up" class="sign-up__submit-button--footer btn btn-sm btn-primary d-block mx-auto mt-2 mt-lg-0 px-5">Subscribe</button>
</div>
</div>
</form><form class="sign-up__form subscription" id="pop-up-subscribe">
<input type="hidden" name="StateSubsidy" value="true">
<input type="hidden" name="Source" value="Pop-up">
<div class="form-group">
<label class="text-primary" for="fNamePopUp">Enter First Name</label>
<input id="fNamePopUp" name="fNamePopUp" class="form-control border-primary">
</div>
<div class="form-group">
<label class="text-primary" for="ZipCode">Enter ZIP Code</label>
<input name="ZipCode" id="ZipCode" class="form-control border-primary">
</div>
<div class="form-group">
<label class="text-primary" for="eAddressPopUp">Enter Email Address (Required)</label>
<input type="email" id="eAddressPopUp" name="eAddressPopUp" class="form-control border-primary" required="">
</div>
<a class="text-center d-inline-block mb-4" href="/privacy">Privacy Policy</a>
<div class="loading text-center mb-3"><img src="//www.coveredca.com/images/loading.gif" alt="Loading..."></div>
<div class="col-8 offset-2">
<button id="signUp" type="submit" class="sign-up__submit-button btn btn-action w-100 gtm-lead-popup-subscribe" disabled="">Subscribe</button>
</div>
</form>Text Content
Skip Navigation menu CC Vert REVERSE Logo Created with Sketch. * Shop and Compare SHOP Logos/CC/Horiz/color Created with Sketch. close search * Get Started chevron_right * Health add Covered California Plans Bronze Silver Gold Platinum Medi-Cal Individuals and Families Children Pregnancy Not sure which plan you qualify for? Shop and Compare * Dental add Dental Coverage Children’s Dental Family Dental * Vision add Vision Coverage Adult Vision Children’s Vision * Support add Support Center Contact Us How-To Videos (800) 300-1506 * (800) 300-1506 phone * Shop and Compare shopping_cart * Apply for Coverage * Sign In search * Sign In * Shop and Compare SHOP search Search close Edit Banner HEALTH INSURANCE WHEN YOU NEED IT. Open enrollment is over, but you can still apply through special enrollment. We are experiencing technical difficulties. Please try again later. Household Income info $ Please enter a number ZIP Code location Please enter a valid ZIP code County Sacramento Household Size info 1 2 3 4 5 6 7 8 Household size must be the same or more than how many need coverage. How many need coverage? 1 2 3 4 5 6 7 8 Cannot be more than the household size When do you want to start coverage? Next year (2022) This year (2021) Please enter a coverage year Age of People Needing Coverage info Age of People Needing Coverage Age of People Needing Coverage info Please enter a valid age for each person. Received unemployment benefits in 2021? info Yes No Calculate Calculate Your Estimate $63 per month for a Silver plan. Bronze as low as $0. You may qualify for: Covered California. * You save $507 per month. * Brand-name plans. This isn’t an application for health coverage. QUICK QUOTE YOU MAY QUALIFY FOR done $63 per month Medi-Cal for a Silver plan. Bronze plans as low as $0. After financial help from: You may qualify for: You may qualify for: Covered California both Covered California and no-cost or low-cost coverage through Medi-Cal. no-cost or low-cost coverage check_circle Financial Help: $507 per month check_circle Bronze, Gold and Platinum plans also available check_circle Coverage for children, adults and families check_circle Free or affordable pregnancy coverage check_circle Because of your income, you may be able to sign up now, even if you don't have another qualifying life event. Continue This isn’t an application for health coverage. info Total Subsidy: $506.80 Members going to cca: 1 Members going to medical: 0 Fed Fairshare: $62.90 FPL%: 217.39130434782606 Percentage of income: 0.0 SLS Benchmark cost: 569.70 SLS Rate: 394.53 Household Rating Factor: 1.44 Edit Calculator Start Over expand_less Loading... Loading... Loading... Our calculator will be back soon, but you can still learn more about how Covered California works. Get Started keyboard_arrow_left keyboard_arrow_right OUR COVERAGE OPTIONS Health, dental and vision care — all in one place. edit Adult Vision Adults can enroll directly into a choice of two different providers. Learn More arrow_forward edit Covered California Children’s Vision Children under 19 get free vision care with a Covered California health plan. Learn More arrow_forward edit Covered California for Small Business Health and dental options for small businesses with 1 to 100 employees. Learn More arrow_forward edit Covered California Bronze Premiums LOWEST Out-of-Pocket HIGHEST Lower monthly premium if you qualify for financial help. Learn More arrow_forward edit More Savings Covered California Silver Premiums LOWER Out-of-Pocket MODERATE Lower monthly premiums if you qualify for financial help, and lower deductibles and copays for eligible people. Learn More arrow_forward edit No Deductibles Covered California Gold Premiums HIGHER Out-of-Pocket LOWER Lower monthly premium if you qualify for financial help. Learn More arrow_forward edit No Deductibles Covered California Platinum Premiums HIGHEST Out-of-Pocket LOWEST Lower monthly premium if you qualify for financial help. Learn More arrow_forward edit Medi-Cal for Individuals and Families Depending on your income, you can get free or low-cost health care. Learn More arrow_forward edit Medi-Cal for Children Children under age 19 can get Medi-Cal, even if their parents don't qualify. Learn More arrow_forward edit Medi-Cal for Pregnancy Free or affordable programs to start pregnancy coverage right away. Learn More arrow_forward edit Covered California Family Dental Adults or families can add dental coverage to their health plan purchase. Learn More arrow_forward edit Covered California Children’s Dental Children get free dental care with a Covered California health plan. Learn More arrow_forward edit Adult Vision Adults can enroll directly into a choice of two different providers. Learn More arrow_forward edit Covered California Children’s Vision Children under 19 get free vision care with a Covered California health plan. Learn More arrow_forward edit Covered California for Small Business Health and dental options for small businesses with 1 to 100 employees. Learn More arrow_forward edit Covered California Bronze Premiums LOWEST Out-of-Pocket HIGHEST Lower monthly premium if you qualify for financial help. Learn More arrow_forward edit More Savings Covered California Silver Premiums LOWER Out-of-Pocket MODERATE Lower monthly premiums if you qualify for financial help, and lower deductibles and copays for eligible people. Learn More arrow_forward edit No Deductibles Covered California Gold Premiums HIGHER Out-of-Pocket LOWER Lower monthly premium if you qualify for financial help. Learn More arrow_forward keyboard_arrow_left keyboard_arrow_right How to Get Covered Edit Feature Explore Discover the programs and benefits available to you. Edit Feature Join See if you qualify for special enrollment. Select the plan that's right for you. Edit Feature All set! Start using your free preventive care. edit Explore Plans HOW CAN WE HELP YOU? When will my coverage start? Affected by Wildfires Transition to Another Program Report a Change to My Account Documents to Confirm Eligibility Tax Information Forgot My Username or Password Penalty for Being Uninsured American Rescue Plan Information edit View All Support Topics DATES AND DEADLINES TODAY'S EVENTS library_add edit Apply for Coverage Enroll in coverage right now through special enrollment. Medi-Cal enrollment is year-round, and open enrollment resumes in the fall. keyboard_arrow_right edit Access Your Form 1095-A Sign in to your account to get this form. You'll need it when you file your 2021 taxes. keyboard_arrow_right COMING SOON see all library_add edit March 31 Deadline for Coverage Starting April 1 Sign up through special enrollment by March 31 for a health plan that starts the following month. READY TO CARE FOR YOUR HEALTH? Shop and Compare or Apply Edit Panel NEW AND NEED ENROLLMENT HELP NOW? GET A CALL BACK IN 15 MINUTES OR LESS. Have a licensed insurance agent call you to discuss your options. It's free and confidential. Get a Call Back Edit Panel HEALTH PLANS FOR SMALL BUSINESSES SEE HOW WE CAN HELP YOURS. Learn More Support arrow_drop_down 2 New savings are here! Wanna learn more? clear NEVER MISS A DEADLINE. Sign up for email updates to get deadline reminders and other important information First Name ZIP Code Email* * required Subscribe SUBSCRIPTION COMPLETE! × Now that you are signed up for updates from Covered California, we will send you tips and reminders to help with your health coverage. Privacy Policy Close GET NOTIFICATIONS × Sign up for email updates to get deadline reminders and other important information. Enter First Name Enter ZIP Code Enter Email Address (Required) Privacy Policy Subscribe CONTACT US (800) 300-1506 OTHER LANGUAGES KEYBOARD_ARROW_UP Language Arabic العربية (800) 826-6317 Cantonese 粵語 (800) 339-8938 Mandarin 普通话 (800) 300-1533 Hmong Hmoob (800) 771-2156 Korean 한국어 (800) 738-9116 Russian русский (800) 778-7695 Filipino Tagalog (800) 983-8816 Armenian հայերեն (800) 996-1009 Farsi فارسی (800) 921-8879 Khmer Khmer (800) 906-8528 Lao Lao (800) 357-7976 Spanish Español (800) 300-0213 Vietnamese Tiếng Việt (800) 652-9528 SERVICE CENTER HOURS Monday to Friday: 8 a.m. - 6 p.m. Saturday and Sunday: Closed NEW CUSTOMERS Get a call back from a licensed agent. arrow_forward SHOP * Shop and Compare * Apply MY ACCOUNT * Sign In * Create an Account Covered California for Small Business Enrollment Partners and Agents Newsroom Careers Register to Vote LEARN * Learning Center * Support * Health * Dental * Vision * Members * What is Covered California? * American Indians and Alaska Natives * Health Care Blog FOLLOW US * Accessibility and Nondiscrimination * Terms of Use * Privacy Policy * Protecting Our Consumers * Español * العربية * 中文 * hmoob * 한국어 * ру́сский * Tagalog * հայերեն * فارسی * Khmer * Lao * Tiếng Việt CoveredCA.com is sponsored by Covered California and the Department of Health Care Services, which work together to support health insurance shoppers to get the coverage and care that’s right for them. Copyright © 2022 Covered California 3.4.0 keyboard_arrow_up TOP