Covered California レビュー 23

Horrendous customer service

The tldr, i had a terrible experience with them, and I think you will too.

First, i applied from abroad, and they said I could only finish over the phone, but then the phone wait was always at least an hour, so I kept getting disconnected. After about 5 days of this, I finally got through.

Second, i was cleared to pay, but the link to blue shield was buggy, and it must have taken me 10 tries over 3 days, and several different browsers before paying successfully.

Then, we were assigned Primary Care doctor's far from us. To change, we had to call and wait forever on bad customer service. Eventually, it came out that we could not use any of the primary care doctors that the CoveredCA website said we could use when we picked our plan.

So, we switched from HMO to PPO. This was 5 days ago. And yet, 5 days later, our plan change is still "being processed" and they told us that our plan needs 7 to 10 business days to be processed so that we can then pay, which takes another 1-2 business days to process, and it took hours of going back and forth (first they said the problem was we hadn't paid, then when I tried to pay they said there needs to be more processing time before we can pay). The last call took 4 hours of going from one agent to the next at CoveredCA and Blue Shield. When an agent doesn't know what to do, they pass you off to someone else and forget about it.

the lady i talked to was helpful in helping me get into my account but pointed out due to my age i will not under stand most things in life . i was actually offened by that comment. just because im 30 doesnt mean i am an ideiot.

Covered California and the health care system are the biggest jokes out there. Dont come to California if you are sick or unwell. They will take all your money and then charge you a premium after. F this crap hole

I ended up in ER at Sutter Hospital vs Kaiser because I passed out and my mom had me sent to her Hospital not mine. There was nothing wrong; I had felt faint and disoriented for takng too much ibuprofin and naproxen for terrible back pain. That’s all I took. They released me after 5 hrs of tests. Between the ambulance and 5 hr treatment in ER my portion that I owed was $7,000. I only gross $53,000/yr. CovCA has very high deductibles and copays for serious situations. I had to pay the full $5000 deductible plus some. You can really get in debt with one ER visit. So be careful, don’t call an ambulance or go to any emergency situation unless you are on deaths door!! CovCA is good for the very poor where you get everything covered. If you make over $20,000 yr you are screwed. It’s a failing national healthcare system. They don’t have the funds to offer decent coverage. CovCA basically covers my flu shot and a checkup once a year. That’s about it. Need to get a loan if you actually need any treatment.

Fix your website

Train customer service to resolve issues and not just send you off to call insurance or social services. If the person qualifies for their old plan and was cancelled or changed to another plan, let them reinstate their old plan ASAP not make them wait 30 days. Notify them days or weeks before the next month bwfore they are being cancelled or changed to MediCAL. Most doctors won't take MediCAL. Shorter hold times. Representatives should not interrupt and not gaslight callers. Not say I am sorry you feel thar way but say I am sorry for the inconvenience and offer solutions. Learn from companies like Amazon and nordstrom who have good customer service. Actually solve the issues not just stall or make the customer wait til next month to have insurance again. Broken system

Received mail for renewal... "log in to see all of your options"... WABAAM! $460/mo, Financial Help discontinued... Are they really trying to help people? Or are they trying to scam your bank account?

Covered California Accused of Failing Consumers: A Firsthand Account of Broken Promises and Mismanagement Under CEO Jessica Altman
Los Angeles, CA – September 4, 2025 – Covered California, the state’s official health insurance marketplace, is under fire from frustrated consumers who say the program has strayed from its mission of providing consistent, affordable health coverage. One consumer has stepped forward to share their personal experience, accusing CEO Jessica Altman and her leadership team of fostering a system that hurts the very families it claims to protect.
A Personal Story of Harm
“I signed up with hope, thinking Covered California would give me and my family peace of mind. Instead, I was met with endless cancellations, inconsistent coverage, and insurance tied unfairly to income fluctuations. At a time when I needed stability most, they left me stranded,” said the consumer.
According to this firsthand account, Covered California’s model of basing eligibility and pricing on income has left families vulnerable. Small changes in reported earnings can result in sudden policy cancellations or unaffordable premium hikes — creating fear, instability, and in some cases, loss of access to critical medical care.
Allegations of Mismanagement
The consumer also alleges that leadership has failed to create a reliable, transparent system:
Families dropped from coverage without warning.
Constant confusion about eligibility and plan continuity.
Inconsistent communication and lack of accountability.
“This isn’t just about me. Millions of Californians are trapped in this broken system. Covered California is supposed to be a lifeline, but instead, it’s become a source of stress and instability. People deserve better,” the consumer added.
Call to Action
This release calls for an immediate investigation into Covered California’s operations and leadership practices under CEO Jessica Altman. Consumers want reform that guarantees stable, transparent, and consistent coverage without punishing working families for minor income shifts.
About the Consumer Statement
This release is based on a personal experience and reflects the perspective of an individual consumer impacted by Covered California. It highlights systemic problems many Californians have voiced and aims to spark public awareness and accountability.

A few years ago, Covered CA was somewhat decent. You'd report your income and get insurance right away (the next month).

Now, Covered CA uses a prorated system. If you can't apply before the 15th of each month, insurance won't start for 4-6 weeks.

Example: you get laid off on the 1st of the month. You apply for EDD/unemployment. The first benefit certification takes a couple weeks to come in (mail/online). You get paid on the 14th. By the time your Covered CA app is reviewed by a case worker, it's too late. Now you're waiting almost 2 months for insurance. If you have chronic/extreme health conditions, you're sore-out-of-luck.

Phone customer service reps... All over the place. Some answer your questions and get what you need. Others say "well [benefit option] can't be done;" and try hanging up quick as possible.

Insurance costs... Unaffordable.
Example: You make $35k salary. For basic Bronze options: $75-100 monthly premiums. For Silver plans: $200-400. For Gold: $300-700. Not as much as COBRA, but still unsustainable.

Overall, I hope to never need Covered CA again. Despite big state funding, Covered CA is becoming more restrictive.

DO NOT USE COVERED CALIFORNIA. Just found out today, covered california terminated my health insurance coverage over a month ago without any notification or explanation. When i called and inquired, they state they cannot send emails due to HIPAA regulations - that is an absolute lie. Not only am I a healthcare provider and am well aware of HIPAA regulations, but if the insurance company can send me emails about claims, covered california can send emails about my coverage. So now I have to pay thousands of dollars in unexpected bills from services i received without knowing my health insurance was cancelled. And apparently i can not get health insurance until open enrollment.

They did two accounts in my name, now I am confused on what amount to pay. They keep on charging me more, when I complained to the insurance company that I didn't know that they increased me, the insurance company told me to call Covered CA for my concerns, which I did. They told me they will help me, and they will follow up but they didn't. When I called my Insurance company and asked if the issue was resolved, it's not. I am still charged the highest amount. I told them why they are not coordinating with each other, Covered CA and the Insurance company. They are giving the burden of solving the problem to the patients. I'm so frustrated with their service. I will not recommend this to anyone.

Besides the rude and uneducated customer service representatives that answer the calls. I’m writing this as a frustrated parent and consumer. Covered California determined that both my husband and I qualify for financial assistance through their marketplace plans—but not our two-year-old daughter. Why? Because our household is under the income threshold, the system automatically forces her onto Medi-Cal, even though her primary doctor doesn’t accept Medi-Cal.

Our only options are:
1. Leave her on Medi-Cal, which she can’t even use at her current pediatrician.
2. Pay full price out-of-pocket for a private plan for her, with no tax credits or subsidies—completely separate from our family plan, despite the fact she’s only two years old.

This is outrageous. We’re being penalized for qualifying for financial help. We should not have to split up our coverage or pay full price for our toddler’s insurance just to keep her with the doctor who’s already been seeing her. This policy is broken. It makes absolutely no sense for a system built on the idea of affordable care.

If you are a family trying to do the right thing, stay insured, and keep continuity of care for your young children—be warned. This is not family-friendly, and there are no real options for parents in our situation.

Covered California, fix this. Families shouldn’t be put in this position.

Can we give this a zero Stars this is literally the worst HealthCare coverage ever I wasn't even notified that I was being transferred over to cover California from Medi-Cal I wish I would have stayed on medical but I'm not able to since I make over a threshold that doesn't exist because I don't ever see my gross income, they changed me to two different Healthcare coverages and didn't even tell me then I got charged for services that I wasn't supposed to be charged for and now we don't even cover Chiropractic services even though my doctor says I have been getting stages of arthritis in my neck first they send me a bill for a family plan then the following month after they send me three separate bills when the bills is saying that I owe $459 when the month before I paid $45 for three people how does it change from $45 to $459 in one month nothing has changed it has to be services rendered this is just crazy president Trump needs to clean this program up it makes absolutely no sense because lunatic Obama put it together and his half-witted staff customer service isn't even help when you call them and the people that are completely rude I told him I was going to file a grievance customer service supposedly transferred me but actually hang up on me then when I called the same exact phone number back push the same exact extension number new guy gets on the phone and tells me that he is the grievance Department what kind of crazy coverage is this and how is this allowed to even be an option this thing should be shut down.

You get a price break (sort of, see below) but man do they make you pay for it in blood sweat and lots of tears.
EVERY. SINGLE, YEAR for the first 3 months of the year they mess it all up, in large and small and every way.
EVERY SINGLE YEAR I log in when i get the 1000 emails and texts that say I HAVE TO SELECT A PLAN NOW OR ELSE!!! I do, I go in and select the SAME plan and tell them my income hasn't changed and I upload my tax returns and what do they do....(spoiler alert - everything but that).
CC tells me Im all set and all good and covered! and then they secretly send me to Medical. I find out by getting a letter in the mail.
BUT CC still charges my Credit Card for the CC plan Im supposed to be on!! (And its hell to get that money back).
Then I call them and they say, you have to call medical. Then I call medical and they say, why did CC send you over here??? And then they send me back to CC which takes SIX WEEKS for CC to look at the paper work! ONLY THEN...(and this whole time I do not have medical coverage but am still being charged for it!)...I can then pick a plan (the same plan I told them I wanted two months back by phone and messaging) and then they say, you're all set, its all good. Then I go the doctor and find out I have no medical coverage.
I call Blue Shield and they say that its so confusing as I now have two Blue Shield plans and I was paying on the one but not on the other and they have no idea which one CC wants me to have! So I call CC and they say that I have two plans now bizarrely. They cancel the one on and then I pay on the new one, via the CC site, but that never works or goes through. So then I have to call Blue Shield and pay anew through them on the phone.
Then I have to wait for CC to figure out that I do have coverage.
OH! And in the process I see that they did the same thing for my husband so he also doesn't have any coverage now for months while I was paying (while he was painting the house up on a ladder). Ive spent HOURS and hours listening to that damn repeat tune on hold. It's not a song, it's sounds that just repeat.
Then CC admits me, 'we see that you were denied CC from Jan 1-March, and were mistakenly charged but we cant refund you without a letter from Medical'. so now I have to call medical... to get them to write a letter to CC stating what CC already knows! to file a claim to be (maybe) paid back.

Its THE crappiest system but what can you do?? (move to costa rica?)

Government and corporate greed combined: Lovely. Such a total mess between CC, ins companies and government. I'm sure it'll only get better now with a president wanting to take the subsidy and all health insurance away who golfs with insurance companies CEOs. (wink wink)

In short. Its hell for the first three months of every single year, no matter how many times I call and message with CC and they tell me its all set. No matter what you do, they will send you to medical for no reason what so ever. They don't even know why. No change in my income. The CS people just seem resigned to it. They try but admit it's a tangled ball of yarn.

AND you pay less monthly (still a ton) but then when you file taxes you have to pay it back as its treated as income. So you get taxed on the subsidy amount. I'm not sure you really save much money actually, after all that hell.

Not a good system at all.

This is crap! They are a pain to work with. They claimed I qualified for Medical when I didn't and told me they will not help me. Then I found out they were helping me when I filed for taxes. The money they "helped" with was taken out of my federal return!
Now, because I didn't know I had to let them know a month before I needed my premium cancelled, I will have to pay for another month. To get help with this I had to file a complaint and may have to wait 60 days. Meanwhile, I will still have a bill which can affect my credit score. Do not bother with coveredca if you can!

Covered California website sucks all it does is say you do not exist

I have had this insurance for 6 years now. Since I work, I pay higher premiums that take a sizable chunk of my income.
My co pays are 45.00 for my primary dr. If I need to see a specialist, it's 95.00. I recently went to the dermatologist, had 3 moles removed. Two days later I received a bill for 776.00. Thinking this was before my insurance paid, I called and was told that this was my share of cost! I have the silver plan which is an hmo . Now I don't go to the doctor unless I really have something going on.

Covered California doesn't see what is real and me to say this because they will think they know better. When they say we don't need to change and nothing won't change "AT ALL" they will keep it the way we have our insurance and won't be "NO PROBLEM". Now there's a problem because if we change our insurance and the doctors don't take Medi-Cal we will be having a problem! Look, I have cancer and the doctors I see won't take Medi-Cal and I don't like to repeat all my history. Because l would say look at the report. And walk out "NO ONE " doesn't have to repeat it. So "NO" Covered California isn't great they will get rude or hang up on you if you don't go their way. "KEEP MY INSURANCE THE WAY I HAVE IT" It's very upsetting to get letters almost every day saying all this B.S. Also, stop adding someone to my household they keep doing that every time they are rude and bully if you don't go their way. If someone asks who they are they are bullies stay away...

Talk about a waste of tax dollars. I spent 2hrs on hold. I called the number they gave me, only to need to be forwarded to a different team. Then I spent an hour as "next in queue" only for the office to close. I don't know who manages these call centers, but we need to shut them down and start over.

Below is a list of my discoveries while insured under CoveredCA.
-Website is more vague than helpful. I found this out the hard way during tax time.
-The plans are horrible. High premiums, Low coverage.
-If you don't report any changes to your salary during the first 6 months you obtain insurance, they will drop your coverage; and it may effect your taxes for the following year.
-If you get a salary increase, the premium triples. Even if you are the sole income earner in your family.
-If you make too much (ie $1 over poverty level), you won't get the credit.
-Calling in to get any support is a joke. Don't bother.