The easiest way to lose your health insurance subsidy or have the health plan cancelled is to not respond to verification requests from Covered California. You have a 95-day Reasonable Opportunity Period to provide documents requested by Covered California. If Covered California does not receive documents or proof, you are eligible, they must turn off the subsidy or cancel the health plan.
How to keep your Covered California subsidy or health plan
Once your application for health insurance is approved by Covered California, the clock starts ticking on the Reasonable Opportunity Period (ROP) of 95-days to submit any proof or verification requests from Covered California. If they do request verification for conditional elements such as income, immigration, or minimum essential coverage, they will send you a letter.
95-day Reasonable Opportunity Period
You can also check your Covered California account for verification requests. The names of household members who have pending requests or actions needed will have a red dot by their names. Clicking on View actions needed & alerts will display all the requests of Covered California. Each action has a due date corresponding to the ROP. Due dates may change if you update your application.
When Covered California cannot verify certain elements of your application, they call it an inconsistency. You must correct or prove that the information on the application is not inconsistent with your current household situation. You have 95 days, the ROP, to provide the verification or proof pertaining to the inconsistencies.
Lack of proof or verification for some inconsistencies will result in the health insurance subsidy being taken away. Requests for additional information regarding income, minimum essential coverage, American Indian or Alaskan Native membership, and Social Security number must be submitted or the individual will lose the subsidy.
If Covered California does not receive proof of citizenship, lawful presence, incarceration status, or life, they must terminate enrollment into the selected health plan.
Verification Requests
Within the letter requesting additional verification for the inconsistencies, Covered California the types of documentation that satisfy the requests.
You can use the income attestation form to verify your income. It is found on the upload documents page.
It can be difficult to prove you do not have minimum essential coverage (MEC) from other coverage. You may have had an employer plan or Medi-Cal that Covered California is picking up on. You can upload a letter where you attest that you or your child has not been offered any other health plan such as employer sponsored, VA, Medi-Cal, or Medicare. Be sure to include the case number on the letter.
Covered California does have a specific form for Medicare. If you are requested to prove you are not enrolled in Medicare, you can fill out the form and upload it to your account.
Most of the time, when we put in the identification numbers associated with certificates of naturalization, visas, and greencards, the Covered California system properly matches them in the federal database. Sometimes it does not work. This is when you need to upload a clear PDF image of the document to your account.
Uploading Covered California documents
To get to the page to upload the verification documents, go to your account, scroll down to eligibility results, click on the link. Each household will be displayed. Click on upload documents and the system will open a new page that shows all of the items that Covered California.
When uploading income verification, make sure you select all the people the verification applies to. You only need one income attestation for all household members with a dollar amount that mirrors the income on the application.
