Different Plans for Different Family Members on Covered California

The short answer

Yes. People on one Covered California application can enroll in different plans, for example Gold for one spouse, Bronze for the other and Silver for the children. On Cover Health CA you choose a plan for each person and see your household's monthly premium, estimated financial help and estimated cost before you apply. Each plan has its own bill, deductible and out-of-pocket maximum, and Covered California decides how your financial help is split between the plans.

How it works

Covered California calls the people who share a plan an enrollment group. A household on one application can have more than one group, each with its own plan, as long as each group follows the rules below.

On Covered California's own website you make the groups after you send your application and get your eligibility results. On Cover Health CA you do it on the plan list, before you apply: you see each plan's price and your household's total first, and your choices go to Covered California with your application.

Who can share a plan

• One plan can cover you, your spouse or domestic partner, and your children under 26.
• A child 26 or older gets a plan of their own: a parent's plan covers children only until 26.
• A parent or another relative on your application gets a plan of their own.

The apply site tells you when two people can't share a plan, before you choose.

What changes when you split

• Each plan sends its own bill.
• Each plan has its own deductible and out-of-pocket maximum. If people on different plans need care in the same year, you may pay toward more than one deductible.
• Each plan charges for up to 3 children under 21, so splitting children can cost more.
• Your financial help is an estimate. Covered California decides the final amount and how it is shared between your plans.

When different plans make sense

• One person needs a doctor or hospital that only one network has.
• One person takes costly medicines.
• One person uses a lot of care and the others very little.
• You want to pay less for the people who rarely see a doctor.

If your income qualifies you for Enhanced Silver, its lower deductibles and copays come only with Silver plans. Someone you move to Bronze or Gold gives them up.

See it before you apply

On Cover Health CA you put each person on a plan right on the plan list, and you see each plan's price and your household's total before you apply, not after the paperwork.