Make Your First Payment
Your plan starts once you pay your first bill.
- If you didn't pay when you enrolled, be sure to make your first payment to your health insurance company (not Covered California) to start using your plan.
Guide to Using Your Plan
Your health plan opens the door to the care you need. Learn how to make the most of your insurance from day one — getting your ID card, finding a doctor, scheduling care and filling prescriptions.
What’s Included in Your Plan
Every plan includes the same More information available — no matter which one you have. These services are covered from day one:
- Outpatient care (care you get without staying overnight in a hospital)
- Emergency services
- Hospital care, including surgery and overnight stays
- Pregnancy, maternity, and newborn care, before and after birth
- Mental health and substance use treatment, including counseling and therapy
- Prescription drugs
- Rehabilitation care and equipment
- Lab tests
- Preventive care, wellness visits, and chronic condition management
- Pediatric care, including dental and vision for children (adult dental and vision aren't included)
This list is a general overview of what plans cover. Contact your health insurance company to learn more about your health plan benefits. What you pay for these services can vary by plan.
Next Steps: Get Ready to Use Your Plan
After you enroll, here are the first things to do.
Check Your Providers
Make sure your doctors, specialists and pharmacies are in your plan's network.
Seeing an out-of-network provider can mean paying the full cost yourself. Check your plan's directory first.
Get Care
You can get care as soon as your plan starts — no need to wait for your ID card.
Just make sure your first payment is processed. If your plan is canceled for non-payment, you'll owe the full cost of any care you received.
Watch for Mail
You’ll get important information in the mail.
- Covered California will send a welcome letter and brochure.
- Your insurance company will send your ID card and enrollment packet.
When Your Plan Starts
Your plan begins on the first day of the month after you enroll and pay your first monthly premium. For example, if you enroll on Dec. 15, your coverage will start Jan. 1.
If you have a major life change — like having a baby, getting married or losing other insurance — you may qualify for a faster start date, even if you're enrolling during open enrollment. For example, a new baby's coverage can start on their date of birth, rather than on the first day of the next month.
Learn more about major life changes.
Choose Your Doctor
Your doctor (sometimes called a primary care physician, or PCP) is the person you'll usually see for checkups and most health concerns. Your insurer may match you with one after you enroll.
You don't have to keep the doctor you're assigned. You can change at any time by contacting your insurance company.
Get Care When You Need It
When you need care, contact your doctor's office to schedule a visit. This works for routine checkups, ongoing health concerns or follow-up care.
Need a specialist? Some plans require a referral first — check with your insurance company before you book.
For urgent but non-emergency care, many plans offer urgent care or telehealth options.
Check your plan materials or contact your insurance company to find out what's available to you.
Use Your Free Preventive Care
Your plan isn't just for when you're sick. Most plans cover preventive care for free. This includes things like yearly checkups, screenings and vaccines. These visits help you stay healthy and catch problems early.
Note: Keep your visit free by telling your provider you want a preventive or wellness visit. If you talk about a new health concern, the visit may be considered a regular visit instead of a preventive one. If this happens, you may receive a bill for your copay or related charges.
For detailed lists of covered preventive services, see:
In an Emergency
If you think you're having a medical emergency, call 911 or go to the nearest hospital. Your plan covers emergency care.
Afterward, you'll have a copay for the visit. The amount depends on your coverage level.
Fill Your Prescriptions
To fill a prescription, bring it to a pharmacy in your plan's network. Your insurance company can help you find one near you.
At the pharmacy, you may need your member ID card or plan ID number.
What you pay depends on your plan's drug list and the drug's tier. These things can change, so check your coverage before you fill a prescription.
Get Help With Your Plan
Have a question about your plan? Find your insurance company's contact information.
Your Member ID Card
Your insurance company sends your ID card after they get your first payment. Paying early helps you get your card and other plan materials sooner.
If you keep the same plan and insurance company at renewal, you can keep your current card. If you switch plans or insurance companies, you'll get a new card and welcome packet after you pay.
Lost your card? Contact your insurance company for a replacement.
If Your Insurance Changes During Treatment
If your new plan doesn't include your current doctor and you're being treated for a serious health condition, here's what to do:
- Call your new insurance company right away to tell them about your treatment.
- They may be able to work with your current doctor while you finish treatment.
- Tell your current doctor you have new insurance.
- Contact your new insurer if you have questions about continuing your care.
Need help talking to your insurance company? The Health Consumer Alliance offers free local help. Call (888) 804-3536 or visit healthconsumer.org
More Help and Info
More resources for managing and making the most of your Covered California plan.