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Physicians: Please Spread the Word About Covered CA Open Enrollment!

December 2, 2014

Dear CMA Member:

Last year the California Medical Association (CMA) and many of our physician members across the state were part of the biggest expansion of health insurance coverage since Medicare 50 years ago — an expansion effort led by Covered California. California truly did make history — reducing the number of uninsured in our state by 3.4 million and reducing the rate of the uninsured from 22% to 11% (the largest decrease in the nation).

California’s physicians play a vital leadership role in communicating with their patients about healthcare issues. Because of that, CMA and Covered California are reaching out to ask you to help ensure that every one of your patients and their friends and families understand their access to affordable, quality health coverage. While the Affordable Care Act is historic and a huge expansion of coverage, there remain more than 3.2 million uninsured Californians eligible for insurance.

This year, the open-enrollment period will be brief — from Nov. 15 through Feb. 15.

Once again, it’s important news for people who can’t afford coverage today or who have been denied because of a pre-existing medical condition. Please be active in spreading the word. Remind your patients and other folks you know who don’t have healthcare coverage that now is their opportunity to get the security and peace of mind that comes from being insured, whether it is through Covered California, through Medi-Cal or without financial help on the individual market.

Here’s how you can help:

  1. Make all your patients aware that open enrollment for Covered California begins Nov. 15, 2014, and closes Feb. 15, 2015. The PDFs accessible at bottom provide valuable and ready-to-use information you can share with your patients. Included in that material is a simple one-page document that you can share with your staff and patients that describes open enrollment. Another PDF shows which plans are offered in each county. If you have any uncertainty regarding the specific plans or products you are participating in, also enclosed is a current list of plan contacts regarding network status. Call or email the plans directly to confirm your status.
  2. If you have a confirmed contract with a Covered California plan to serve the individual market, consider displaying the enclosed Covered California "I'm In" placard prominently in your office so patients know you are a participating physician or medical group. We know there was far too much confusion last year and want to make sure that physicians, office staff, and patients understand the networks and health plans with which you contract. Again, ensure that you have verified your contracting status for the Covered California plan (see #1 above) if you are at all unclear.
  3. Help us identify any specific patients you have who have been helped already by having coverage through Covered California and receiving care in your practice. We continue to collect these real-world stories, which are the best way to tell the story of coverage and care.

CMA and Covered California share the view that the Affordable Care Act is not just about getting people enrolled for coverage; it’s about making sure patients get the care they need. Enrollment is just the start. The finish line is to ensure that people who enroll get the quality care they need and deserve. We know that the initial launch was rocky in some areas and that some of the health plans need to improve their communication with both patients and physicians. We are committed to working together to make sure provider directories are accurate, networks are adequate, and consumers and those they depend on — the physicians providing their care — get clear and accurate information. While it is far from perfect, we believe that Covered California is succeeding in connecting Californians with coverage, and, with your continued support, we’re looking forward to helping even more Californians in the months and years to come.

Again we want to thank you for all that you have done and ask you to help us continue our success during this important new healthcare era. We know that in many ways this year will be harder. There will continue to be bumps along the way. However, we are committed to dealing with these challenges quickly because we know the difference it can make in the lives of the Californians we are seeking to serve.


Peter V. Lee
Executive Director
Covered California

Dustin Corcoran
Chief Executive Officer
California Medical Association


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