An Exclusive to The San Bernardino American News- Connecting Communities to Coverage  with   Dr.  Monica  Soni, Chief  Medical  Officer  of  Covered California

LAGRANT COMMUNICATIONS

Making Confident Health Coverage Decisions for the Year Ahead

Choosing a health plan can feel overwhelming, especially for individuals making important decisions about their coverage for the first time or reassessing their needs for the upcoming year. Covered California provides tools, financial assistance, and trusted guidance to help individuals and families review their options and select coverage that aligns with their needs. Connecting Communities to Coverage highlights how consumers can use the Shop & Compare Tool, learn about the different plan options and free support, and take steps to ensure they have the right coverage in place for the year ahead.

Q&A with Dr. Monica Soni

1. Why is it so important for individuals to review their health coverage options each year?

People’s health needs, budgets, and life circumstances can change. Reviewing coverage annually helps ensure individuals are enrolled in a plan that still fits their needs. Coverage is more than protection during emergencies — it’s routine visits that support better health year-round with access to free preventive care, including annual checkups and screenings, mental health and substance abuse services, and free children’s dental insurance.

2. How does the Shop & Compare Tool help people make more informed decisions?

The Shop & Compare Tool allows individuals to review their options in just four steps. By entering four key pieces of information — coverage year, ZIP code, household income, and household size and ages — consumers can view estimated monthly costs, compare benefits across plans, check whether they qualify for financial help, and understand how different plan tiers affect costs. It helps consumers get a clear picture of their choices before making a decision.

3. What should consumers understand about Bronze, Silver, Gold, and Platinum plans?

All plans cover the same essential health benefits, but they differ in how costs are shared. Bronze plans offer the lowest monthly premiums with higher out-of-pocket costs when receiving care. Silver plans provide additional savings for eligible consumers through cost-sharing reductions. The state of California is also offering extra help.  Individuals with annual incomes under $25,800 and families of four with incomes under $53,000 can get a Silver plan for $0, but the financial assistance is only available through Covered California.  Gold and Platinum plans have higher monthly premiums but much lower costs when receiving care — often a better fit for those who see the doctor more regularly or manage ongoing conditions. Understanding these differences helps consumers choose the plan that best matches their health needs and budget.

4. Provide an example of costs for a couple living in the Inland Empire?

A 60-year-old couple earning around $43,000 could get a Bronze plan for $372 or a Silver plan for $2,568 for 2026. It is important to know your options and not worry about the estimated $1,800 penalty the California Franchise Tax Board would charge for not having insurance.

5. What is the most important message for people making decisions right now?

This year is like no other, as conversations about Enhanced Premium Tax Credits have underscored how important it is for consumers to understand the savings available to them and review their options with the latest information.  Coverage is important because research indicates that people without health insurance have more serious health outcomes and are likely to be hospitalized for avoidable health issues.

Don’t wait. Reviewing your options now ensures you have the coverage you need going into the new year. Individuals must enroll by December 31 to have coverage starting January 1 with continuous and uninterrupted access to care. 

6. How can Californians learn more or enroll?

Californians can explore their coverage options and enroll in several ways. Individuals can complete an application online at CoveredCA.com, by phone at (800) 300-1506, or in-person with free help from one of more than 14,000 insurance agents or certified community enrollers who are available statewide to answer questions, explain plan options, and help individuals choose coverage that meets their needs.

Dr. Monica Soni, MD, is the Chief Medical Officer for Covered California, where she leads efforts in health equity, quality transformation, and clinical innovation. As a board-certified internal medicine physician and health care leader with over a decade of experience, Dr. Soni is committed to improving affordability, access, and health outcomes for all Californians.