Consumer Assistance at Covered California

Covered California Service Center

Main Phone Number: 1-800-300-1506

TTY/TDD:1-800-889-4500

Other Phone Numbers:
العربية (Arabic) 1-800-826-6317
Armenian 1-800-996-1009
中文 (Chinese) 1-800-300-1533
فارسی (Farsi) 1-800-921-8879
Tagalog (Filipino) 1-800-983-8816
Hmoob (Hmong) 1-800-771-2156
Khmer 1-800-906-8528
한국어 (Korean) 1-800-738-9116
Lao 1-800-357-7976
ру́сский (Russian) 1-800-778-7695
Español (Spanish) 1-800-300-0213
Tiếng Việt (Vietnamese) 1-800-652-9528 

Hours of operation: Monday-Friday, 8:00 a.m. – 6:00 p.m. (except state holidays)
Extended hours during peak enrollment season (open until 8:00 p.m. Monday-Friday and 8:00 a.m. to 6:00 p.m. on Saturday)

Website: www.coveredca.com

Tips about Covered California enrollment periods

• Open enrollment is the time of year when everyone can apply for a Covered California plan. This usually happens from November to January.
• If you have recently experienced a major life change, you may be able to sign up at other times as a special enrollment. Qualifying events include the loss of health coverage through a job, the birth of a child, and other life-changing events. Learn more
• If you are eligible for Medi-Cal, you can sign up at any time of the year.
• Usually if the ​open enrollment period is closed and you have not experienced a qualifying event, the next time you can sign up for a Covered California plan would be during the next open enrollment period.

Complaint Data Highlights

The highlights below are based on information Covered California reported to CDII about its consumer assistance service center and about its State Fair Hearings in 2021.

• State Fair Hearings conducted by the California Department of Social Services (CDSS) are an avenue for Covered California members and applicants to appeal decisions about eligibility, financial help, and coverage enrollment.
• Covered California determinations about Medi-Cal eligibility also are addressed through this hearing process.

Consumer assistance volume

4,304,260 phone calls and other contacts

Complaint volume

6,321 (including 998 formal State Fair Hearings conducted by CDSS and 5,323 hearing requests resolved informally by Covered California)

Complaint review time

30 days on average overall. 67 days on average for a formal State Fair Hearing. Complaint review times ranged from 0-499 days.

• Most State Fair Hearings must be conducted no later than 90 days from the date the hearing request was filed.
• CDSS refers some hearing requests to Covered California for informal resolution instead of conducting a formal hearing with an Administrative Law Judge. These complaints usually have a faster resolution process than the formal hearing process.
• There is a faster hearing process for certain appeals involving consumers with urgent clinical issues.

Reasons for complaints

1. Denial of Coverage (54% of complaints)
2. Eligibility Determination (42%)
3. Cancellation (4%)

Top results of the complaint review

1. Complaint Withdrawn (84% of complaints)
2. No Action Requested/Required (6%)
3. Compromise Settlement/Resolution (5%)
4. Covered California Position Substantiated (3%)
5. Covered California Position Overturned (2%)

Note: The Complaint Withdrawn result includes complaints where the problem was fixed before a State Fair Hearing took place.