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People With Chronic Conditions

When you have an ongoing health condition, cost matters — but it's not the only thing to weigh. You also need a plan that covers your care without a break. This page can help you compare your options. It also explains what to do if your care is disrupted when you switch plans.

What to Check Before You Choose a Plan

When you have ongoing health needs, comparing plans can mean looking beyond the monthly .

Before you choose a plan, check to see if your:

  • Doctors and hospitals are in the plan's network
  • Medications are on the plan's drug list (called a formulary)
  • Pharmacy of choice works with the plan
  • Scheduled treatments, tests, therapy or other care will continue with your new plan

It also helps to look beyond your monthly payment. Plans with lower monthly premiums often have higher and , which can add up quickly if you use care often. You can compare plan levels to see how our plans differ in cost and coverage.

Find a Plan That Covers Your Care

See which plans cover your doctors, hospitals and medications, and what they may cost based on your household size and income.

Shop and Compare

Changing Plans While Getting Treatment

Some people being treated for a serious condition can temporarily continue care with their doctor, hospital or other provider after switching plans or changing networks. This is called continuity of care. It's not automatic, and your doctor or hospital must agree to the arrangement.

Not all conditions or situations qualify for continuity of care. Contact your new health insurance company about your situation and how to request it. You should also tell your current doctor that you have new health insurance. Continuity of care decisions are made between you, your health insurance company, and your doctor or hospital. Covered California is not involved in these decisions.

Denied or Delayed Requests

If your continuity of care request is denied or delayed, you can file a formal grievance (also known as a complaint or appeal) with your health insurance company. Ask them how to start that process.

For free, confidential and local help with the grievance process, contact the Health Consumer Alliance at (888) 804-3536. They can help you work with your health insurance company and, if necessary, with health insurance regulators. They can also help you dispute denials of health services, prevent disruption in care and resolve billing problems.

You can also contact the California Department of Managed Health Care's Help Center at (888) 466-2219 if:

  • You need medications or care urgently and your health insurance company is not responding.
  • Your grievance is not solved to your satisfaction.

Support for People Living With HIV or AIDS

Help Paying for HIV Prescription Drugs and Premiums

The AIDS Drug Assistance Program (ADAP) within the California Department of Public Health helps eligible people who are uninsured or underinsured access HIV prescription drugs. For ADAP eligibility information, visit the Office of AIDS ADAP Eligibility webpage or call (844) 421-7050.

If you're already enrolled in ADAP, you may also get help with:

Additional Services and Resources

People living with HIV or AIDS may be eligible for additional services funded through the Ryan White Program, including case management, nutritional support, transportation and free legal services. Contact the California Department of Public Health's Office of AIDS at (916) 449-5900 for more information.

More Information and Support

These pages can help you compare plans, understand costs and get help with your health insurance.

  • Compare Plan Levels

    Learn how Bronze, Silver, Gold and Platinum plans differ in monthly cost and what you pay when you get care.

  • Use Your Plan After You Enroll

    Learn how to use your health insurance plan, find care and understand next steps after enrollment.