Information on Cost-Sharing and Payments With Respect To Out-of-Network Coverage

You can find information about Out-of-Network costs for each Qualified Health Plan (QHP) offered on the Exchange on the Covered California website, via the PREVIEW PLANS functionality. You can access this functionality by scrolling to the bottom of the homepage, to the site footer, and clicking Preview Plans. This will allow you to view the “Summary of Benefits and Coverage” for each Plan, for each QHP.

Click on the following link to visit the PREVIEW PLANS page directly. (The documentation below will show you how to display the Out-Of-Network costs for each plan.)


DIRECTIONS to arrive at the Relevant Summary of Benefits and Coverage document

Having arrived on the page, enter the required customer information, and then click “See My Results”

You will be taken to the MY OPTIONS page
Click the yellow “Preview Plans” button at the bottom of the page.

The selection page, shown below, will display.
Go to the bottom right corner, and click “Choose a Plan”

You will see all of the QHPs available to you on the Exchange. Pick one that you’re interested in, and click on the QHP Issuer’s logo to see detailed information about the product from that QHP Issuer.

The Plan Details page will display. Click on the Download summary of benefits and coverage link (just under the Monthly Premium box) to find the Out-of-Network costs.

When you click the link the Summary of Benefits and Coverage document for that particular plan will display.

Place the cursor on the first page, right click, and select the Find option. Enter out of network to get complete information on out of network costs for that plan.