Patient-Centered Benefit Design

Covered California is leading the way for consumers by using a patient-centered benefit design. What this means is consumers can shop across our different health insurance companies knowing that the benefits are the same, depending on metal tier, no matter which company they choose.

Consumers get an apples-to-apples comparison about copays, deductibles and other out-of-pocket costs so there are no surprises when they use their plan. The consumer can choose their coverage level based on the metal tier system and can then compare the costs and star ratings of the plans within that metal tier in their area.

For a detailed look at the patient-centered benefit design, please refer to our 2024 Patient-Centered Benefit Design or 2025 Patient-Centered Benefit Design. This chart gives you information about plan costs of care, including copays, deductibles, and out-of-pocket maximum costs.