California Health Insurance Guide

From its iconic beaches and national parks to vibrant cities and rich cultural heritage, California remains a desirable place to live, and understanding your health insurance options here is key to protecting your health and finances.
As of 2025, the uninsured rate in California reflects steady enrollment and ongoing efforts to improve access. If you’re currently without coverage, here’s what you need to know about getting insured in California.

Health Insurance Options in California

California offers a range of health insurance options tailored to residents’ needs, depending on age, income, employment, and family size. Here are the most common coverage types available:

Employer-Sponsored Insurance

Many California residents receive health insurance through their employer. If your workplace offers coverage, this is usually the most convenient and streamlined option.

ACA Marketplace Plans 

The Affordable Care Act (ACA) allows individuals and families to buy health insurance through federal or state Marketplaces. These plans offer essential health benefits, free preventive care, and protection for preexisting conditions.

If you don’t have employer coverage, you may qualify for subsidies to lower your premiums. Use our ACA Subsidy Calculator to check your eligibility.

Starting this year, the Centers for Medicare & Medicaid Services (CMS) is requiring income verification to confirm eligibility for premium subsidies. As part of this effort, CMS will reduce the ACA subsidies by $5 per month for individuals who are automatically re-enrolled in fully subsidized plans without verified eligibility.

ACA Plan Types

ACA marketplace plans are available in four tiers: Bronze, Silver, Gold, and Platinum, each with distinct costs and coverage levels. Plans also vary by provider networks and out-of-pocket expenses, so compare carefully to find what fits your needs.

Marketplace Plans:

• Bronze: Low monthly premiums, higher out-of-pocket costs; ideal for minimal healthcare usage.
• Silver: Moderate costs; eligible for cost-sharing reductions (CSRs).
• Gold: Higher monthly premiums with lower out-of-pocket costs; best for frequent healthcare users.
• Platinum (if available): Highest premiums, lowest out-of-pocket costs.

Metal Tier Breakdown:

Medicaid

California’s Medicaid program, Medi-Cal, provides free or low-cost health coverage for eligible low-income residents. Medi-Cal covers services such as preventive care, hospital stays, mental health, maternity, and prescriptions.

Short-Term Plans

California prohibits the sale of health insurance plans that do not meet Affordable Care Act standards. As a result, short-term health plans are not available in the state. Residents seeking temporary coverage should explore ACA marketplace plans, Medi-Cal, or COBRA.

Children’s Health Insurance Program (CHIP)

Children in California who qualify for low-cost insurance are typically covered under Medi-Cal, which absorbed the state’s previous CHIP program. It serves children and pregnant women in families that earn too much to qualify for standard Medi-Cal but still need affordable coverage.

Student Health Insurance

College students in any state have multiple health insurance options, including staying on a parent’s plan until age 26, enrolling in a school-sponsored plan, or applying for coverage through the ACA Marketplace. Depending on your income and location, you may also qualify for Medicaid, CHIP, or low-cost catastrophic or short-term plans, making California student health insurance accessible and flexible for a wide range of needs.

Medicare

Medicare plans are available for residents aged 65+ and younger individuals with qualifying disabilities. Options include:

• Medicare Advantage (Part C)
  • Medicare Advantage is an alternative to Original Medicare offered by private insurers to those enrolled in Parts A and B. These plans often include extra benefits and cost protections but typically require using a specific network of providers.
• Prescription Drug Plans (Part D)
  • Medicare Part D provides prescription drug coverage for anyone with Medicare, helping pay for medications and many vaccines. Offered by private insurers, these plans vary in cost and coverage and can be joined during specific enrollment periods.
• Medicare Supplement (Medigap)
  • Medicare Supplement plans, or Medigap policies, help cover the out-of-pocket costs that Medicare Part A and Part B don’t pay. Since Original Medicare (Parts A and B) lacks an out-of-pocket maximum, these plans can limit your expenses for medical services.

COBRA Coverage

If you’ve lost employer-sponsored coverage, COBRA allows you to temporarily continue your plan — typically at full cost. It’s a bridge option while transitioning to other coverage.

Enrollment Periods in California

Open Enrollment for 2026 Coverage:

November 1, 2025 – January 31, 2026
California offers an extended open enrollment window compared to most states.

Special Enrollment Period:

You can enroll year-round if you experience a qualifying life event (QLE), including:

• Job loss
• Marriage or divorce
• Birth/adoption
• Relocation
• Income changes

You typically have 60 days from the event to apply for a new plan.

Health Insurance Providers in California

As of 2025, individual and family plans on the Covered California marketplace are typically offered by:

• Anthem Blue Cross
• Blue Shield of California
• Health Net
• Kaiser Permanente
• L.A. Care
• Molina Healthcare
• Oscar Health
• Valley Health Plan
• Western Health Advantage

Plan availability may vary by county or zip code. Some carriers may also offer standardized plans or participate in California’s public option initiatives.

Understanding Health Insurance Costs

Understanding these key terms can help you choose the right plan:

• Premium: Monthly payment to maintain your plan
• Deductible: Amount paid out-of-pocket before insurance starts covering services
• Copayment (Copay): Fixed fee per medical visit or prescription
• Coinsurance: Percentage you share with the insurer after meeting your deductible
• Out-of-Pocket Maximum: The most you’ll pay per year for covered services
• In-Network vs. Out-of-Network: Using providers in your plan’s network helps reduce costs

Bottom Line

Health insurance in California comes with many choices—whether from your employer, through the ACA marketplace, or public programs like Medicaid and Medicare. By staying informed and comparing plans during the right enrollment periods, you can secure affordable, reliable coverage that supports your well-being and budget.

Need help choosing a plan? Use our ACA Subsidy Calculator to see if you are eligible for ACA plan financial aid or speak with a licensed insurance agent about all your options.