California Health Insurance

California Health Insurance Plans 

The Golden State offers various options for health insurance to fit your budget and health needs. You can qualify for financial help with Marketplace plans or coverage through low-income programs. 

• State Marketplace Plans: Essential health benefits/coverage differs by metal levels
  • Catastrophic Plans: Lower-cost emergency coverage available for those under the age of 30
• Medicaid: State/Federal healthcare program for those with lower income or certain disabilities
• Medicare: Federal healthcare program for those age 65 and older and those with certain disabilities

Explore these different types of major medical health insurance plans in California based on your health needs, budget, as well income, and age eligibility. 

California ACA Marketplace

California offers affordable health insurance for individuals and families through Covered California, the state Marketplace.

NOTE: If you’re self-employed with no employees, you qualify as an individual. 

• Plans are available in four metal levels: bronze, silver, gold, and platinum.
  • Each metal plan covers a percentage of your healthcare costs, from 60% (bronze) to 90% (platinum), with bronze being the least expensive and platinum the most expensive.
  • Catastrophic plans are also available for individuals under the age of 30.
• All plans provide comprehensive coverage, including essential health benefits such as hospitalization, maternity care, prescription drugs, and preventive services.

Open enrollment is from [November 1 to January 31] each year for independent individual and family health insurance plans regulated by the Affordable Care Act (ACA). 

Subsidies For ACA Plans 

Obamacare (ACA) subsidies are financial aid to help pay for your monthly premiums based on your income and household size, not your employment status. So you can still qualify for savings on an Obamacare plan even if you’re unemployed or in between jobs. You can report your expected income from unemployment benefits when applying for coverage.

• Subsidies are available if the benchmark plan costs more than 8.5% of your income, with no cap on income level. 
• Our ACA subsidy calculator helps you determine your eligibility for healthcare subsidies based on your income, household size, and location. The tool also accounts for special cases like unemployment benefits.”

Catastrophic Health Insurance for Financial Hardship

Catastrophic health insurance is typically for those under 30, but if you’re over 30 and facing financial hardship (e.g., eviction, high medical debt, or bankruptcy), you can qualify for a hardship exemption to purchase a catastrophic plan.

While not as comprehensive as standard Obamacare plans, catastrophic plans include all ACA essential health benefits. 

Plans for Students in California

• College Health Insurance: Enrolling in your school’s health plan is one of the best ways to get low-cost health insurance. Most plans qualify as coverage under the Affordable Care Act (Obamacare), meaning they offer the essential health benefits required.
• Parent’s Health Plan: Under the ACA, you can usually stay on your parent’s health plan until age 26. You can enroll even if you don’t live with your parents, they don’t claim you as a dependent, or you leave school. Coverage typically ends on your 26th birthday.
• California Obamacare Insurance for Students: You can purchase your own Obamacare plan through Covered California. Keep in mind that you must enroll during the Open Enrollment Period unless you qualify for a Special Enrollment Period.

If You Qualify for Low-Income Coverage

California has expanded Medicaid through its Medi-Cal program, providing no or low-cost health benefits to eligible families and individuals based on income. See if you qualify. 

Children who were previously covered under California’s Children’s Health Insurance Program (CHIP) were transitioned to Medi-Cal in 2013. Low- and middle-income parents who cannot afford health insurance for their children can apply through Medi-Cal. 

Medicare

There are several Medicare options available. The default is Original Medicare, which includes Part A (hospital) and Part B (medical) insurance, which are managed by the federal government. 

Many enrollees add plans sold by private insurance companies, such as Medicare Part D (prescription coverage) or Medicare Supplement insurance. These plans fill in gaps of coverage that Part A and B don’t cover. Residents can also opt for a Medicare Advantage plan, an alternative to Original Medicare that can include additional benefits. 

Short-Term Medical Plans

This state prohibits the sale of health plans that don’t provide comprehensive coverage or essential health benefits, including short-term health plans that don’t qualify under the Affordable Care Act (ACA).

Next Steps

Whether you’re applying for health insurance in California for yourself or a family of four, make sure to review all your options. Examine what makes sense for your needs and budget.

Resources

• Health Insurance Marketplace (CoveredCA)
  • Click here to apply for coverage, compare plans, and enroll. For questions, call 1-800-318-2596 (TTY: 1-855-889-4325).
• State Assistance
  • Click here to find a local navigator or certified application counselor to help you get health benefits coverage.
• Understanding Health Insurance
  • Click here for resources to understand health insurance and the marketplace better.

Article Sources

1. Covered California. “Covered California.” Covered California. 7 June 2024, https://www.coveredca.com.
2. California Department of Health Care Services. “Medi-Cal.” California Department of Health Care Services. 7 June 2024, https://www.dhcs.ca.gov/services/medi-cal/Pages/default.aspx.
3. Healthcare Insider. “California Student Health Insurance.” Healthcare Insider. 7 June 2024, https://healthcareinsider.com/california-student-health-insurance-29281.
4. Healthcare.com. “Medicare Basics.” Healthcare.com. 7 June 2024, https://www.healthcare.com/medicare-basics-181670.
5. California Department of Insurance. “Overview of Health Insurance.” California Department of Insurance. 7 June 2024, https://www.insurance.ca.gov/01-consumers/110-health/10-basics/overview.cfm.