Individual and Family
Who Qualifies for Covered California Health Insurance?
Published on November 30, 2018
Residents in most states use HealthCare.gov to apply for Obamacare health insurance. California is one of the few states that maintains its own state health insurance marketplace for Affordable Care Act (ACA)-compliant health plans. At CoveredCA.com, Californians can choose individual, family, or business health insurance policies that comply with the ACA. Covered California also provides a portal for Medi-Cal and qualified dental and vision coverage.
Who qualifies for Covered California health insurance?
To qualify for Obamacare or Covered California plans, California residents must:
- Live in the U.S.
- Be a legal U.S. citizen or legal resident
- Not be incarcerated
Who qualifies for help with Covered California premiums?
Several types of financial assistance that may dramatically reduce your health insurance costs are available with Covered California/ACA health insurance:
- Premium assistance: Premium assistance in the form of income credits can be applied immediately to reduce your health insurance premiums.
- Cost-sharing reductions: Purchasers with modest family incomes may qualify for reductions in deductibles for specific plans.
- Medi-Cal: Your application process may alternatively qualify you or your family members for Medi-Cal, California’s Medicaid program.
Qualifying for financial assistance is determined primarily by how your family’s modified adjusted gross income, or MAGI, compares to guidelines presented in the Federal Poverty Level Chart. For example, you may qualify for a premium subsidy if your income is between one and four times the federal poverty level for a similar-sized household. In addition to income, the purchaser’s age, household size and zip code are used to determine premium costs and subsidies. Covered California also has special rules for children, the disabled, and pregnant women. To learn more about ACA subsidies, click here.
When and where to apply for Covered California health insurance
California will accept applications for 2019 from October 15, 2018 to January 15, 2019 through CoveredCA.com, eHealth.com, or any other broker or insurer in the state. The state’s open enrollment period is longer than the federal open enrollment period available to citizens in most other states. Medi-Cal applications are accepted at any time.
You may also apply for ACA plans at any time if you experience certain life events that will qualify you for a Special Enrollment Period. These qualifying life events include:
Loss of health coverage
- Losing existing health coverage, including job-based, individual, and student plans
- Losing eligibility for Medicare, Medicaid, or CHIP
- Turning 26 and losing coverage through a parent’s plan
Changes in household
- Getting married or divorced
- Having a baby or adopting a child
- Death in the family
Changes in residence
- Moving to a different ZIP code or county
- A student moving to or from the place they attend school
- A seasonal worker moving to or from the place they both live and work
- Moving to or from a shelter or other transitional housing
Other qualifying events
- Changes in your income that affect the coverage you qualify for
- Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
- Becoming a U.S. citizen
- Leaving incarceration (jail or prison)
- AmeriCorps members starting or ending their service
You can browse previous articles on Covered California Open Enrollment to learn more about the open enrollment period.
At eHealth, we can help with Covered California
eHealth offers the same plans and prices available at Covered California. We can help you apply for tax credits online and show you affordable alternatives that aren’t available through the official Covered California website. We also have a prescription drug tool that can help you identify a plan that offers the best prices for your medications. Additionally, our licensed agents are available to answer any questions you may have. Get started with our simple health insurance comparison and application tool today.