Covered California
Covered California is the state’s official health insurance marketplace, established under the Affordable Care Act (ACA). It allows California residents to compare health insurance plans, review costs and benefits, and select coverage that meets their healthcare needs and budget.
Eligible individuals and families may also qualify for financial assistance that can help reduce monthly premiums and other healthcare costs. Small-business owners can explore employee coverage through Covered California for Small Business. Covered California offers plans from recognized insurance companies at several coverage levels.
Our experienced insurance professionals can help you understand your options, compare available plans, determine whether you may qualify for financial assistance, and complete the enrollment process.
FAQs
Why do I need health insurance?
Health insurance helps protect you and your family from unexpected medical expenses. It can help cover the cost of doctor visits, hospital care, prescription medications, preventive services and other essential care.
Having coverage also makes it easier to receive routine checkups, vaccinations and screenings that can help detect health concerns early. Most importantly, health insurance provides financial protection and peace of mind when medical care is needed.
Is there a penalty for not having health insurance in 2027?
Yes. California residents who do not maintain qualifying health coverage in 2027 may owe a state tax penalty when filing their 2026 tax return in 2027, unless they qualify for an exemption. The amount varies based on income, household size and the number of months without coverage.
What is open enrollment?
Open enrollment is the annual period when individuals and families can enroll in health insurance or change their existing coverage. Covered California’s open enrollment period runs from November 1 through January 31. For 2027 coverage, it begins November 1, 2026. Learn more about enrollment dates
What is special enrollment?
A Special Enrollment Period allows you to enroll in or change health coverage outside open enrollment after a qualifying life event. Most enrollment periods last 60 days, while individuals losing Medi-Cal generally receive 90 days.
Qualifying events may include:
Losing employer-sponsored or other qualifying coverage
Turning 26 and losing coverage through a parent
Moving to California or gaining access to new plans after moving within California
Getting married or entering a domestic partnership
Having, adopting or receiving a child into foster care
Gaining U.S. citizenship or lawful presence
Losing Medi-Cal eligibility
Returning from active-duty military service
Being released from incarceration
For most qualifying events, coverage begins on the first day of the month after plan selection. Different effective-date rules may apply to certain events, including a birth, adoption or foster-care placement. View qualifying life events.
Why there are different premiums for the same coverage plan among different insurance companies?
Premiums vary because each insurance company has different provider networks, negotiated rates and anticipated healthcare costs. Rates may also depend on the enrollee’s age, location, household members and selected plan. A higher premium does not always mean better coverage, so it is important to compare benefits, provider networks, prescription coverage and out-of-pocket costs not just the monthly premium.
What are Medicaid / Medi-Cal?
Medicaid is a public health insurance program for eligible individuals and families. In California, the program is called Medi Cal. It provides free or affordable coverage for services such as doctor visits, hospital care, prescriptions, preventive care, mental health care, dental care and vision care. Eligibility is generally based on income, household size, age and other circumstances. Enrollment is available throughout the year.
How can I change my Medi-Cal plan to a subsidized health insurance?
Do not cancel your Medi Cal coverage solely to qualify for financial assistance. Report changes in your income, household or eligibility to your county social services office. If the county determines that you are no longer eligible for Medi Cal, you may qualify for a 90 day Special Enrollment Period through Covered California. Financial assistance may be available based on current eligibility requirements. Review special enrollment information.
How many financial assistance can you get from Covered California?
The amount varies based on your projected annual household income, household size, ages, location and the cost of available plans. Eligible applicants may receive a tax credit that lowers their monthly premium. Some applicants may also qualify for an Enhanced Silver plan with lower deductibles, copayments and other medical expenses. View the current income guidelines.
What documents are required to apply for financial assistance?
You will generally need the following information for members of your household:
Full names and birth dates
Social Security numbers, when applicable
Citizenship or immigration information for applicants
Current income information, such as recent pay statements or a tax return
Information about any health coverage available through an employer or another program
Covered California may request additional documents if your information cannot be verified electronically. Eligibility depends on California residency and current federal and state requirements. Review acceptable documents.
What are the differences between HMO/PPO/EPO plans?
An HMO generally requires you to choose a primary care doctor and receive referrals before seeing most specialists. Except for emergencies, care usually must be received within the plan network.
A PPO generally offers a larger network and allows you to see specialists without a referral. You may receive care outside the network, but your medical expenses will usually be higher.
An EPO generally allows you to see specialists without a referral, but you must use providers within the plan network except during an emergency. Exact referral and coverage rules vary by plan. Compare plan types
