How Do I Know If I’m Eligible for Covered California?
Covered California is a valuable resource for Californians who don’t have access to health insurance through their employers. If you’re thinking about signing up, you should understand basic eligibility rules about who qualifies for Covered California. Along with the eligibility requirements for getting health insurance in California, there are also specific rules for who can get certain tax credits and subsidies.
Exploring all of these Covered California requirements with Freeway Insurance can help you determine if Covered CA is right for you. We don’t charge you for helping.
Understanding Covered California
If you’re exploring health insurance options, you’ve probably heard about Covered CA. But what exactly is this health insurance program?
What Is Covered California?
Covered California is the Golden State’s health insurance marketplace program. It offers multiple types of health policies based on the Affordable Care Act rules and requirements. All ACA plans provide coverage for certain essential health benefits, such as emergency services, prescriptions, mental health treatment, and preventive services.
Why It Matters for California Residents
If you don’t have coverage through an employer, you’ll need to explore other options. The Covered CA marketplace was designed to provide you with quality, affordable care, even if you don’t have an employer-sponsored plan or if you have pre-existing conditions that disqualify you from other private policies.
General Covered California Eligibility Requirements
If you’re wondering, “Am I eligible for Covered California?” the answer depends on a few key requirements. The state’s marketplace was designed to be available to most California residents who don’t have other options for insurance. Here are the main eligibility restrictions you should know.
Access to Employer Plans
Covered California is only available to people who don’t have other options for health insurance, such as self-employed individuals and people whose employers don’t offer health benefits. If your employer offers company-sponsored health coverage, you won’t be able to apply for an ACA plan.
Citizenship and Residency Status
You also need to be a lawful resident of California. That includes:
- U.S. citizens
- Permanent residents
- Temporary residents
- Refugees
- People with protected status
- People on worker or student visas
It’s important to note that DACA recipients no longer qualify for Covered California as of August 2025.
Age Requirements
Covered California plans are required to offer dependent coverage up to age 26. If your parents have ACA coverage, that means they can keep you on their family plan. If you aren’t on a parent’s or guardian’s plan, you can sign up for your own individual ACA policy once you turn 18.
Household Income Guidelines
Your income doesn’t impact your eligibility for ACA plans. However, it can affect your eligibility for tax credits and subsidies. Tax credits that decrease your monthly premium are only available based on Covered California income limits. If you make between 100% and 400% of the federal poverty level, you may qualify for a credit. Assistance is also based on a sliding scale, so you’ll get more of a tax credit if you have a lower income.
Special Situations That Affect Eligibility
There are a few unique situations that can impact your Covered CA health plan. Here’s a basic breakdown:
Pregnant Individuals and Families
Growing your family through birth or adoption is considered a qualifying event for the ACA. That means that you’ll be able to switch to a family plan and get coverage for your new child, even if they arrive outside of standard open enrollment.
Self-Employed or Gig Workers
Covered California is a particularly popular option for self-employed individuals and gig workers. This is because you typically won’t have the option for employer-sponsored coverage as an independent contractor. The ACA marketplace allows you to apply for a new plan or change your plan within 60 days of the baby’s birth or adoption. Outside of that period, you may need to wait until the next enrollment period. It’s important to note that these limits only apply to ACA policies, and you can apply for Medi-Cal, which is California’s version of Medicaid, at any time.
Students and Young Adults
If you’re a student, you may be able to get coverage through multiple avenues. As a young adult under 26, you still qualify to be on your parent’s or guardian’s health plan. You might also have health insurance options through your college. However, Covered California gives you the option to waive your school-provided coverage and sign up for an ACA plan instead. Finally, if you don’t have a policy from your parents or your college, you can sign up for a marketplace policy as an individual once you turn 18.
Recent Job Loss or Income Changes
Losing your job typically means losing your health policy. If you lose coverage, you can qualify for a special enrollment period to sign up for a marketplace plan. If you’re already on an ACA policy, changes to your income could impact how much you pay for coverage. For example, a decrease in income could increase your eligibility for health premium tax credits.
How To Calculate Your Eligibility
The best way to determine your California health insurance eligibility is by simply applying for a plan through the Covered California marketplace. Remember, if you’re a lawful California resident who doesn’t have access to an employer plan, you’re probably eligible. However, you might want to know whether you qualify for premium tax credits before you get started.
Using the Covered California Shop and Compare Tool
The Covered California website has a helpful tool to help you determine if you qualify for a tax credit or subsidy, and if so, how much you can expect to pay for various plans. All you have to do is input your zip code, your total household income, and some additional details about which members of your household need coverage. Then, you can select options for how much you expect to use your health policy.
The tool will let you know about potential savings. However, this is just a tool you can use as a guideline, and you won’t know specific numbers until you submit your Covered California application during open enrollment.
Understanding Federal Poverty Levels (FPL)
The government determines whether you qualify for a health insurance tax credit by looking at your household income in comparison to the federal poverty level. For 2026, the federal poverty level is $15,650 for one person, and you can make up to 400% of that amount to qualify for a tax credit. That means the income cap for a tax credit is $62,600 for an individual. That number varies depending on how many people are in your household.
What To Do If You’re Not Eligible
If you don’t qualify for a Covered California plan, that doesn’t mean you can’t get quality health insurance. There are other options available.
Alternative Health Coverage Options
If you don’t have coverage through an employer but also don’t qualify for the marketplace, you can explore coverage from private brokers. These plans are usually based on your health history. If you’re generally healthy, these private policies can be a good option.
Medi-Cal or Other State Programs
Medi-Cal is another popular option. You don’t have to be a lawful resident to sign up for Medi-Cal coverage. It’s available to most people from 19 to 64. If you exceed the age requirements, you could be eligible for the state’s Medicare program.
See If You Qualify for Covered California Health Coverage Now
Getting the right health coverage in California is essential for protecting your finances and your well-being. Covered California’s widespread eligibility makes it easy for most California residents to get covered. By learning about common restrictions and limits ahead of time, you can navigate the open enrollment process with ease.
Here at Freeway, we know that health insurance can be confusing. Our knowledgeable agents will guide you through the entire enrollment process, helping you understand exactly what credits and subsidies apply to your situation. And we don’t charge you for the service! Just call us at 877-423-1508.
FAQs About Covered California
Get answers to common questions about how ACA plans work in the Golden State by reviewing these FAQs:
Can Undocumented Immigrants Apply for Covered California?
Undocumented immigrants aren’t eligible for coverage through the California ACA health plans. Although DACA recipients could previously get Covered CA health insurance, their eligibility ended in August 2025. However, immigrants aged 26 to 49 can apply for Medi-Cal. Even if you’re undocumented, you can qualify for Medi-Cal as long as you meet its income restrictions.
How Is Household Income Calculated for Eligibility?
Your eligibility is based on your estimated household income for the year you’re receiving coverage. You calculate your official income based on your adjusted gross income (AGI) when you do your taxes. To come up with an estimate, look at your household AGI from the previous tax year, then add or subtract based on any upcoming changes in your income.
Can Students Qualify for Covered California?
Yes, students can qualify. Even if they have insurance through their university, they can choose to opt out in favor of an ACA marketplace plan.
How Often Do I Need to Verify My Eligibility?
You will need to confirm your eligibility every year during the open enrollment period.
What Happens If My Income Changes During the Year?
An income change during the year could impact your health insurance tax subsidies. For example, if you claim the maximum discount, but end up making too much to qualify for the tax credit, you will have to pay back the difference during tax season. You can update your projected income throughout the year to adjust your tax allowance as quickly as possible and avoid owing a large sum.
Can I Apply for Covered California Outside Open Enrollment?
You can apply for ACA plans outside of open enrollment in certain situations, known as qualifying events. Qualifying events include loss of coverage, marriage, moving, having a baby, and adopting a child. In these situations, you’ll usually receive a 60-day special enrollment period where you can sign up for a plan.
