{"id":12360,"date":"2025-12-02T05:58:00","date_gmt":"2025-12-02T05:58:00","guid":{"rendered":"https:\/\/www.freeway.com\/knowledge-center\/?p=12360"},"modified":"2025-12-02T18:00:03","modified_gmt":"2025-12-02T18:00:03","slug":"covered-california-eligibility","status":"publish","type":"post","link":"https:\/\/www.freeway.com\/knowledge-center\/health-insurance\/covered-california-eligibility\/","title":{"rendered":"How Do I Know If\u00a0I\u2019m\u00a0Eligible for Covered California?\u00a0"},"content":{"rendered":"\n<p>Covered California is a valuable resource for Californians who&nbsp;don\u2019t&nbsp;have access to health insurance through their employers. If&nbsp;you\u2019re&nbsp;thinking about signing up, you should understand basic eligibility rules about who qualifies for Covered California. Along with the eligibility requirements for getting&nbsp;<a href=\"https:\/\/www.freeway.com\/california-health-insurance\/\" target=\"_blank\" rel=\"noreferrer noopener\">health insurance in California<\/a>, there are also specific rules&nbsp;for&nbsp;who can get certain tax credits and subsidies.&nbsp;&nbsp;<\/p>\n\n\n\n<p>Exploring all of these Covered California requirements&nbsp;with Freeway Insurance&nbsp;can help you determine if Covered CA is right for you.&nbsp;We&nbsp;don\u2019t&nbsp;charge you for helping.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Understanding Covered California<\/strong>&nbsp;<\/h2>\n\n\n\n<p>If&nbsp;you\u2019re&nbsp;exploring health insurance options,&nbsp;you\u2019ve&nbsp;probably heard&nbsp;about Covered CA. But what exactly is this health insurance program?&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>What Is Covered California?<\/strong>&nbsp;<\/h3>\n\n\n\n<p>Covered California is the Golden State\u2019s health insurance marketplace program. It offers multiple&nbsp;<a href=\"https:\/\/www.freeway.com\/knowledge-center\/health-insurance\/understanding-health-insurance\/whats-the-best-health-plan-for-you-hmo-ppo-epo-or-pos\/\" target=\"_blank\" rel=\"noreferrer noopener\">types of health policies<\/a>&nbsp;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.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Why It Matters for California Residents<\/strong>&nbsp;<\/h3>\n\n\n\n<p>If you&nbsp;don\u2019t&nbsp;have coverage through an employer,&nbsp;you\u2019ll&nbsp;need to explore other options. The Covered CA marketplace was designed to provide you with quality, affordable care, even if you&nbsp;don\u2019t&nbsp;have an employer-sponsored plan or if you have pre-existing conditions that disqualify you from other private policies.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>General Covered California Eligibility Requirements<\/strong>&nbsp;<\/h2>\n\n\n\n<p>If&nbsp;you\u2019re&nbsp;wondering, \u201cAm I eligible for Covered California?\u201d&nbsp;the&nbsp;answer depends on a few key requirements. The state\u2019s marketplace was designed to be available to most California residents who&nbsp;don\u2019t&nbsp;have other options for insurance. Here are the main eligibility restrictions you should know.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Access to Employer Plans<\/strong>&nbsp;<\/h3>\n\n\n\n<p>Covered California is only available to people who&nbsp;don\u2019t&nbsp;have other options for health insurance, such as self-employed individuals and people whose employers&nbsp;don\u2019t&nbsp;offer health&nbsp;benefits. If your employer offers company-sponsored health coverage, you&nbsp;won\u2019t&nbsp;be able to apply for an ACA plan.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Citizenship and Residency Status<\/strong>&nbsp;<\/h3>\n\n\n\n<p>You also need to be a lawful resident of California. That includes:&nbsp;<\/p>\n\n\n\n<ul>\n<li>U.S. citizens\u00a0<\/li>\n<\/ul>\n\n\n\n<ul>\n<li>Permanent residents\u00a0<\/li>\n<\/ul>\n\n\n\n<ul>\n<li>Temporary residents\u00a0<\/li>\n<\/ul>\n\n\n\n<ul>\n<li>Refugees\u00a0<\/li>\n<\/ul>\n\n\n\n<ul>\n<li>People with protected status\u00a0<\/li>\n<\/ul>\n\n\n\n<ul>\n<li>People on worker or student visas\u00a0<\/li>\n<\/ul>\n\n\n\n<p>It\u2019s&nbsp;important to note that DACA recipients no longer qualify for Covered California as of August 2025.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Age Requirements<\/strong>&nbsp;<\/h3>\n\n\n\n<p>Covered California plans&nbsp;are required to&nbsp;offer dependent coverage up to&nbsp;age&nbsp;26. If your parents have ACA coverage, that means they can keep you on their family plan. If you&nbsp;aren\u2019t&nbsp;on a parent\u2019s or guardian\u2019s plan, you can sign up for your own individual ACA policy once you turn 18.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Household Income Guidelines<\/strong>&nbsp;<\/h3>\n\n\n\n<p>Your income&nbsp;doesn\u2019t&nbsp;impact&nbsp;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.&nbsp;Assistance&nbsp;is also based on a sliding scale, so&nbsp;you\u2019ll&nbsp;get more of a tax credit if you have a lower income.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Special Situations That Affect Eligibility<\/strong>&nbsp;<\/h2>\n\n\n\n<p>There are a few unique situations that can&nbsp;impact&nbsp;your Covered CA health plan.&nbsp;Here\u2019s&nbsp;a basic breakdown:&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Pregnant Individuals and Families<\/strong>&nbsp;<\/h3>\n\n\n\n<p>Growing your family through birth or adoption is considered a qualifying event for the ACA. That means that&nbsp;you\u2019ll&nbsp;be able to switch to a family plan and get coverage for your new child, even if they arrive outside of standard&nbsp;<a href=\"https:\/\/www.freeway.com\/knowledge-center\/health-insurance\/when-is-health-insurance-open-enrollment\/\" target=\"_blank\" rel=\"noreferrer noopener\">open enrollment<\/a>.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Self-Employed or Gig Workers<\/strong>&nbsp;<\/h3>\n\n\n\n<p>Covered California is a particularly popular&nbsp;option&nbsp;for self-employed individuals and gig workers. This is because you typically&nbsp;won\u2019t&nbsp;have the&nbsp;option&nbsp;for employer-sponsored coverage as an independent contractor. The ACA marketplace allows you to apply for a new plan or change your plan within&nbsp;60 days&nbsp;of the baby\u2019s birth or adoption. Outside of that period, you may need to wait until the next enrollment period.&nbsp;It\u2019s&nbsp;important to note that these limits only apply to ACA policies, and you can&nbsp;apply for&nbsp;Medi-Cal, which is California\u2019s version of Medicaid, at any time.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Students and Young Adults<\/strong>&nbsp;<\/h3>\n\n\n\n<p>If&nbsp;you\u2019re&nbsp;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\u2019s or guardian\u2019s health plan. You might also have health insurance options through your college. However, Covered California gives you the&nbsp;option&nbsp;to waive your school-provided coverage and sign up for an ACA plan instead. Finally, if you&nbsp;don\u2019t&nbsp;have a policy from your parents or your college, you can sign up for a marketplace policy as an individual once you turn 18.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Recent Job Loss or Income Changes<\/strong>&nbsp;<\/h3>\n\n\n\n<p>Losing your job typically means losing your health policy. If you lose coverage, you can qualify for a\u00a0<a href=\"https:\/\/www.freeway.com\/insurance-options\/health-insurance\/health-insurance-special-enrollment\/\" target=\"_blank\" rel=\"noreferrer noopener\">special enrollment period<\/a>\u00a0to sign up for a marketplace plan. If\u00a0you\u2019re\u00a0already on an ACA policy, changes to your income could\u00a0impact\u00a0how much you pay for coverage. For example, a decrease in income could increase your eligibility for health premium tax credits.\u00a0<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full is-resized\"><img decoding=\"async\" width=\"1000\" height=\"667\" src=\"https:\/\/www.freeway.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2025\/12\/fwy-how-do-i-know-if-im-eligible-for-covered-california-2.jpg\" alt=\"Young people work through Covered California paperwork to find out if they are eligible for health insurance through Covered California.\" class=\"wp-image-12361\" style=\"width:612px;height:auto\" srcset=\"https:\/\/www.freeway.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2025\/12\/fwy-how-do-i-know-if-im-eligible-for-covered-california-2.jpg 1000w, https:\/\/www.freeway.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2025\/12\/fwy-how-do-i-know-if-im-eligible-for-covered-california-2-300x200.jpg 300w, https:\/\/www.freeway.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2025\/12\/fwy-how-do-i-know-if-im-eligible-for-covered-california-2-768x512.jpg 768w, https:\/\/www.freeway.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2025\/12\/fwy-how-do-i-know-if-im-eligible-for-covered-california-2-750x500.jpg 750w, https:\/\/www.freeway.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2025\/12\/fwy-how-do-i-know-if-im-eligible-for-covered-california-2-294x196.jpg 294w, https:\/\/www.freeway.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2025\/12\/fwy-how-do-i-know-if-im-eligible-for-covered-california-2-320x213.jpg 320w, https:\/\/www.freeway.com\/knowledge-center\/wp-content\/uploads\/sites\/2\/2025\/12\/fwy-how-do-i-know-if-im-eligible-for-covered-california-2-285x190.jpg 285w\" sizes=\"(max-width: 1000px) 100vw, 1000px\" \/><\/figure><\/div>\n\n\n<h2 class=\"wp-block-heading\"><strong>How To Calculate Your Eligibility<\/strong>&nbsp;<\/h2>\n\n\n\n<p>The best way to&nbsp;determine&nbsp;your California health insurance eligibility is by simply applying for a plan through the Covered California marketplace. Remember, if&nbsp;you\u2019re&nbsp;a lawful California resident who&nbsp;doesn\u2019t&nbsp;have access to an&nbsp;employer&nbsp;plan,&nbsp;you\u2019re&nbsp;probably eligible. However, you might want to know whether you qualify for premium tax credits before you get started.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Using the Covered California Shop and Compare Tool<\/strong>&nbsp;<\/h3>\n\n\n\n<p>The Covered California website has a helpful tool to help you&nbsp;determine&nbsp;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&nbsp;additional&nbsp;details about which members of your household need coverage. Then, you can select options for how much you expect to use your health policy.&nbsp;<\/p>\n\n\n\n<p>The tool will let you know about potential savings. However, this is just a tool you can use as a guideline, and you&nbsp;won\u2019t&nbsp;know specific numbers until you&nbsp;submit&nbsp;your Covered California application during open enrollment.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Understanding Federal Poverty Levels (FPL)<\/strong>&nbsp;<\/h3>\n\n\n\n<p>The government&nbsp;determines&nbsp;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.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>What To Do If&nbsp;You\u2019re&nbsp;Not Eligible<\/strong>&nbsp;<\/h2>\n\n\n\n<p>If you&nbsp;don\u2019t&nbsp;qualify for a Covered California plan, that&nbsp;doesn\u2019t&nbsp;mean you&nbsp;can\u2019t&nbsp;get quality health insurance. There are other options available.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Alternative Health Coverage Options<\/strong>&nbsp;<\/h3>\n\n\n\n<p>If you&nbsp;don\u2019t&nbsp;have coverage through an employer but also&nbsp;don\u2019t&nbsp;qualify for the marketplace, you can explore coverage from private brokers. These plans are usually based on your health history. If&nbsp;you\u2019re&nbsp;generally healthy, these private policies can be a good&nbsp;option.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Medi-Cal or Other State Programs<\/strong>&nbsp;<\/h3>\n\n\n\n<p>Medi-Cal is another popular&nbsp;option. You&nbsp;don\u2019t&nbsp;have to be a lawful resident to sign up for&nbsp;<a href=\"https:\/\/www.freeway.com\/insurance-options\/health-insurance\/types-of-health-insurance\/medical-health-insurance\/\" target=\"_blank\" rel=\"noreferrer noopener\">Medi-Cal coverage<\/a>.&nbsp;It\u2019s&nbsp;available to most people from 19 to 64. If you exceed&nbsp;the age&nbsp;requirements, you could be eligible for the&nbsp;state\u2019s&nbsp;Medicare program.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>See If You Qualify for Covered California Health Coverage Now<\/strong>&nbsp;<\/h2>\n\n\n\n<p>Getting the right health coverage in California is essential for protecting your finances and your well-being. Covered California\u2019s 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.&nbsp;<\/p>\n\n\n\n<p>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.&nbsp;And we&nbsp;don\u2019t&nbsp;charge you for the service! Just&nbsp;call&nbsp;us at&nbsp;<a href=\"tel:877-423-1508\" target=\"_blank\" rel=\"noreferrer noopener\">877-423-1508<\/a>.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>FAQs<\/strong>\u00a0About Covered California<\/h2>\n\n\n\n<p>Get answers to&nbsp;common questions&nbsp;about how ACA plans work in the Golden State by reviewing these FAQs:&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Can Undocumented Immigrants Apply for Covered California?<\/strong>&nbsp;<\/h3>\n\n\n\n<p>Undocumented immigrants&nbsp;aren\u2019t&nbsp;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&nbsp;you\u2019re&nbsp;undocumented, you can qualify for Medi-Cal&nbsp;as long as&nbsp;you meet its income restrictions.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>How Is Household Income Calculated for Eligibility?<\/strong>&nbsp;<\/h3>\n\n\n\n<p>Your eligibility is based on your estimated household income for the year&nbsp;you\u2019re receiving coverage. You calculate your official income based on your adjusted gross income (AGI) when you do your taxes. To&nbsp;come up with&nbsp;an estimate, look at your household AGI from the&nbsp;previous&nbsp;tax year, then add or subtract based on any upcoming changes in your income.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Can Students Qualify for Covered California?<\/strong>&nbsp;<\/h3>\n\n\n\n<p>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.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>How Often Do I Need\u00a0to\u00a0Verify My Eligibility?<\/strong>\u00a0<\/h3>\n\n\n\n<p>You will need to confirm your eligibility every year during the open enrollment period.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>What Happens If My Income Changes During the Year?<\/strong>&nbsp;<\/h3>\n\n\n\n<p>An income change during the year could&nbsp;impact&nbsp;your health insurance tax subsidies. For example, if you claim the&nbsp;maximum&nbsp;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&nbsp;a large sum.&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Can I Apply for Covered California Outside Open Enrollment?<\/strong>&nbsp;<\/h3>\n\n\n\n<p>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,&nbsp;you\u2019ll&nbsp;usually receive a 60-day special enrollment period where you can sign up for a plan.&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Covered California is a valuable resource for Californians who&nbsp;don\u2019t&nbsp;have access to health insurance through their employers. If&nbsp;you\u2019re&nbsp;thinking about signing up, you should understand basic eligibility rules about who qualifies for Covered California. Along with the eligibility requirements for getting&nbsp;health insurance in California, there are also specific rules&nbsp;for&nbsp;who can get certain tax credits and subsidies.&nbsp;&nbsp; Exploring [&hellip;]<\/p>\n","protected":false},"author":1002606,"featured_media":12362,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8],"tags":[],"importance":[],"type-content":[],"acf":[],"_links":{"self":[{"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/posts\/12360"}],"collection":[{"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/users\/1002606"}],"replies":[{"embeddable":true,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/comments?post=12360"}],"version-history":[{"count":2,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/posts\/12360\/revisions"}],"predecessor-version":[{"id":12364,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/posts\/12360\/revisions\/12364"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/media\/12362"}],"wp:attachment":[{"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/media?parent=12360"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/categories?post=12360"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/tags?post=12360"},{"taxonomy":"importance","embeddable":true,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/importance?post=12360"},{"taxonomy":"type-content","embeddable":true,"href":"https:\/\/www.freeway.com\/knowledge-center\/wp-json\/wp\/v2\/type-content?post=12360"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}