Most likely, yes!  Approximately 90% of California enrollees get financial help.  How much financial help depends on your household size, family income and where you live.

You could pay as little as $0/month for your plan, and you won’t pay more than 8.5% of your income for our Covered CA Silver plan.  You may also qualify for low or no-cost Medi-Cal.

The following is need for every household member who is applying for coverage:

• Home ZIP code
• Birth date
• Proof of current household income*
• California ID or driver’s license
• Social Security number or Individual Taxpayer Identification Number, if you have one
• Proof of citizenship or lawful presence (e.g., U.S. passport, certificate of citizenship or naturalization document, green card, or a valid visa)**

*Proof of current income of all members in the tax household, such as a recent tax return, W-2, or pay stub. A dependent’s income should only be included if their income level requires them to file a tax return. A household is defined as the person who files taxes as the primary tax filer and all the dependents claimed on that person’s taxes. If you don’t file taxes, you can still qualify for free or low-cost insurance through Medi-Cal.
**You can apply for your eligible child or spouse even if you are not eligible. Households that include members who are not lawfully present can also apply. 

Most insurance companies offer three types of plans:

“HMOs”

Health Maintenance Organizations only cover medical services inside the plan’s network.  HMOs often require members to get a referral from their primary care doctor to see a specialist.

“PPOs”

Preferred Provider Organizations pay for medical services both inside and outside the plan’s network, but members pay a higher amount of the cost for out-of-network care. No referral is required to see a specialist.

“EPOs”

Exclusive Provider Organizations generally don’t cover care outside the plan’s network, but members may not need a referral to see an in-network specialist.

It’s important to note that not all HMOs, PPOs and EPOs are the same. Before choosing a plan, use the Shop and Compare tool at CoveredCA.com to get details like what doctors and hospitals are covered and what it will cost to see a doctor out-of-network.

California was created to help legal California residents compare, afford and enroll in brand-name health insurance plans.  Most people who enroll receive financial help, and everyone is guaranteed the same, high-quality coverage.  All private information, including immigration and citizenship status, is kept confidential.

ARE YOU ELIGIBLE?

Under the Affordable Care Act, most immigrants qualify for health coverage, including the following groups:

• Lawful permanent residents or “green card holders.”
• Lawful temporary residents.
• Non-immigrant status holders, including work visas and student visas.
• Persons fleeing persecution, including refugees and asylees.
• Other humanitarian immigrants, including those granted temporary protected status.

WHAT IF I’M FROM A MIXED IMMIGRATION STATUS FAMILY?

Some households have both lawfully present and non-lawfully present individuals. Although an individual that is not lawfully present is ineligible for coverage under a Covered California plan, they can still apply for health coverage on behalf of household members that are lawfully present. For example, if you are not lawfully present, but your child is a U.S. citizen, you can apply on his or her behalf. You only need to provide information on immigrant status for family members applying for coverage.

“PUBLIC CHARGE” AND YOUR PRIVACY

Financial help through Covered California, including advanced premium tax credit (APTC), state premium assistance, and cost-sharing reduction (CSR) to help pay for care, and free or low-cost coverage through Medi-Cal are NOT public benefits under the public charge rule and will NOT be considered when making a public charge determination. If you are concerned about how your personal information will be shared with the federal government or whether applying for coverage through Covered California will negatively affect you or a member of your household, you can call the Health

Consumer Alliance (HCA) at 888-804-3536 for free, confidential legal assistance, or visit the California Department of Social Services Public Charge Provider List.

Individuals and families who experience a qualifying life event can enroll in a Covered California health insurance plan outside of the annual open enrollment period, which is usually from November through January each year.  This is called special enrollment.  In most cases, you have 60 days after the date of the qualifying life event to enroll or change your existing plan.  If you know ahead of time when you will lose your health insurance, you have an additional 60 days to enroll before that date to prevent any gaps in coverage.

WHAT ARE QUALIFYING EVENTS?

• Lost health insurance
• Married, divorced, or new domestic partnership
• Child is born, adopted or received into foster care
• Moved to or within California

WHEN DOES COVERAGE START?

For most people, your enrollment will be effective the first day of the month after you apply. In some situations, such as if you are pregnant or adopt a child, you may choose to have your enrollment begin on a different date.   

WHO IS NOT ELIGIBLE FOR COVERED CALIFORNIA?

If you are not lawfully present in California, you are not eligible for a Covered California plan. However, you can still apply through Covered California to find out if you are eligible for full-scope Medi-Cal up to age “26” or for pregnancy coverage.  Individuals who are not lawfully present generally qualify for limited-scope Medi-Cal and can apply through Covered California for insurance that covers emergency services only.

In California, most people are required by law to have health insurance or pay a tax penalty:
$800/adult + $400/child under 18, up to $2,400/household, or 2.5% of your annual household income over your California tax filing threshold, whichever is higher.