We make it easy to find Affordable Care Act coverage in California that fits your needs.
If you’ve arrived at this page, you may be wondering how the Affordable Care Act affects California residents. The 2010 Affordable Care Act, also known as Obamacare, is health-care reform legislation aimed at making health insurance more affordable and accessible for Americans. The law also establishes health insurance Marketplaces, or “exchanges,” which are government-run websites where you can go to purchase health coverage for yourself or your family if you don’t already have it.
There are two kinds of Marketplaces available, and the type you have access to will depend on the state you live in. There’s the federal health insurance Marketplace (also known as Healthcare.gov) in some states, and there are state-run Marketplaces in other states. California has its own state health exchange set up, also known as Covered California.
If you already have health insurance (for example, through an employer), it’s likely that you don’t need to make changes to your coverage. However, if you don’t already have health coverage and aren’t eligible for an exemption, you could face a tax penalty under Obamacare unless you enroll in a health plan.
Covered California is the state health insurance exchange, but it isn’t your only option if you’re purchasing a health plan on the individual and family Marketplace. You can also find health coverage directly through insurance companies — or through a licensed insurance broker like eHealth.
To learn more about how Obamacare works in California and your health coverage options, read on.
In California, like the rest of the country, the Affordable Care Act requires most U.S. citizens, U.S. nationals, and permanent residents to have health coverage that meets minimum coverage requirements. Unless you qualify for an exemption, you could pay a tax penalty if you go without health coverage for two months in a row or longer.
If you aren’t in the United States lawfully, you are exempt from the requirement to have health coverage. You won’t be eligible to enroll in a health plan through the California health insurance exchange, although you may be able to enroll in private health insurance outside of Covered California.
If you aren’t legally present in the country, you can still apply for health coverage through Covered California through a lawfully present family member (for example, through a dependent child). For more information on health coverage eligibility in California, visit CoveredCA.com.
Like in the rest of the United States, the health plans available on Covered California fall into four metal levels. The metal levels reflect the costs you can expect to pay for health plans in each category; they don’t have to do with the quality of care.
Health plans sold on the California health exchange fit into the following four metal levels:
The California health exchange also offers an Enhanced Silver plan for certain individuals with limited income who qualify for lower out-of-pocket costs. With an Enhanced Silver plan, eligible individuals who purchase a Silver plan will have the lower cost-sharing benefits of a Gold or Platinum plan — but for the cost of a Silver level plan. There are three types of Enhanced Silver plans available, and each type has a different level of cost sharing:
Minimum coverage plans may be another coverage option if either of the following is true for you:
Also known as “catastrophic” coverage in some states, minimum coverage plans are another class of health insurance and cover the same minimum essential benefits as other Marketplace plans. These plans typically have lower premiums than other health plans, but you’ll need to meet a high deductible before the plan begins to pay for most medical costs. Minimum coverage plans are designed to protect you in a “worst-care scenario.”
In California, minimum coverage plans do cover some benefits before you reach the deductible. You generally won’t have to pay copayments or coinsurance for the following benefits (even if you haven’t met your deductible yet):
With the exception of the above benefits, you’ll pay 100% for all other health-care services until you meet the plan deductible. In California, those enrolled in a minimum coverage plan pay a negotiated in-network cost for health-care services. After your out-of-pocket spending has reached the deductible, the plan pays for 100% of covered health-care benefits.