California ACA Marketplace Guide 2026
Last updated: February 2026
Disclaimer: This guide provides general information about health insurance enrollment and is not legal or financial advice. Eligibility rules and subsidy amounts can change. Always verify current requirements with Covered California before enrolling.
Finding affordable health insurance in California can feel overwhelming, especially when you're trying to figure out if you qualify for help paying your premiums. The rules seem complicated, enrollment deadlines feel stressful, and comparing dozens of plans is exhausting. The good news is that California makes the process easier than most states.
Here's the short answer: If your household income is between $20,783 and $60,240 per year for an individual (or $43,056 to $124,800 for a family of four), you likely qualify for premium subsidies through Covered California. The average California resident saves $338 per month on health insurance through these subsidies. Many Californians qualify for even more help, with some paying less than $10 per month for comprehensive coverage.
California runs its own state exchange called Covered California, which means you get more enrollment time and additional state subsidies compared to states using the federal marketplace. Open enrollment for 2026 coverage runs from November 1, 2025 through January 31, 2026, giving you three full months to compare plans and enroll.
This guide walks you through exactly how Covered California works, how to check if you qualify for subsidies, and how to complete your enrollment step by step.
How Covered California Works
Covered California is the state's official health insurance marketplace created under the Affordable Care Act. It's where California residents shop for and purchase individual and family health insurance plans. More than 1.8 million Californians currently get their coverage through the exchange.
Every plan sold through Covered California must cover essential health benefits. These include doctor visits, emergency care, hospital stays, prescription drugs, maternity care, mental health services, preventive care, and pediatric services including dental and vision. No plan can deny you coverage or charge you more because of pre-existing conditions.
Plans are organized into metal tiers based on how costs are shared between you and the insurance company. The tier you choose affects your monthly premium and what you pay when you use care.
Bronze plans have the lowest monthly premiums but higher out of pocket costs when you use care. They work well for healthy people who rarely need medical services and want protection against major expenses. The insurance company pays about 60% of covered costs on average.
Silver plans offer moderate premiums with moderate cost sharing. They're the most popular choice, especially for people who qualify for extra cost sharing reductions. The insurance company pays about 70% of covered costs.
Gold plans have higher premiums but lower costs when you need care. They're a good fit if you use healthcare regularly or have ongoing prescriptions. The insurance company pays about 80% of covered costs.
Platinum plans have the highest premiums but the lowest out of pocket expenses when you use care. They make sense if you have significant medical needs and want predictable costs. The insurance company pays about 90% of covered costs.
Covered California is the only place where you can access premium subsidies and cost sharing reductions that make coverage more affordable. If you buy the same plan directly from an insurance company outside the exchange, you pay full price without any financial help.
Who Qualifies for Covered California Subsidies
Premium subsidies through Covered California are available to California residents whose household income falls within certain ranges. The subsidies are actually tax credits that reduce your monthly premium, and most people can have them applied directly to their monthly bill rather than waiting for a tax refund.
For 2026, the income ranges for subsidy eligibility work like this:
| Household Size | Medi-Cal Max Income | Covered CA Subsidy Range |
|---|---|---|
| 1 person | Up to $20,783/year | $20,783 to $60,240/year |
| 2 people | Up to $28,208/year | $28,208 to $81,760/year |
| 3 people | Up to $35,633/year | $35,633 to $103,280/year |
| 4 people | Up to $43,056/year | $43,056 to $124,800/year |
| 5 people | Up to $50,481/year | $50,481 to $146,320/year |
| 6 people | Up to $57,906/year | $57,906 to $167,840/year |
If your income falls at or near the Medi-Cal maximum, you'll likely qualify for Medi-Cal rather than Covered California. Medi-Cal provides free or very low cost health coverage and has no monthly premium for most enrollees. It covers the same essential benefits and often has lower out of pocket costs.
The Inflation Reduction Act extended enhanced subsidies through 2025. Under current law, nobody pays more than 8.5% of their household income on a benchmark Silver plan premium. Congress may extend these enhanced subsidies, but if they expire, some higher income households will see reduced assistance.
Your subsidy amount depends on your income, household size, age, and the cost of plans in your area. Lower income households receive larger subsidies. Older enrollees typically get more help because their base premiums are higher. Someone earning $35,000 per year might receive $400 or more in monthly subsidies, while someone earning $55,000 might receive $150 per month.
Understanding how your income affects your options is important. Covered California and Medi-Cal use the same application, and the system will automatically determine which program you qualify for based on your information.
Special Subsidies for Silver Plans
If your income is between 100% and 250% of the federal poverty level, you may qualify for additional help called cost sharing reductions. These extra subsidies are only available on Silver tier plans.
Cost sharing reductions lower your deductible, copays, and maximum out of pocket costs without raising your premium. An enhanced Silver plan can function like a Gold or even Platinum plan in terms of coverage, while still having a Silver tier premium. This is one of the least understood but most valuable benefits in the ACA.
For a single person in 2026, cost sharing reductions are available if your income falls in these ranges:
Income between 100% and 150% FPL (roughly $15,650 to $23,475) qualifies for the most generous cost sharing reductions. Your Silver plan deductible might drop from $3,000 to under $500, and your maximum out of pocket could fall from $8,000 to around $2,500.
Income between 150% and 200% FPL (roughly $23,475 to $31,300) qualifies for moderate cost sharing reductions. Your deductible and out of pocket maximum will be lower than a standard Silver plan but not as dramatically reduced.
Income between 200% and 250% FPL (roughly $31,300 to $39,125) qualifies for basic cost sharing reductions. The reductions are smaller but still meaningful.
This is why many financial advisors recommend Silver plans for lower income households. You get the premium subsidy plus the cost sharing reductions, making your total healthcare costs much more manageable than any other tier.
When to Enroll: Open Enrollment and Special Periods
Covered California's open enrollment period for 2026 coverage runs from November 1, 2025 through January 31, 2026. This is the main window when anyone can sign up for coverage, regardless of their circumstances.
Timing matters for when your coverage starts. If you want coverage starting January 1, 2026, you need to complete your enrollment by December 15, 2025. Enrollments completed between December 16 and January 15 will have coverage starting February 1. Enrollments completed between January 16 and January 31 will have coverage starting March 1.
California offers a longer enrollment window than most states. The federal marketplace closes on January 15, but California gives you an extra two weeks to make your decision.
Outside of open enrollment, you can still enroll if you experience a qualifying life event. These special enrollment periods last 60 days from the date of the event and give you a second chance to get covered.
Qualifying life events that trigger special enrollment include:
Losing health coverage from a job, aging off a parent's plan at age 26, losing Medi-Cal eligibility, or having COBRA coverage expire. Getting married, getting divorced, or entering a domestic partnership. Having a baby, adopting a child, or placing a child for foster care. Moving to California from another state or moving to a new California county where different plans are available. Gaining citizenship or lawful presence in the United States. Being released from jail or prison. Experiencing domestic abuse or spousal abandonment. Being affected by a California wildfire or other declared state emergency.
American Indians and Alaska Natives can enroll in or change Covered California plans at any time throughout the year without needing a qualifying event.
If you miss open enrollment and don't have a qualifying event, you'll need to wait until the next open enrollment period. Going without coverage can be risky both financially and for your health.
How to Apply for Covered California: Step by Step
Applying for Covered California takes about 30 to 45 minutes if you have your documents ready. The process is straightforward, but preparation helps avoid delays and ensures you get the right subsidy amount.
Step 1: Gather Your Information
Before you start the application, collect the following for everyone in your household who needs coverage:
Social Security numbers for U.S. citizens, or document numbers for lawfully present non-citizens (such as Permanent Resident Card numbers, work permit numbers, or visa information). Dates of birth for all household members. Employer and income information, including recent pay stubs, your most recent tax return, or documentation of self-employment income. Information about any current health coverage you or family members have. Immigration documents if applicable. Your California address and county.
Having this information ready prevents the frustration of stopping mid-application to search for documents.
Step 2: Create an Account at CoveredCA.com
Go to CoveredCA.com and click "Apply Now." You'll create an account with your email address and a password. Choose a strong password and keep these credentials somewhere safe because you'll need them to manage your coverage throughout the year.
Covered California will send important notices to your email, so use an address you check regularly.
Step 3: Complete the Application
The application asks about your household composition, income, and current coverage. Answer each question carefully and honestly. Your subsidy amount is calculated based on your projected annual income for the coverage year, not your current income or last year's income.
When estimating your income, include wages, salaries, tips, self-employment income, Social Security benefits (for some household members), unemployment compensation, alimony received, and investment income. You can exclude child support, veterans' disability payments, and workers' compensation.
If you're not sure about your expected income, estimate conservatively. You can update your income information during the year if your situation changes. Underestimating income could result in owing money back at tax time, while overestimating means you'll get a larger refund but pay more each month.
Step 4: Review Your Eligibility Results
After you submit your application, Covered California determines whether you qualify for Medi-Cal, Covered California with subsidies, or Covered California without subsidies. The determination usually happens immediately.
If you qualify for Medi-Cal, you'll be directed to complete your enrollment through your county's Medi-Cal office or BenefitsCal.com. Medi-Cal enrollment can happen at any time and provides comprehensive free or low cost coverage.
If you qualify for Covered California, you'll see a list of available plans with your personalized prices after subsidies are applied.
Step 5: Compare and Choose a Plan
Look at more than just the monthly premium when comparing plans. Consider the annual deductible, which is what you pay before insurance kicks in. Look at the maximum out of pocket limit, which is the most you'd pay in a year even with serious illness or injury. Check whether your doctors are in the plan's network. Verify that your prescriptions are covered and at what tier. Compare copays for services you use regularly, like primary care visits or specialist appointments.
Use the "Find a Doctor" and "Find a Pharmacy" tools on Covered California to check that your preferred providers are in network before you enroll.
Step 6: Enroll and Pay Your First Premium
Once you select a plan, confirm your enrollment. You'll receive information about how to pay your first month's premium directly to the insurance company. Your coverage won't start until you pay that first premium, so don't delay.
Set up automatic payments if possible to avoid accidental coverage lapses. Missing a premium payment can result in losing your coverage, and getting back on a plan outside of open enrollment may not be possible.
Major Insurance Companies on Covered California
Several large health insurance companies offer plans through Covered California. Availability varies by region, so not all insurers are available in every county.
Kaiser Permanente is available in most urban and suburban areas and operates as an integrated system where your doctor, hospital, and pharmacy are all part of Kaiser. Members generally use Kaiser facilities for all their care. Kaiser tends to have competitive premiums and strong preventive care programs.
Blue Shield of California and Anthem Blue Cross offer PPO and HMO options with broad provider networks that include many community hospitals and physician groups. PPO plans allow you to see out of network providers at higher cost, while HMO plans require referrals to see specialists.
Health Net serves many California counties with both HMO and PPO plans. Molina Healthcare focuses on lower cost options in select regions and is popular among subsidy eligible enrollees.
L.A. Care Health Plan serves Los Angeles County residents and is the largest publicly operated health plan in the country. Sharp Health Plan is available in San Diego County with a focus on that region's healthcare providers.
For 2026, premium increases range from about 7% to 15% depending on the insurer, before subsidies are applied. However, most subsidy eligible enrollees won't feel the full impact of rate increases because their subsidies adjust to keep coverage affordable relative to their income.
Check Your Eligibility Before You Apply
Before spending time on the full application, you can get a quick estimate of what you might qualify for. Eligibility screening tools ask basic questions about your income, household size, and county, then show you whether you're likely eligible for Medi-Cal, subsidized Covered California, or unsubsidized coverage.
A free eligibility screener can show you estimated subsidy amounts and plan prices in about five minutes. Tools like Benefits USA check your potential eligibility for Covered California along with other programs like Medi-Cal, CalFresh, and tax credits you might be missing. Many Californians qualify for multiple programs and don't realize it.
These screening tools don't submit anything official or access your personal records. They just help you understand your options before you commit to the full application process. If the screener shows you're likely eligible for significant subsidies, that's a strong signal to complete the official application.
What Happens After You Enroll
Once you're enrolled and your first premium is paid, your insurance company will send you a member ID card and welcome packet. This typically arrives within two to three weeks of your first payment.
You can usually access your member portal online before your physical card arrives. The portal lets you find doctors, check coverage details, and print a temporary ID card if you need care right away. Save your insurance company's customer service number in your phone for quick access.
Schedule any preventive care appointments you've been putting off. Covered California plans cover annual checkups, vaccinations, and screenings at no cost to you. Preventive care visits don't count toward your deductible.
Keep your income information updated throughout the year. If you get a raise, lose a job, have a baby, or experience another significant change, log into your Covered California account and report it. This keeps your subsidy amount accurate and prevents surprises at tax time. Failing to report income changes can result in owing money back when you file your taxes.
Your coverage continues until you cancel it, lose eligibility, or stop paying premiums. Covered California will send you renewal information before open enrollment each year so you can make changes or keep your current plan.
Frequently Asked Questions
What if my income is too low for Covered California subsidies?
If your income falls at or near 138% of the federal poverty level (about $20,783 per year for an individual or $43,056 for a family of four), you likely qualify for Medi-Cal instead of Covered California. Medi-Cal is free or very low cost and provides comprehensive coverage. When you apply through Covered California, the system automatically checks your Medi-Cal eligibility.
Can I get Covered California if I have a job that offers insurance?
Yes, but with conditions. If your employer offers affordable coverage that meets minimum standards, you generally can't get Covered California subsidies. However, if your employer coverage costs more than 8.39% of your household income for self-only coverage, or if it doesn't meet minimum value standards, you may still qualify for subsidized Covered California.
What documents do I need to apply?
You'll need Social Security numbers or immigration documents for all household members, income information like pay stubs or tax returns, and dates of birth. You don't need to upload documents during the application, but Covered California may request verification later.
How long does it take to get approved?
Many applications are approved immediately if the information matches government records. Some applications require additional verification, which can take several weeks. Apply early during open enrollment to ensure coverage starts on time.
Can immigrants get Covered California?
Lawfully present immigrants can purchase Covered California plans and receive subsidies. Undocumented immigrants cannot enroll in Covered California, but may qualify for emergency Medi-Cal and can purchase coverage outside the marketplace at full price. Immigration rules are complex, so consult an immigration attorney if you have concerns about how applying might affect your status.
What if I miss open enrollment?
You'll need to wait until the next open enrollment period unless you have a qualifying life event. Losing other coverage, moving, getting married, or having a baby all qualify for special enrollment. The special enrollment period lasts 60 days from the event. Plan ahead to avoid gaps in coverage.
Next Steps
If your income falls within the subsidy eligible range, applying for Covered California is worth the 30 to 45 minutes it takes. The average enrollee saves over $4,000 per year on health insurance premiums, which is money that goes back into your pocket.
Start by checking your eligibility with a free screening tool to estimate your subsidy amount. Then gather your documents and apply through CoveredCA.com during open enrollment or within 60 days of a qualifying life event.
Covered California's customer service line is available at 1-800-300-1506 if you have questions or need help completing your application. Certified enrollment counselors can also provide free in-person assistance throughout California. Find local help at CoveredCA.com by clicking "Find Help Near You."
Don't wait until the last day of open enrollment. Technical issues and high call volumes can make it difficult to complete enrollment at the deadline. Give yourself at least a week before the deadline to finish your application.
