Applying for ACA health insurance in California means applying through Covered California, the state's official health insurance marketplace. If your household income falls between 100% and 400% of the Federal Poverty Level (FPL), you may qualify for premium tax credits that lower your monthly costs. Below 138% FPL, you will likely be directed to Medi-Cal instead. This guide walks through exactly what you need, what the 2026 income limits are, and how to complete your application from start to finish. Not sure what you qualify for? Run a free eligibility check before you apply.
What Is Covered California?
Covered California is the state-run marketplace where Californians can shop for ACA-compliant health insurance plans and apply for financial assistance. It was created under the Affordable Care Act and serves as the only place where Californians can receive federal premium tax credits (also called subsidies) to lower their monthly health insurance costs.
Plans sold through Covered California must cover essential health benefits including doctor visits, emergency care, prescription drugs, mental health services, maternity care, and preventive screenings. You cannot be denied coverage or charged more based on pre-existing conditions.
2026 Income Limits for Covered California
Your income relative to the Federal Poverty Level determines what kind of help you can get. For 2026, these are the key income thresholds:
| Household Size | 100% FPL (Subsidy Floor) | 138% FPL (Medi-Cal Limit) | 250% FPL (CSR Limit) | 400% FPL (Subsidy Ceiling) |
|---|
| 1 person | $22,045 | ~$30,422 | ~$55,113 | $88,180 |
| 2 people | $29,845 | ~$41,185 | ~$74,613 | $119,380 |
| 3 people | $37,645 | ~$51,950 | ~$94,113 | $150,580 |
| 4 people | $45,540 | ~$62,845 | ~$113,850 | $182,160 |
| 5 people | $53,340 | ~$73,609 | ~$133,350 | $213,360 |
FPL amounts are based on 2026 federal guidelines. Dollar figures marked "~" are approximate calculations.
What Each Threshold Means
Below 138% FPL: You will likely qualify for Medi-Cal (California's Medicaid program), which is free or very low cost. Covered California will refer you automatically when you apply.
138% to 250% FPL: You qualify for premium tax credits AND cost-sharing reductions (CSRs). CSRs lower your deductibles, copays, and out-of-pocket maximum. You must enroll in a Silver plan to receive CSRs.
250% to 400% FPL: You qualify for premium tax credits only. No cost-sharing reductions apply at this income level.
Above 400% FPL: As of 2026, the enhanced subsidies from the American Rescue Plan and Inflation Reduction Act have expired. Households earning above 400% FPL receive no federal premium assistance and must pay full premiums.
A Major Change for 2026
Through 2025, enhanced subsidies allowed households earning over 400% FPL to still receive some help, capped at 8.5% of income. Those enhanced subsidies expired December 31, 2025. Starting in 2026, the subsidy cliff is back: earn one dollar over 400% FPL and you receive zero federal premium assistance. If you are close to the 400% threshold, it is worth understanding your options carefully before assuming you don't qualify.
When You Can Apply
Open Enrollment: Covered California's open enrollment runs November 1 through January 31 each year. This is the primary window to enroll, switch plans, or renew coverage for the upcoming year.
Special Enrollment Period (SEP): Outside of open enrollment, you can still apply if you experience a qualifying life event within the past 60 days. Common qualifying events include:
- Losing job-based health insurance (including COBRA exhaustion)
- Turning 26 and aging off a parent's plan
- Moving to California from another state
- Getting married or divorced
- Having a baby, adopting a child, or taking in a foster child
- Losing Medi-Cal coverage
- Income change that affects your eligibility
After a qualifying event, you generally have 60 days to enroll. Coverage typically starts the first day of the month after you select a plan.
What You Need to Apply
Gather these items before you start your application. Having everything ready shortens the process to 15 to 30 minutes for most households.
Identity and household information:
- Social Security numbers for each applicant
- Dates of birth for each household member
- Current address and contact information
Immigration status (if applicable):
- Immigration documents such as a green card, visa, or work permit
- Non-citizens must be "lawfully present" to enroll in Covered California; undocumented residents can apply for Medi-Cal separately
Income information:
- Recent pay stubs (last 1 to 2 months)
- W-2 or 1099 forms from the prior year
- For self-employed applicants: most recent tax return and current profit/loss estimate
- Documentation for any other income sources: Social Security, unemployment, alimony, rental income, or investment income
Coverage history:
- If you have employer-sponsored insurance available to you, Covered California will ask for details about that coverage and its cost
How to Apply: Step by Step
Step 1: Check Your Eligibility First
Before creating an account, use a free screening tool like the BenefitsUSA screener or the Covered California calculator to estimate what you qualify for. Knowing whether you land in Medi-Cal territory, subsidy territory, or above 400% FPL helps you set expectations.
Step 2: Visit CoveredCA.com
Go to coveredca.com and click "Get Started" or "Apply Now." You can create an account or begin as a guest. Creating an account lets you save your progress and come back later.
Step 3: Enter Household Information
You will answer questions about everyone in your household, including names, dates of birth, Social Security numbers, and immigration status. Include people you file taxes with or who live in your home, even if they will not be on your insurance plan.
Step 4: Report Your Income
Covered California asks for your expected household income for the coverage year, not your prior year income. Use your most recent pay stubs as a starting point. If your income will change significantly from last year, adjust accordingly. Underestimating income can lead to having to repay subsidies at tax time; overestimating means leaving money on the table.
Step 5: Compare Plans
After entering your information, the system shows plans you qualify for, along with your estimated subsidy amount and what you would pay per month. Plans are organized by metal tier:
| Metal Tier | What You Pay Monthly | What Insurer Covers (Roughly) |
|---|
| Bronze | Lowest premium | ~60% of medical costs |
| Silver | Mid-range premium | ~70% of medical costs |
| Gold | Higher premium | ~80% of medical costs |
| Platinum | Highest premium | ~90% of medical costs |
If you qualify for cost-sharing reductions, you must choose a Silver plan to access them. A Silver plan with CSRs can have significantly better coverage than a Gold plan in some cases.
Step 6: Submit and Pay
Review your application summary, then submit. After submitting, you must pay your first month's premium by the deadline shown to activate coverage. Most insurers accept credit cards, debit cards, or bank transfers. Coverage typically starts the first of the month after your payment clears.
Step 7: Submit Any Requested Documents
Covered California may ask you to verify your income or immigration status after you enroll. You typically have 30 days to upload supporting documents. Respond to these requests promptly or your coverage can be canceled.
Other Ways to Apply
By phone: Call Covered California at 1-800-300-1506 (TTY: 1-888-889-4500). Agents are available Monday through Friday 8 a.m. to 6 p.m. PST.
In person: Certified enrollment counselors and licensed agents across California can help you apply at no cost. Find a counselor near you at coveredca.com. This is especially useful if your situation is complicated or you are not comfortable applying online.
By mail: Paper applications are available for download at CoveredCA.com. Mail-in applications can take longer to process, so this is not recommended if you are approaching a deadline.
What Happens After You Enroll
Once you have coverage, carry your insurance card and use in-network providers to keep your costs down. Review your plan's Summary of Benefits and Coverage to understand your deductible, copays, and out-of-pocket maximum before your first appointment.
At tax time, you will receive Form 1095-A from Covered California showing how much subsidy was paid on your behalf during the year. You will need this form to file Form 8962 with your federal taxes and reconcile your premium tax credits. If your income ended up higher than estimated, you may owe some subsidy back. If it was lower, you may receive additional credit.
Covered California vs. Medi-Cal
| Feature | Covered California | Medi-Cal |
|---|
| Who qualifies | 100% to 400% FPL (primarily) | Up to 138% FPL |
| Monthly premium | Yes, reduced by subsidies | Free or very low |
| Copays and deductibles | Yes (reduced with CSRs) | Low or none |
| Application | coveredca.com or 1-800-300-1506 | coveredca.com or county social services |
| Enrollment period | Open enrollment or SEP | Any time of year |
| Dental and vision | Not included in standard plans | Included for most enrollees |
If you apply through Covered California and your income falls below 138% FPL, the system will refer you to Medi-Cal automatically. You do not need to apply separately in most cases.
Frequently Asked Questions
How long does a Covered California application take?
Most online applications take 15 to 30 minutes if you have your income and household information ready. Families with several members or complex income situations may need 45 minutes or more.
Can I apply for Covered California outside of open enrollment?
Yes, if you have a qualifying life event such as losing job-based insurance, moving to California, getting married, or having a baby, you can apply during a Special Enrollment Period. You generally have 60 days from the qualifying event to apply.
What if I am undocumented?
Undocumented residents are not eligible for Covered California plans or premium tax credits. However, undocumented immigrants in California can apply for full-scope Medi-Cal if they meet income requirements. Children and pregnant individuals may qualify regardless of immigration status. Contact your county social services office or a local enrollment counselor for help.
What is the income limit to get help paying for Covered California?
For 2026, your household income must be at or below 400% of the FPL to qualify for federal premium tax credits. For a single person, that is approximately $88,180 per year. For a family of four, it is approximately $182,160. If your income is below 138% FPL, you will likely qualify for Medi-Cal instead.
Do I have to repay subsidies if my income changes?
Yes. Covered California subsidies are based on your estimated income for the year. At tax time, the IRS reconciles what was paid versus what you were actually entitled to. If your income was higher than estimated, you may owe some of the subsidy back. Report income changes to Covered California throughout the year to minimize surprises.
Can I keep my doctor with Covered California?
Each plan has a network of doctors and hospitals. Before enrolling, check whether your preferred providers are in-network for the plan you are considering. Covered California's website lets you search by plan and provider.
Is there a penalty for not having health insurance in California?
Yes. California has its own individual mandate. If you can afford health insurance but choose not to enroll, you may owe a state tax penalty when filing your California state taxes. The penalty is based on your household size and income.
What is a Special Enrollment Period qualifying event?
A qualifying event is a major life change that allows you to enroll outside of open enrollment. Common qualifying events include losing employer-sponsored insurance, turning 26, moving to California, getting married, having a baby, or losing Medi-Cal eligibility. You typically have 60 days from the event to apply.
How do cost-sharing reductions work?
Cost-sharing reductions (CSRs) lower your out-of-pocket costs when you use health care. They reduce deductibles, copays, and out-of-pocket maximums. To receive CSRs, your income must be between 138% and 250% FPL, and you must enroll in a Silver plan. The government pays the insurer directly for CSR benefits, so there is no separate application.
Where can I get free help applying?
Certified enrollment counselors and licensed agents across California offer free application help. You can find one near you through CoveredCA.com or by calling 1-800-300-1506. You can also use the BenefitsUSA screener to check your eligibility before speaking with anyone.
For a broader look at all the programs you may qualify for in California, visit our California benefits guide.
