Health Insurance FAQs

Yes, the penalty for each uninsured resident will be at least $900 per adult and $450 per dependent child under 18 in the household. A family of four that goes uninsured for the whole year would face a penalty of at least $2,700.

If you apply for health insurance through Covered California, you will still have the opportunity to apply and qualify for subsidies.

For 2026, Covered California’s Open Enrollment Period is from November 1, 2025, to January 31, 2026.

Individuals could only enroll in health insurance or switch plans during the Open Enrollment Period, which was only a few months of the year. After the enrollment period was over, if they did not qualify for special enrollment, individuals would no longer be able to apply for health insurance or make adjustments to their plans.

In 2026, premiums are rising 10.3% on average and benefits are shrinking. Silver Plans face the biggest impact, with higher deductibles and out-of-pocket limits.

Switching from a PPO to an HMO or downgrading your plan (Platinum → Gold → Silver) can help save costs. Opening a Traditional IRA may reduce your household income for health insurance, helping you qualify for more subsidies and better coverage.

For 2026, Covered California’s Open Enrollment Period is from November 1, 2025, to January 31, 2026.

if you are looking for a new plan effective on January 1st, 2026, you need to complete the application before December 31st, 2025.

If you are looking for a new plan effective on February 1st, 2026, you need to complete the application before January 31st, 2026.

For 2026, Covered California’s Open Enrollment Period is from November 1, 2025, to January 31, 2026. 

1. If you miss this open enrollment period, you will not be able to purchase health insurance unless you qualify for special enrollment, in which you would have to apply for health insurance within 60 days of your qualifying life event which include:

   1. A child is born, adopted or received into foster care; your child is placed into foster care or is up for adoption

   2. Loss of employer-sponsored coverage, or your COBRA coverage is exhausted (Note: Not paying your COBRA premium is not considered loss of coverage)

   3. Loss of Medi-Cal coverage

   4. Moved to California from out of state or moved within California and gained access to at least one new Covered California health insurance plan

Without an SSN, you cannot apply for most health insurance plans used by U.S. residents. Standard travel insurance often does not cover routine medical needs, and pre-existing conditions such as diabetes, high blood pressure, or pregnancy are frequently excluded. For seniors 65 and older, not having an SSN also means you cannot apply for federal Medicare.

But don’t worry! In this situation, you can contact KCAL Insurance, and we will help you find the best health insurance plan based on your needs and circumstances, ensuring reliable and comprehensive coverage so you can confidently handle all your healthcare challenges.
Call KCAL Insurance today.

Covered California and the IRS are connected in the sense where Covered California uses the household income and household size on the 1040 tax form to calculate health insurance premiums and check for eligible federal subsidies for the applicant. If you are a resident with a taxable income (citizen, green card holder, working visa holder, etc.), and your family income meets the requirement, you may qualify for subsidies and medical costs.  

Based on your annual household income, you may qualify for federal subsidies in the form of Medi-Cal, premium assistance, or cost-sharing reductions. To determine whether you qualify for premium assistance, please refer to this chart.

To find your adjusted gross income, take a look at Line 2A, 6A and 11 on Form 1040.

If you have your paycheck statement, rental income, interest income, or income from the EDD, you can use it as proof of income. If you do not have any valid documents, you can ask your accountant or employer to provide you with a signed proof of income statement.

If you have non-taxable social security benefit, income living abroad or non-exempt interest, you should include these as income to calculate the accurate MAGI amount.

*Please consult your CPA for further tax questions.

If you want to enroll for health insurance with subsidies during open enrollment, you cannot cancel your Medi-Cal coverage.

If you do not need subsidies, you can cancel your Medi-Cal coverage and purchase health insurance without subsidies during open enrollment.

You will need to provide proof of income to the county office where you reside to update your family income, and then you can apply for general health insurance.

PPO premiums continue to increase as it has done so in the past few years. If your health is in good condition and you do not expect to go to the doctor’s often, then you can consider switching to an HMO or EPO plan.

You can also open an IRA to reduce the taxable income so that when you apply for government subsidies you will have lower premiums and get better benefits.

If your doctor is not contracted with your current insurance company, then you can switch to an insurance company that your doctor is in contract with.

If your primary care physician only accepts group health insurance and you are self-employed, or a 1099 employer, feel free to contact KCAL to see what your options are.

Since the benefits would be the same, one way to help you choose the right insurance company is based on the quality of service and the size of the medical network.

If you want to be able to see a doctor easily and don’t want to delay treatment due to conflicts with your medical network, then Kaiser Permanente would be the best option. Its comprehensive medical system and latest medical equipment make it easy to see a doctor. 

If the company you work at offers you and your family group health insurance, you won’t be able to purchase insurance with government subsidies for you and your family. As long as the company-provided health insurance is considered affordable and meets certain standards, then maybe you qualify for subsidies of Family Glitch.

If you and your family are applying for subsidies when your company offers group health insurance to you and your family, then your subsidies will be returned to the government.

However, if the out-of-pocket amount you have to pay for the employer-sponsored plan’s premium (not including the premium your family pays), then you and your family can apply for government subsidies for health insurance after submitting necessary documentation.