Find Affordable Health Care Suited for You

You qualify for a special enrollment period 60 days following certain life events including:

• Legal separation or divorce
• Marriage or domestic partnership
• Cessation of dependent status (attaining the maximum age to be eligible as a dependent child)
• Birth, adoption, or placement for adoption
• Loss of coverage due to termination of employment or reduction in the number of hours of employment
• Relocating to California
• Returning from military active duty
• Release from incarceration

Whether you buy health insurance through Covered California or through a private insurance market, it fulfills the ACA’s health insurance requirement. If you are within 138% and 600% of the federal poverty line, you might qualify for federal subsidies and can therefore apply through Covered California. If you do not want to provide tax return information or proof of income, you can choose to purchase off-exchange health insurance.

Below is a comparison between Covered California and off-exchange insurance:

Currently 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.

Here are the main differences among the three plans:

When choosing a health plan, take into consideration you and your family’s needs. If you have a primary care physician you want to see, make sure your primary care physician is in that network.

Unless you qualify for special enrollment, you can only purchase health insurance during the Open Enrollment Period, which occurs only once a year.

The 2026 Open Enrollment period starts on November 1, 2025 and ends on January 31, 2026.

Yes, effective 2020, the U.S. health care law has mandated that people under 65 years of age are required to purchase health insurance or they would have to pay a penalty. If you live in California and you are not insured in health insurance provided by the government or insured under group health insurance provided by your employer, you may purchase health insurance through Covered California or purchase off-exchange health insurance.

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.

Based on your annual household income, you may qualify for federal subsidies in the form of Medi-Cal, premium assistance, or cost-sharing reductions.

As long as you are a resident with a taxable income (citizen, green card holder, working visa holder, etc.), you are required to have health insurance whether it’s through your employer, Covered California, etc. If you do not, you will be penalized and fined. To determine whether you qualify for premium assistance, please refer to the chart below:

Plans through Covered California are divided into tiers—bronze, silver, gold, platinum, and more. The higher the tier, the more expensive the premium. Everyone’s medical needs and income levels are different so you can choose the plan that best meets you and your family’s medical needs!

• Ambulatory patient services
• Emergency services
• Hospitalization
• Maternity and newborn care
• Mental health and substance use disorder services, including behavioral health treatment
• Prescription Drugs
• Rehabilitative and habilitative services and devices
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services, including dental and vision care

Please feel free to contact us at KCAL we’d be more than happy to help you enroll or switch insurance plans for 2026! Chat with an agent now!