California Health Insurance Exchange

Let Us Help You Find the Right Covered California Health Plan

Finding the right health insurance in the Golden State shouldn’t be a struggle. The health insurance marketplace in California, officially called Covered California, is a free, state-run program under the Affordable Care Act (ACA) where you can compare private health plans and unlock government subsidies to lower your monthly costs.

At Health for California, we want to help you understand how the California Health Benefit Exchange works so you can find an affordable, ACA-compliant plan.

State vs. Federal: How the California Health Insurance Exchange Works

While most states use the federal health insurance marketplace, HealthCare.gov, California created its own independent platform. If you live in the Golden State, you must use Covered California to qualify for financial assistance. The federal site is not available to Californians.

Who Should Use the California Insurance Exchange?

Covered California is the right choice if:

• You do not have any health insurance.
• You do not qualify for Medicare.
• You don’t get health benefits through your job.
• You do not get health insurance through your spouse’s employer.
• You’re looking for better or more affordable private plans than what you currently have.

Top Marketplace Plans and Health Insurance Carriers in California

There are numerous health plans to choose from on the Covered California insurance exchange. Two of the most common are HMOs and PPOs. Health Maintenance Organization plans (HMOs) allow you to have a primary care doctor but require referrals for any specialized care, while Preferred Provider Organization plans (PPOs) allow you to coordinate your care within their network of providers. The cost of your plan can depend on the size and flexibility of the network you choose.

Health plan rates may change each year due to factors like health care costs and regulations, but most Covered CA enrollees are shielded from large premium hikes. If you qualify, government subsidies and state funding can offset most of these increases. Some individuals and families may be eligible for Medi-Cal, California’s Medicaid program.

As you browse health plans on Health for California, some of the most popular carriers include:

• Kaiser Permanente: Ideal if you want convenience, coordinated care, and don’t mind getting most treatment within the Kaiser network.
• Blue Shield of California: Offers a broad selection of PPO and HMO plans statewide, including for those living in rural areas.
• Health Net: Provides a range of affordable plan options, especially focused on families and budget-friendly HMOs.
• Molina Healthcare: Specializes in affordable HMO plans in select regions, particularly valued for Medi-Cal and lower-cost coverage.

You can view more Covered California insurance carriers to compare rates, networks and special features directly.

Understanding Covered California Metal Tiers

Every plan through the California Health Benefit Exchange covers the same set of essential health benefits. The main difference is how you and your insurance company split the costs. These cost-splitting plans are categorized into metal tiers:

• Bronze: Lowest monthly premium. You’ll receive 60% coverage and pay 40% out of pocket.
• Silver: Best value — required for extra cost-sharing reductions (CSRs). You’ll receive 70% coverage and pay 30% out of pocket.
• Gold: You’ll receive 80% coverage and pay 20% out of pocket
• Platinum: Highest premium, lowest out-of-pocket costs. You’ll receive 90% coverage and pay 10% out of pocket.

Qualifying for Financial Assistance and Subsidies

Covered California and Medi-Cal use your household size and yearly income, measured by the Federal Poverty Level (FPL), to help you afford your health plan in several ways:

• Premium tax credits: If your family’s income is between 138% and 400% of the FPL, you qualify for federal premium tax credits, also called subsidies. These directly lower your monthly cost on most ACA plans.
• Enhanced Silver plans and CSRs: If your income falls between 138% and 250% of the FPL and you choose a Silver plan, you can unlock extra discounts on co-pays, deductibles and your maximum out-of-pocket costs. These additional savings are called cost-sharing reductions (CSRs) available through Enhanced Silver plans.
• Medi-Cal: If your income is at or below 138% of the FPL, you qualify for Medi-Cal, which is California’s free or very low-cost health insurance program. When you apply through Health for California, we can automatically check if you or your family members qualify for Medi-Cal and help you enroll.

What You Need to Get Started

If you want to apply for a plan or subsidy through the California Health Benefit Exchange, have these ready:

• Estimated household income for this year
• Social Security numbers for all applicants
• Immigration or citizenship information, if applicable

Compare Exchange Plans With Health for California

With almost 2 million Californians enrolling in coverage over the last two years, Covered California remains a trusted pathway to health care.

If you want to see your plan options, compare prices and unlock your exact state and federal subsidies all in one place, Health for California can help you every step of the way. Get your free quote and discover your top coverage options in just 30 seconds.