Eligibility for Obamacare in California

California residents wondering, “What are the requirements to apply for the Affordable Care Act (ACA) health insurance?” should learn about the factors pertaining to eligibility. Finding out how to qualify for ACA subsidies is also beneficial for those who have low incomes. Obamacare coverage eligibility requirements for enrolling in health insurance plans considers milestones to initiate periods outside of standard open enrollment times. It is important for California residents to be aware that Obamacare is not a form of health insurance, but rather legislation designed to regulate private health insurance and increase the protections, rights and benefits of consumers. Discover who is eligible for Obamacare health insurance plans by clicking here for our comprehensive California guide.

Enrollment Requirements of ACA in California

Obamacare coverage requires all residents to have a health care insurance plan. Those who are eligible for Obamacare plans but opt out of coverage are subject to pay a penalty for the periods they are not covered, known as “shared responsibility payment.” Residents must also apply for Obamacare during open enrollment periods, which typically start in November and end in January of the covered year. However, there are certain situations that can allow petitioners to enroll in coverage outside of this timeframe. These are called “qualifying life events.”

You may qualify for ACA enrollment if you recently lost your previously existing health plan. This includes individual plans, student plans and plans obtained through an employer. You may also be eligible if you recently lost your coverage under Medi-Cal, CHIP or Medicare or if you just turned 26 years of age and your parent’s plan no longer covers you.

You may meet Obamacare coverage eligibility requirements if there is a change in your family. This includes if you are about to get married or divorced, having a baby or preparing to adopt a child or if a family member recently died. You may be eligible to enroll in Obamacare plans if you are about to move to a new zip code or if you are moving out of a shelter into another form of transitional housing. You may also qualify if you are a student moving away from home to attend school or moving back home from school. If you are a seasonal worker and you are moving to or from the place you live and work, you may be able to apply for health coverage under the ACA.

There are other recent changes that can help you apply for the Affordable Care Act such as becoming a U.S. citizen and acquiring membership to a federally recognized tribe. Other changes include an adjustment of your income, leaving incarceration and beginning or ending a career with AmeriCorps. Find out more about other circumstances that create special enrollment periods for health insurance applicants in California within our in-depth guide.

Who is eligible for Obamacare in California?

To be eligible for ACA enrollment in insurance plans through Covered California, petitioners must be U.S. citizens, U.S. nationals, lawful residents (temporary or permanent) and immigrants with work or student visas. You are not eligible for Obamacare if your employer or a family member’s employer offers affordable coverage. You cannot apply for Obamacare plan if you qualify for Medicaid, Medicare or another government subsidy program.

Residents who qualify for Obamacare plans or insurance through an employer but refuse coverage will pay a penalty unless they are exempt. If you are eligible for ACA exemptions, you will not have to pay the fee. For instance, you do not need to qualify for ACA if you are suffering from financial hardship, your income does not meet tax filing requirements or the lowest price of available health coverage would cost you more than a certain percentage of the household income. You also do not need to qualify for ACA if you obtain services from an Indian Health Services provider or are a member of a federally recognized tribe. Likewise, if you are a member of a health care sharing ministry or a religious group with religious objections to health insurance. You are exempt from applying for ACA health coverage if you are serving a term in jail or prison, or you are living overseas.

You also do not need to worry about Obamacare coverage requirements if you were uninsured for less than two consecutive months in any 12 month period. Find out more about the shared responsibility payment in our detailed California guide, downloadable here.

What are the Affordable Care Act income requirements in California?

You qualify for ACA insurance plans if your household has an income between zero and 400 percent of the federal poverty level (FPL). The specific amounts of income for ACA vary based on the size of the family. By means of example, the Affordable Care Act income requirements for an individual must be less than $47,520 whereas a family of four cannot have household earning higher than $97,200. With the initial Obamacare income requirements, ACA subsidies were determined by the total about of wages earned, with lower income household receiving more upfront assistance. When petitioners are eligible for ACA subsidies for insurance plans through Covered California, they will be notified of the health plan costs before enrolling.

Discover more about ACA subsidies and eligibility requirements in our California guide.


What Are the Available Health Services in California?

Low-cost, and even free health benefits are available to a large number of California residents, with some being offered to low-income applicants and others being offered to elderly or disabled individuals. However, before you can access these health services, you need to submit the appropriate application and prove that you meet the necessary qualifications. To learn all about the different health benefits you can receive in California and the application procedures that you must undergo to obtain these benefits, download our free comprehensive guide.


Who Is Eligible to Obtain California Health Benefits?

California’s health programs have various eligibility requirements that applicants must meet in order to successfully enroll. Income, age and other factors are all taken into consideration in the eligibility verification process. Find out which health benefits you qualify for here.