Margaret Huntley Last Updated On: August 9, 2023

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How to Find the Best Health Care Insurance in California

California is a state with endless opportunities. There isn’t another state quite like Cali, with its surfing culture, gorgeous coastal weather, Hollywood dreams, and just about everything else you can think of, from professional sports teams to DisneyLand! The only problem with having so many things to get out there and experience is having sufficient healthcare insurance in California to protect your health as you do your thing—whatever that may be!

So if you’re ready to break free from your parent’s health insurance plan, or you’re prepared to switch your coverage to a plan that better fits your needs, then read on, and we’ll explain everything you need to know about California health insurance.

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Health Insurance Options in California

There is no one-size-fits-all health insurance policy. Fortunately for California residents, you have various health insurance options that suit every budget, from government-funded Medi-Cal to health insurance offered through private insurance. Once you understand the different types of health insurance, it’s relatively easy to discover which policy suits you.

Medi-Cal

Suppose health insurance is just out of reach for you and your family. In that case, you should consider applying for Medi-Cal—a government-subsidized health insurance program for Americans living below the federal poverty line. Although Medicaid differs by state, California’s health insurance program is called Medi-Cal, and it provides low-cost or no-cost health insurance for qualifying applicants.

To qualify for California’s Medi-Cal subsidized health insurance plan, here are the conditions:

- You must be living 138% below the poverty line
- You may qualify if you meet any of these criteria:
  - Over 65
  - Disabled
  - Blind
  - Under 21
  - Are pregnant
  - Are in a nursing home
  - You have refugee status
  - Are screens for breast/cervical cancer
  - Parents/caregiver of an eligible child

You may also qualify for Medi-Cal if you’re in these programs:

- - - Refugee Assistance
    - Foster Care or Adoption Assistance Program
    - CalWorks (AFDC)
    - CalFresh
    - SSI/SSP

If you’re interested in enrolling in the Medi-Cal health insurance program, there are many ways to apply, including:

Mail: Get an application (single streamlined application) in English or other languages and send it in. Check out Medi-Cal’s website for more details about where to mail it!
In Person: If you want to apply in person, head to your local county office.
Online: Go to the Medi-Cal website and apply with a few clicks of the mouse!

Medi-Cal covers all essential health benefits, such as:

Outpatient services, like seeing your primary care provider
Inpatient services, like hospitalization
Emergency services
Pregnancy or post-natal care
Mental health care
Substance use disorder care
Prescription medication
Laboratory services, like bloodwork
Rehabilitative and habilitative services, like physiotherapy
Wellness and preventative care
Chronic disease care
Pediatric services
In-home or long-term care

Medi-Cal is a great option for those who otherwise couldn’t afford health insurance and allows them to get the care they need.

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Covered California

California offers low-income health insurance to individuals living 138% below the federal poverty line and another subsidized plan for those that don’t qualify for Medi-Cal, called Covered California. Covered California is premium assistance offered through the state’s health insurance marketplace. To qualify, your individual or family income must be within the range of 0-400% of the federal poverty line.

Medicare

For those approaching their 65th birthday or for qualifying individuals, there is Medicare. Medicare is sold in units referred to as parts. If you qualify for Medicare, you can elect to buy an Original Medicare plan that bundles Part A and Part B, or you can purchase Medicare Advantage (Part C) that’s sold through private insurance that bundles Part A, Part B, and supplemental coverage (e.g., Part D).

Part A: Plan A covers hospital visits. Hospital visits are free unless you’re new to Medicare.
Part B: Part B covers medical services such as visiting your primary care provider.
Part C: Part C or “Medicare Advantage” bundles Part A, Part B and supplemental coverage, like dental, eye care, or prescription medication. Medicare Advantage is a popular choice, only offered through independent insurance companies.
Part D: Part D is optional coverage for prescription medication.

Everyone that turns 65 automatically qualifies for Medicare and you can be fined if you don’t enroll on time, unless you have health insurance from another source, like your employer.

COBRA Health Insurance

If you’ve got health insurance through your employer and suddenly lose your job—which means no health insurance—you have a 60-day window to sign up for COBRA if you haven’t already sourced new coverage.

Employer-sponsored health insurance means you and your employer both pay into the cost of your premiums, but with COBRA, there is no cost-sharing; you pay the full freight. Unfortunately, this coverage is often costly; on average, it’s more than $600 a month. You’d be better off turning to Covered California or exploring private health insurance choices if you’re going to pay that much for COBRA.

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Student Health Insurance

College students have a variety of health insurance options available to them. They can take out health insurance through Covered California or any of these other options:

Remaining on Your Parent’s Health Insurance: You don’t need to take out health insurance if your parents have good coverage. However, if you’re over 26, you’ll need to get your own plan.
Student Health Plans: For full-time students, especially those studying out of state and between the ages of 17-29, you can find affordable health insurance through the marketplace. Premiums are paid annually or semiannually.
School-Sponsored Plans: Another option to get health insurance coverage is through your college. However, if you may transfer schools or are part-time, you should not consider this coverage.

Being in school can stretch any budget as is, so finding affordable health insurance is key.

Individual Health Insurance

If you’re interested in getting private health insurance, it’s easy to pick the plan that best serves your needs as it’s offered in metallic tiers—bronze, silver, gold, or platinum. Each tier covers the 10 essential health care benefits under the Affordable Care Act (ACA).

Here’s what each of the metallic tiers offers:

Bronze: Bronze is the most affordable plan. With bronze health insurance, you’ll get these features:
- Insurance pays 60% of your medical expenses while you cover 40% out of pocket
- Low monthly premiums
- High deductibles
- Bronze coverage is excellent for healthy individuals that don’t require routine medical care
Silver: Silver policies are one of the most popular health insurances on the state exchange offering mid-level protection. Silver plans are a popular choice because they’re eligible for premium tax credits, which decrease the cost of your health insurance premiums.
- Insurance pays 70% of your medical expenses while you cover 30% out of pocket—this figure can change if you’re using tax credits
- Moderate monthly premiums
- Lower deductibles than bronze plans
- For more affordable rates, eligible applicants can apply for low-income subsidies or “cost-sharing” with silver plans
Gold: Gold health insurance plans are ideal for policyholders that require routine medical treatment, as the higher monthly premiums result in lower deductibles and net expenses.
- Insurance pays 80% of your medical expenses while you cover 20% out of pocket
- Higher monthly premiums
- Lower deductible amounts
- Lower out of pocket amount
Platinum: Platinum health insurance in California may not be the most affordable plan. However, it is perfect for policyholders with chronic conditions or that need frequent medical attention, as it has high premiums but the lowest out of pocket amount.
- Insurance pays 90% of your medical expenses while you cover 10% out of pocket
- Highest monthly premiums
- Lowest deductible amounts
- Lowest out of pocket amounts

If any of these tiers stand out and you’re curious about how much it’ll cost you, get access to free, no-risk quotes here.

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When Is Open Enrollment?

Open enrollment is the time of year when you shop or make changes to your health insurance.

For Californians, open enrollment runs from November 1—January 15. If you miss this deadline, you’ll have to wait until next year, or you might be able to change your plan if you’ve had a qualifying life event, like a job change or marriage.

How Much Is Private Health Insurance in California?

The average cost of a silver health insurance plan in California for a 40 year old man is around $550—this figure has risen by 1% since 2022.

Affordable health insurance in California depends on the metallic tier you buy. Here’s a detailed cost breakdown of how much you can expect to pay for health insurance by tier and age.

Metallic Tier	Cost For A 21 Year Old	Cost For A 40 Year Old
Bronze	$370	$470
Silver	$425	$550
Gold	$500	$635
Platinum	$650	$830

Your best bet? Shop around until you find a plan that fits your budget and your needs.

Does California Offer Short-Term Health Insurance?

Because short-term health insurance doesn’t cover all essential health benefits, in 2018, the Senate passed Bill 910 outlawing the sale of short-term coverage. Thus, you won’t be able to take out a short-term health insurance plan in California.

How Health Insurance Premiums Are Calculated

In California, there’s never an excuse to be bored as there are endless things you can see and do, like visiting DisneyLand, the ocean, or walking in a public park—we all like different things! Insurance companies also function differently than others; this actually works in your favor as every provider uses different factors and algorithms to calculate your premiums. Your health insurance rates are calculated using these factors:

Factors such as age that every insurer uses to set premiums.
The state’s health insurance regulations.
The plan you choose.
Your unique factors, e.g., where you live.
How many people you’re insuring.

Because plans use different factors to calculate costs, you can easily find a great deal just by shopping around.

Final Thoughts on Finding Health Insurance in California

Suppose you’re lucky enough to call California home, like over 39 million other Americans. In that case, you know the state doesn’t just have beautiful views along the Pacific Coast Highway, but it also offers many health insurance choices! Health insurance in California is affordable and gives you peace of mind that no matter what happens when you’re out exploring the state, you’ll have medical coverage.

To help you find the best health care insurance in California, here’s what you need to ask yourself:

Budget: How much do you make annually, and how much can you afford to spend on premiums? If you make below or just above the federal poverty, consider Medi-Cal or Covered California, whereas if you can afford to pick your policy, try private health insurance.
Individual vs. family: Are you paying for individual or group coverage? Individual coverage will always be cheaper than paying for a family.
Age: If you’re 17-29, you can try a student plan, or over 65, then try Medicare.
Medical History: When you’re trying to figure out how much coverage you need, ask yourself if you or any household member need routine medical care? If so, then a platinum private health insurance plan is ideal.

Once you know what type and kind of California health insurance you want, never settle on your first quote; always shop around! Every insurer uses different calculations to set your rates, so it pays to compare quotes.

If you want to start discovering the best health insurance coverage in California, get access to free quotes fast just by clicking here.

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Margaret Huntley Margaret Huntley is a creative writing and philosophy student at Western University. She has been working as a freelance writer for over two years and has written about everything from insurance, to poker, to health and wellness for international businesses.