Covered California
Income Limits
Covered California Income Limits
- View Covered California Income Guidelines and See Chart to Calculate Your Health Care Options
- Obamacare Income Guidelines Chart Based on the Federal Poverty Level
- Government Programs and Assistance Based on Income Ranges
- Health Insurance Income Limits During Pregnancy
- Income Limits for Medi-Cal for Families With Children
- How to Provide Proof of Income
- Get a Quote for Covered California Health Insurance
View Covered California Income Guidelines and See Chart to Calculate Your Health Care Options
The Covered California income limits require consumers to have a household income that ranges from 0% to 400% of the Federal Poverty Level (FPL) in order to qualify for assistance on a government health insurance plan.
Based on your household income, you may qualify for up-front tax credits when you enroll in health insurance in California through the Covered California Health Exchange. Be aware that free health insurance plans will be available starting in 2022.
Obamacare Income Guidelines Chart Based on the Federal Poverty Level
According to Covered California income guidelines and salary restrictions, if an individual makes less than $47,520 per year or if a family of four earns wages less than $97,200 per year, then they qualify for government assistance based on their income. If the family has a lower household net income, then a greater amount of government assistance is available to the family. Tax deductions can lower your income level. View the Covered California income limits chart below.
Government Programs and Assistance Based on Income Ranges
For adults, the following Covered California income restrictions apply:
- 0% – 138% of FPL: You qualify for Medi-Cal.
- > 138% – 400% of FPL: You qualify for a subsidy on a Covered California plan.
- > 138% to 150%: You also qualify for the Silver Enhanced 94 Plan.
- > 150% to 200%: You also qualify for the Silver Enhanced 87 Plan.
- > 200% to 250%: You qualify for the Silver Enhanced 73 Plan.
Health Insurance Income Limits During Pregnancy
Under the Affordable Care Act, all marketplace and Medicaid plans need to provide coverage for pregnancy and childbirth. You qualify for pregnancy coverage even if you’re already pregnant when you apply for coverage. It’s important to have health coverage when you’re planning on having a baby for the following reasons:
Health maintenance organization (HMO): HMOs provide low out-of-pocket costs with a limited choice of providers and out-of-network coverage only in emergencies. These plans revolve around seeing a primary care doctor who can make specialist referrals.
It makes the delivery affordable: The U.S. is known for having one of the highest costs for delivery and maternity care globally. While you might have to pay something out-of-pocket, depending on your income and healthcare coverage, having insurance cuts the cost of delivery considerably.
It gives you access to emergency care: Everyone wants a healthy pregnancy, but complications can occur. Getting immediate access to emergency treatment and care can help save you and the baby.
Since having health coverage and getting access to healthcare is critical during pregnancy, the income requirements for pregnant people are slightly different than those for people who aren’t currently expecting a baby. Here’s what you might qualify for, depending on your income level:
Medi-Cal: If your earnings fall between 138% and 213% of the poverty level, you may qualify for modified adjusted gross income (MAGI) Medi-Cal during your pregnancy.
Medi-Cal Access Program (MCAP): The Covered California income limits for MCAP are between 213% and 322% of the poverty level. MCAP charges a small fee and provides comprehensive coverage for pregnant individuals.
When you apply for Medi-Cal while pregnant, your eligibility is presumed while your application is reviewed. That means you can take advantage of immediate coverage, ensuring you and your baby get the care you need.
Income Limits for Medi-Cal for Families With Children
Adults qualify for Medi-Cal with a household income of less than 138% of FPL. However, according to the Covered California income guide, children who enroll on Obama Care California plans may qualify for Medi-Cal when the family has a household income of 266% or less. The children must be under 19 years of age to qualify. Also, C-CHIP, the County Children’s Health Initiative Program, offers health care coverage for children when the family income is greater than 266% and up to 322% of FPL.
How to Provide Proof of Income
Acceptable proof can include:
- A pay stub
- A bank statement
- Your W-2
- A tax return
Reporting Mid-Year Changes in Household Earnings
If your income increases during the year, this may affect what levels of subsidies you qualify for according to Covered California income limits. It also may affect whether or not you, your spouse or your children qualify for certain government assistance programs. If you have a significant income change mid-year, you may be required to report that to Covered California or to Medi-Cal.
Get a Quote for Covered California Health Insurance
If you need health insurance or help affording health coverage, you might qualify for Medi-Cal or a subsidy. Health for California can help you determine whether you qualify for a subsidized or Medi-Cal plan based on your income and current situation. Get a quote today.
