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Summary of article:
After California’s universal insurance is opened to the public, people who meet income requirements can enjoy zero premium or low deductible medical insurance, and state subsidies will also be expanded, but it will still not be able to fully make up the gap of the closing federal subsidies.
「California The open period for Covered California insurance officially begins November 1. Although some policyholderspremium price Subsidies will be cancelled, and “zero premium” plans will still be available to those eligible. Some low-income families can also choose medical insurance plans with better benefits, with a minimum deductible of 5 yuan for family doctor visits, 8 yuan for specialist outpatient visits, and zero yuan for drug deductibles.
huaxingInsurance Individual health insurance manager Jasmine Hung announced that California’s state-level premium subsidy budget for 2027 will be increased by 300 million yuan, and the subsidy income eligibility threshold will be raised from 165% to 200% of the federal poverty level (FPL). Policyholders whose family income does not exceed 150% of the poverty line can choose the silver-level plan with a monthly premium of zero yuan. As for specific optional plans and actual premiums, they still need to be confirmed based on the policy holder’s eligibility and the area they live in.
Covered California estimates that more than 500,000 California residents will receive state subsidies in 2027. The new subsidy eligibility will allow 200,000 originally ineligible residents to receive subsidies and help 90,000 people avoid losing health insurance. However, the increase in state subsidies is still not enough to fully fill the gap left by the expiration of the federal Enhanced Premium Tax Credit (EPTC).
Jasmine said that when people look at the income statement, they can first confirm how many people there are in the family, and then see what range the family’s total annual income falls in. After meeting the income requirements, you will also need to confirm which health plan you can choose based on your individual eligibility. Taking a one-person family as an example, people with an annual income of 22,026 to 23,940 yuan fall into the income range of the Silver 94 plan; People with an annual income of 23,941 to 31,920 yuan fall into the Silver 87 income range.
For a family of two, the annual income is NT$29,865 to NT$32,460, which falls into the Silver 94 income range; An annual income of NT$32,461 to NT$43,280 falls within the Silver 87 income range. For a family of three, the annual income is 37,703 yuan to 40,980 yuan, which falls into the income range of Silver 94; The annual income of 40,981 yuan to 54,640 yuan is Silver 87. The above amounts are converted based on the ratio of income to the federal poverty line for reference in understanding the income limits for different family sizes. However, these limitations do not mean that people who meet the income requirements will definitely be able to receive the specified plan, and actual eligibility must still be reviewed and confirmed by Covered California.
Jasmine said that it is also important which plan you choose after meeting your income requirements. Taking the Silver 94 plan as an example, the deductible amount for visiting a family doctor is 5 yuan, the deductible amount for visiting a specialist is 8 yuan, and the deductible amount for medicine is 0 yuan. In the Silver 87 plan, the lump sum deduction is 15 yuan for family doctors and 30 yuan for specialists. For the Silver 70 plan, the lump sum deductible is $50 for family doctors and $100 for specialists.
Different plans have different medical deductibles. People should select the appropriate plan based on their eligibility, medical needs and budget. Jasmine reminded that people should not only look at whether the plan has “zero premium”, but also consider the frequency of their general medical visits, whether they need specialist diagnosis and treatment, and other expenses of the plan. Even though the monthly premium may be the same, the actual cost of seeing a doctor may vary.
It is reported that existing policyholders with California coverage can renew or change their plans starting October 1, and the open enrollment period in 2027 will be from November 1 to January 31, 2027. People can visit the official Covered California website (
Summary FAQ
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Policyholders whose household income does not exceed 150% of the federal poverty line can choose a Silver-level plan with a monthly premium of $0; As far as the actual options available, they must still be reviewed and confirmed by Covered California based on individual eligibility and the area in which they are located.
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The Silver 94 plan has better benefits. The lump sum deductible amount for family doctors is 5 yuan, for specialist outpatient service is 8 yuan, and the drug deductible amount is 0 yuan. It is suitable for people who visit doctors more frequently or who need more medicine.
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The state-level premium subsidy budget will be increased to 300 million yuan in 2027, and the income eligibility threshold will be increased from 165% to 200% of the FPL. It is estimated that more than 500,000 people could benefit, but this is still not enough to fully fill the gap left by the end of federal subsidies.
