Free Health Insurance in California in 2023

Typically, individual health insurance coverage in California will cost you between $160 and $800 per month and the cost will depend on age, gender, location, policy type, enrollment period, number of insured family members on the policy, etc. But if you qualify through low income, you can get free or significantly discounted healthcare services for yourself and for your children.

Over 30 percent of California residents receive free or low-cost health insurance and dental care from the two main programs offered in the state: Medical and CHIP:

• Medi-Cal is California’s version of Medicaid services, which provides 90% of free health care in the state,
• Children’s Health Insurance Program (CHIP) - a program that provides coverage for children, and has an expanded Medicaid participation eligibility - provides around 10% of free health care in the state.

Residents who may not qualify for Medicaid coverage to get completely free health insurance, typically qualify for other affordable health insurance options through subsidies and discounts. In California, you can get comprehensive coverage using subsidies, starting as low as $10 per month from private insurance companies that offer health marketplace coverage.

An estimated 7 percent (≈3 million) of California’s residents do not have health insurance at all. If all of them applied for individual health coverage, a third would qualify for free or low-cost health insurance.

Most people who enroll for financial aid in California - receive it, especially if they earn less than 400% of the year’s Federal Poverty Level, which qualifies them for Advanced Premium Tax Credit cost sharing reductions. FPL is set at the federal government level (see “Who Qualifies for Free Healthcare” section below).

Does California Offer Free Health Insurance?

Yes, California offers free health insurance through Medi-Cal, which gives low-income earners and their children access to health services and dental care. Federal and state revenues help to fund Medi-Cal. The Medi-cal program eligibility is determined by taxable income and is based on modified adjusted gross income. The Federal Poverty Level (FPL) is used by Medi-Cal as its income cutoff.

You can qualify for Medi-cal if you are a California resident with an annual household income of 138% of the Federal Poverty Level (FPL) or less. This number changes every year. (see “Who Qualifies for Free Healthcare” section below).

In some situations you can also get Medi-Cal coverage if you are:

1. Pregnant
2. Under 21 years of age
3. Disabled
4. Older than 65
5. In an intermediate care home
6. A caretaker relative of an age-eligible child

You can also qualify for Medi-Cal if you are in the following California social services programs:

1. Refugee assistance program
2. Adoption assistance program (AAP)
3. Supplemental Security Income / State Supplementary Payment (SSI/SSP)

California has expanded its Medicaid program to cover people below certain income levels. Medicaid and Children’s Health Insurance Program (CHIP) offer free or inexpensive health care. Children’s Health Insurance Program offers health insurance for kids so they may receive regular checkups, vaccinations, and dental treatment to stay healthy.

How To Get Free Health Insurance in California?

You can get free health insurance in California through Medi-Cal and through the children’s program - CHIP. Children and adults with low household income can participate in these programs and have various medical services paid for. To qualify for free health care in California, in 2023 you had to earn $20,120 per year or less as a single individual and $34,307 or less for a family of three.

Medi-Cal Application

Application for Medi-cal is available year-round for qualified enrollees and in some cases can start immediately. If you need health insurance coverage and the hospital staff determines that you may qualify for free health insurance under the Presumptive eligibility, a participating California hospital may help initiate the application for you.

Otherwise, Medi-cal application is done through Covered California health insurance marketplace during the open enrollment period (typically between 1 November and 31 January), or year round - as a Special Enrollment Period (SEP), through:

• BenefitsCal - a portal where Californians can get and manage benefits online,

• Mail - send a filled out and printed paper application by mail to:

  Covered California

  P.O. Box 989725

  West Sacramento, CA 95798-9725

• By phone,

• In person at a local county enrollment center with the help of a certified enroller.

Note: Although most of the county facilities are not open for in-person assistance, they are available to provide enrollment support by request and over the phone.

Medi-Cal Eligibility Determination

After filling out the application form, your local enrollment office will reach out to you with an eligibility decision letter (Notice of Action), where it will outline whether you fall under Medi-Cal or Covered California health care insurance plans.

9 out of 10 people who enroll or sign up for individual coverage through Covered California - receive financial help.

To apply for Medi-cal, you would need the following information and documents:

• Names, dates of birth, and Social security numbers of all family members
• Proof of immigration or citizenship status
• Employer and income information

Disability-based applications may take up to 90 days to be processed, while a regular application may take up to 45 days.

If your Medi-cal application is denied, you can file an appeal and receive a decision within 30 days. If the results of the appeal are not satisfactory, you can ask for a State Fair Hearing, where a judge will review your case.

To learn more about Medi-Cal eligibility decisions, call, or write:

California Department of Social Services

P.O. Box 944243

Sacramento, CA 94244-2430

Who Qualifies For Free Healthcare in California?

While Medicaid eligibility varies, typically, you can qualify for free medical care in California based on:

• your own or your parent’s income,
• if you are pregnant and on low-income, or
• if you have certain types of cancer.

If you earn less than 138% of the federal poverty level, you can qualify for a program which can be completely free or will have very limited required out-of-pocket expenses.

The FPL is adjusted every year, so the qualifying amount of income changes every year with it:

Additionally, you can qualify for free Medi-cal health insurance plan in California through:

• Hospital Presumptive Eligibility (HPE) - if you come to a participating California hospital, and the hospital staff assesses your Medicaid eligibility and decides that you are likely qualified, you will receive free treatment. The HPE coverage period ends when the state makes the determination on whether to allow you into Medi-Cal on a full-time basis.

  Between 2020 and 2022, every month an average of over 24 thousand Californians qualified for free health insurance coverage through HPE.

• Child Health and Disability Prevention Program (CHDP) - which gives access to free scheduled and periodic health services to all California residents under the age of 21. If qualified based on income, these children can also get access to the full Medicaid coverage for free.

  An average of 21 thousand California’s children qualify for CHPD every month.

  Note: If the pregnant individual is not enrolled in Medi-Cal, they may choose to get comprehensive health insurance coverage under Medi-Cal Access Program (MCAP), where the cost of coverage is 1.5% of their Modified Adjusted Gross income (MAGI).

• Presumptive Eligibility for Pregnant Women (PE4PW) - is a program that allows low-income pregnant women to get immediate free health insurance coverage for pregnancy-related services, while the application for Medi-Cal is being processed. While pregnant, you can qualify for Medi-cal if you earn 213% of FPL or less ($31,055 in 2023).

  An average of over 6 thousand California pregnancies every month are covered by free health insurance plan through PE4PW Medi-cal.

• Breast and Cervical Cancer Treatment Program (BCCTP) - provides health insurance access to low-income California residents who have been diagnosed with breast and/or cervical cancer, whose income is below the 200% of the Federal Poverty Level (multiply the FPL in the table above by 2).

You can check your eligibility for free health insurance by speaking with a knowledgeable health insurance agent and checking the Covered California marketplace.

What Is the Maximum Income to Qualify for Free Health Care in California?

You need to earn less than 138% of the poverty level to qualify for free health insurance coverage in California, unless you are pregnant, in which case the amount is 213% of FPL or less.

In 2023, the maximum income allowed to qualify for free health insurance plan based on the household size was:

• One person: $20,121
• Two people: $27,214
• Three people: $34,307
• Four people: $​​41,400
• Five people: $48,494

Add $7,094 to the income limit for every person in a household above 5 people.

If pregnant, the maximum income to qualify for free health insurance is 213% of tax dependent household’s FPL:

• One person: $31,055
• Two people: $42,003
• Three people: $52,951
• Four people: $​​63,900
• Five people: $74,848

Add $10,948 to the income limit for every person in a household above 5 people.

Can I Apply For Medi-Cal If I Have A Job Based Plan?

If you have a private health insurance plan through your employer, you can still qualify and apply for Medi-Cal. If your annual income is less than 138% of the federal poverty line (FPL), Medi-Cal coverage can supplement your existing job based plan (see “Who Qualifies for Free Healthcare” section above).

Once Medi-Cal coverage is obtained, when you need to use your health insurance, your medical provider will first submit a claim to your job-based private insurance company, after which Medi-Cal will cover any remaining excess costs.

Is Medi-Cal Always Free?

Medi-Cal is always free only for Californians who earn below the 138% of the federal poverty level (see the table above). Medi-Cal users who meet this requirement do not have to pay premiums, co-payments, and other out of pocket costs. Their Medi-cal is free.

If you earn more than $20,120 per year, you may have to pay a small premium for coverage - typically under $40 per month.

Is California Giving Free Health Care to Immigrants?

Immigrants who are lawfully present in the state can have access to cost-effective, high-quality health care coverage through the Covered California marketplace. Depending on their income, immigrants might also be qualified for Medi-Cal, which offers no-cost coverage or receive help paying for a Covered California health plan using subsidies given if you earn less than 400% of the Federal Poverty Line.

While undocumented immigrants cannot purchase Covered California health plans, they can still apply through Covered California to check if they qualify for Medi-Cal low or no-cost coverage. For families with mixed immigration statuses (those with both legally and illegally present members), the members who are not legally present may apply to Covered California for health insurance coverage for the legally present family members.

Free Health Insurance for Immigrant Children in California

Children’s Health Insurance Program provides free or low cost insurance for children in working families, including families with a variety of immigration statuses. A child under 19 years old can get full free health insurance benefits in California regardless of immigration status - as long as the income criteria are met. Speak with a state-licensed health insurance agent for more details.

What Happens If You Don’t Have Health Insurance in California?

If you do not have health insurance for yourself or your family in California, you will have to pay fines to the state, and if a medical emergency occurs - you are liable for all the incurred costs out-of-pocket.

• The average cost of a primary care appointment without insurance in California is around $200, a broken leg or arm can cost over $5,000 to fix, while hospital stay can be $10,000 per day and more.
• In 2023, the penalty for not having coverage was $850 per adult, and $425 per child under 18 years old - $2,125 for a family of three. The penalty is paid as part of the state income tax return. (see California Franchise Tax Board’s Penalty Estimator Tool to calculate your debt to the state)

Most California residents who earn less than $100,000 per year can qualify for federal subsidies when buying private health insurance marketplace plans, or can get coverage for free. Speak with a California-licensed health insurance agent to discuss marketplace coverage and other affordable health insurance options based on your set of needs and eligibility criteria.