Recommended Plans for 2025

These standardized health plans are the most commonly selected by Californians. Each plan must cover the same essential health benefits, but they differ in how costs are shared between you and the insurance company.

Financial Assistance Available

Depending on your annual Modified Adjusted Gross Income you may qualify for up to two levels of financial assistance. Click here to view the Income Guidelines. This chart will help you determine which levels of financial assistance you may qualify for.

Level 1: Premium Assistance

Assistance in lowering your monthly premium. This level applies to all annual incomes listed between 138% and 400% on the Income Guidelines chart.

Level 2: Premium + Enhanced Benefits

Assistance in lowering your monthly premium PLUS Enhanced benefits under the Silver Cost Sharing Reduction plans. Enhanced benefits plans have lowered Deductibles, Copays, and Maximum Out-of-Pocket Costs. This level only applies to annual income listed between 138% and 250% on the Income Guidelines Chart.

Silver Cost Sharing Reduction Plans

There are 3 types of Silver Cost Sharing Reduction plans and the ONLY way to enroll in one of these plans is if your Adjusted Gross Income is listed under Gray Silver Cost Sharing Reductions (CSR) section of the Income Guidelines chart. Click below to view the benefits of the plan you may qualify for and see how it compares to Bronze, Gold & Platinum plans.

Plan Benefits Comparison
Enhanced Silver 73 Enhanced Silver 73 Plan Benefits Enhanced Silver 73 vs. Bronze, Gold & Platinum
Enhanced Silver 87 Enhanced Silver 87 Plan Benefits Enhanced Silver 87 vs. Bronze, Gold & Platinum
Enhanced Silver 94 Enhanced Silver 94 Plan Benefits Enhanced Silver 94 vs. Bronze, Gold & Platinum
Important Note for Families with Children

All children under the Age of 19 will qualify for Medi-Cal if your Annual Gross Income is below 266% on the Income Guidelines chart. This means even if the parents qualify for one of the Enhanced plans listed above, their children under the age of 19 will still only qualify for Medi-Cal. In these cases, parents will be on a separate plan from their children. This is what the Affordable Care Act intended to do for most families that qualify for financial assistance.

Our Recommended Plans

Plan Name Why This Plan? Annual Deductible Out-of-Pocket Max Actions
Silver
Silver 70
Silver 70 is our most popular plan. It offers moderate monthly premiums with reasonable deductibles and copays. $5,400 $8,700 View Details
Bronze
Bronze 60 HDHP
HSA Compatible
Bronze 60 HDHP has the lowest monthly premium and qualifies for a Health Savings Account (HSA). $6,650 $6,650 View Details
Gold
Gold 80
Gold 80 offers the lowest deductibles and copays. Best if you use healthcare services frequently. $0 $8,700 View Details
Silver
Enhanced Silver 73
Silver 73 is an enhanced silver plan for those who qualify based on income. Lower copays and deductibles than Silver 70. $0 $6,100 View Details
Under 30? Consider Minimum Coverage

If you are under the age of 30 and you do not qualify for financial assistance according to the Income Guidelines chart, then you may want to consider the Minimum Coverage Plan. This will be the lowest priced plan available for you to purchase.

Note: Premium assistance cannot be used to purchase the Minimum Coverage Plan and it is only available for individuals under the age of 30 unless you qualify for a hardship exception.

View Minimum Coverage
Interested in a Health Savings Account?

Covered California does offer the Bronze 60 HSA medical plan. Please visit our FAQs to find out why an HSA medical plan might be right for you.

Compare the benefits of the low-cost bronze 60, bronze HSA and minimum coverage plans by viewing the low cost plan benefit comparison chart.

View Bronze HSA Plan

Differences between HMO, EPO & PPO plans

Plan Feature HMO EPO PPO
Designate a primary care physician? Yes No No
Need a referral to see a specialist? Yes No No
Out-of-network benefit? No No Yes
Level of flexibility Minimal Medium High
Access to convenience care and urgent care clinics? Maybe Maybe Yes

Key Definitions

This is amount you have to pay before the insurance covers any of the services listed in Orange on the Medical Plans Chart. This is the amount you are essentially self-insuring. You are only subject to the deductible if you need medical attention. Therefore, you only pay for the medical services you get rendered. This amount takes effect on January 1st of every year, so even if you satisfy the deductible in 2024, you will have to meet it again in 2025.

This is amount the entire family combined will have to pay before the insurance covers any of the services. The deductible requirement will be waived for all members in the family once two or more people in the family have combined to satisfy this amount. For example, if Mom & Dad both reach their individual deductible amounts ($5,000 each = $10,000 combined) under the Bronze plan, then their children will not have to meet any deductible and will only have to pay the copay amounts listed.

This is the amount you will have to pay the IN-NETWORK Medical provider for that specific service(s) listed on the Medical Plans Chart.

This is the most you will pay for all medical services in a calendar year when using IN-NETWORK Medical providers. This comes into play if you ever need a major medical procedure done. For Example, if you have a baby, you will most likely end up paying this amount to the hospital and doctors when you deliver the baby. This is most you will be responsible for in any calendar year. So even if your IN-Network medical providers charge $100K for a procedure, you will only pay a maximum of $6,350 under the Bronze plan because the insurance company will pay the rest. You will also be 100% covered from that point on.

This is the most a family will pay for all medical services in a calendar year when using IN-NETWORK Medical providers. Every member in the family will be 100% covered once two or more people in the family have combined to satisfy this amount. For example, if Mom & Dad both reach their individual Maximum Out-of-Pocket amounts ($6,350 each = $12,700 combined) under the Bronze plan, then their children will have also meet their Out-of-Pocket Maximums.

These are doctors and hospitals that have contracted with a specific Health Insurance company. You want to make sure to ALWAYS use IN-Network / Contracted medical providers whenever possible because the cost savings will be substantial. For example, HMO & EPO plans will not even provide coverage if you use an OUT-OF-NETWORK medical provider unless it is a life threatening emergency. PPO plans will offer up to 50% reimbursement of what they would have paid one of their IN-NETWORK medical providers for the OUT-OF-NETWORK services you got rendered. Please visit our Find an IN-NETWORK Provider page to find out which Insurance companies your Doctor is IN-NETWORK / Contracted with.

Need More Help?

Please contact us via Phone, Text or Email:

Phone (818) 350-2675
Text (818) 350-2675
Email [email protected]

We are Covered California certified, which means we'll help you get health insurance online, via email or over the phone. Our goal is to make acquiring Health Insurance easy for you! We will help you determine if you qualify for financial assistance and make sure you complete the Covered California application correctly. Our services are free, so just have a photo ID, proof of income, and your SSN and we'll take care of the rest!