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California health insurance  -  Health Reform Questions  -  other eligibility requirements

Are There Other Requirements Besides Income For Subsidy?

California health insurance ratesIncome is the major driver for subsidy qualification but there are other requirements that must also be met.

Let's look at these in more detail.


The applicant must establish their citizenship in order to qualify for a health subsidy. Information submitted during the enrollment process will be "pinged" against the Department of Homeland Security to establish citizenship.

If there is conflicting information, additional support paperwork may be need in order to qualify.


State residency is also required in order to qualify for a health subsidy (and health plan enrollment for that matter) in California. Residency is generally met if a person permanently resides in the State for the majority of the year.

Again, additional information may be required such as utility bills.

Group Coverage Offering

No access to affordable group health coverage of minimum value.

This is a tricky one and we wrote an entire article on it here. Just the availability of specified group health coverage can make a person (and potentially their dependents) unable to qualify for a health subsidy. Make sure to read the full article if you're offered any group coverage.


An incarcerated person is not able to qualify for a health subsidy. There are special stipulations for parole issues, etc.
Eligible for Medi-Cal or Medicare
If you are now eligible for Medi-Cal under the new expanded requirements, you will not be eligible for a health subsidy although you can purchase a Metallic plan.
These are main qualifying factors outside of income.

We are happy to help you with any questions at 800-320-6269 regarding your particular situation to make sure you get the most health subsidy available to you.


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If Your Income
Is In This Range

Current Years Estimate; All those that file together on one 1040:

Single Person: $16k - $47k
2 People $22k - $64k
3 People $27k - $80k
4 People $33k - $97k

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