Estimate your eligibility for financial assistance or Medi-Cal based on 2024-2025 guidelines.
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How Covered California Subsidies Work
Covered California is the state's health insurance marketplace where individuals and families can find affordable coverage. Financial assistance is primarily provided through Advanced Premium Tax Credits (APTC), which lower your monthly premium, and Cost-Sharing Reductions (CSR), which lower out-of-pocket costs like deductibles and copays.
Subsidies are calculated based on your Modified Adjusted Gross Income (MAGI) and where you fall relative to the Federal Poverty Level (FPL). Under current legislation, subsidies have been expanded to ensure that most Californians do not pay more than 8.5% of their income for a benchmark Silver plan.
2024 Federal Poverty Level (FPL) Thresholds
Household Size
100% FPL (Annual)
138% FPL (Medi-Cal Limit)
400% FPL
1
$14,580
$20,121
$58,320
2
$19,720
$27,214
$78,880
3
$24,860
$34,307
$99,440
4
$30,000
$41,400
$120,000
Medi-Cal vs. Covered California
If your income falls below 138% of the FPL, you generally qualify for Medi-Cal, which is California's Medicaid program offering no-cost or low-cost coverage. If your income is above 138%, you qualify for a health plan through Covered California, and most people receive significant monthly subsidies to help pay for it.
How to Use This Calculator
Household Size: Include yourself, your spouse, and any tax dependents.
Annual Income: Use your projected gross income for the year you are seeking coverage.
Age: Age affects the baseline price of insurance plans, though not the subsidy percentage itself.
function calculateCoveredCA() {
var size = parseInt(document.getElementById('householdSize').value);
var income = parseFloat(document.getElementById('annualIncome').value);
var age = parseInt(document.getElementById('applicantAge').value);
var resultsArea = document.getElementById('results-area');
var resTitle = document.getElementById('resTitle');
var resMain = document.getElementById('resMain');
var resDetails = document.getElementById('resDetails');
if (isNaN(income) || income <= 0) {
alert("Please enter a valid annual income.");
return;
}
// 2024 FPL Guidelines (Approximate for CA)
var baseFPL = 14580;
var incrementFPL = 5140;
var householdFPL = baseFPL + (incrementFPL * (size – 1));
var percentOfFPL = (income / householdFPL) * 100;
resultsArea.style.display = "block";
resultsArea.className = ""; // reset
if (percentOfFPL <= 138) {
// Medi-Cal Eligible
resultsArea.classList.add("medical-theme");
resTitle.innerHTML = "Eligibility Estimate:";
resMain.innerHTML = "Medi-Cal Likely";
resDetails.innerHTML = "Based on your household size of " + size + " and income of $" + income.toLocaleString() + " (" + Math.round(percentOfFPL) + "% of FPL), you likely qualify for Medi-Cal, which provides free or low-cost health coverage in California.";
} else {
// Covered CA Subsidy Logic
resultsArea.classList.add("subsidy-theme");
// Simplified subsidy estimation based on the 8.5% income cap rule
var maxPremiumPercent;
if (percentOfFPL <= 150) maxPremiumPercent = 0;
else if (percentOfFPL <= 200) maxPremiumPercent = 0.02;
else if (percentOfFPL <= 250) maxPremiumPercent = 0.04;
else if (percentOfFPL <= 300) maxPremiumPercent = 0.06;
else if (percentOfFPL <= 400) maxPremiumPercent = 0.085;
else maxPremiumPercent = 0.085;
var monthlyIncome = income / 12;
var maxMonthlyContribution = monthlyIncome * maxPremiumPercent;
// Estimate average benchmark plan cost (SLCSP) based on age
// Base cost around $450/mo for a 40 year old, adjusted 3% per year of age
var baseBenchmark = 450;
var ageFactor = 1 + ((age – 40) * 0.03);
if (age < 21) ageFactor = 0.635;
var estimatedPlanCost = baseBenchmark * ageFactor;
var estimatedSubsidy = estimatedPlanCost – maxMonthlyContribution;
if (estimatedSubsidy 0) {
resMain.innerHTML = "$" + Math.round(estimatedSubsidy) + " / month";
resDetails.innerHTML = "Your income is " + Math.round(percentOfFPL) + "% of the Federal Poverty Level. You likely qualify for financial assistance. This subsidy is applied directly to your monthly premium, significantly reducing your costs.";
} else {
resultsArea.className = "fullprice-theme";
resMain.innerHTML = "Full Price Plan";
resDetails.innerHTML = "Based on your income and age, your estimated health plan costs fall below the 8.5% income cap, meaning you may not qualify for a monthly tax credit, but you can still purchase a plan through Covered California.";
}
}
}