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California Individual Mandate 2021

Do I Have to Get Health Insurance in California?

Learn whether you must have health coverage under the Affordable Care Act (Obamacare) in California.

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Updated: 2020-11-01 by

California law requires you to have health insurance.

Unless you qualify for an exemption, you will be required to pay a tax penalty if you go without health insurance in California. 

Even though the federal tax penalty for being uninsured has gone away, California passed its own law imposing a tax penalty for state residents. The California law took effect on January 1, 2020.

To avoid the California tax penalty, you must have what California considers "minimum essential coverage" (MEC) or prove your eligibility for an exemption.

What Qualifies as Minimum Essential Coverage in California?

If you have any of the following types of health coverage, you won’t have to pay a penalty:

  • an individual health plan purchased from Covered California
  • a comprehensive health plan from your employer
  • coverage through a government program such as Medicare, Medi-Cal, CHIP, or TriCare
  • coverage through the University of California student health insurance or other student health or voluntary dependent plans.

If you aren’t sure whether your current plan qualifies, talk to the plan provider.

What Doesn't Qualify as Minimum Essential Coverage?

Some types of health plans don't meet the requirements for minimum essential coverage. These include vision insurance, dental insurance, workers’ compensation, coverage that is limited to a specific condition, and plans that offer only discounted medical services.

Am I Exempt From the California Health Insurance Requirement?

Under certain conditions, you won't have to pay the California tax penalty for being uninsured. You're automatically exempt if you don't have to file a California income tax return. And you won't face a penalty if the premium payments for the lowest-cost plan on the exchange is more than 8.24% of your household income for the year. Additional exemptions include:

  • You lack coverage for fewer than three consecutive months of the year.
  • You are enrolled in limited scope Medi-Cal coverage.
  • You are a U.S. citizen who lived abroad during the tax year.
  • You are not a legal U.S. resident.
  • You are a member of a health care sharing ministry.
  • You are a member of a religious group that is conscientiously opposed to accepting health care benefits, including Social Security and Medicare, and you obtain a certificate of exemption.
  • You are a member of a federally recognized Indian tribe.
  • You are in jail or serving a prison sentence.

You may also apply for a hardship exemption from Covered California. Hardship exemptions are decided on a case by case basis, but they may cover situations such as homelessness, domestic violence, bankruptcy.

You can claim some exemptions on your California state tax return but must apply for others through Covered California. For more information, see Covered California's Penalty and Exemptions page.

Learn More

To find out how to get covered, see How to Sign Up for Obamacare in California.

For information about costs, see How Much Does Obamacare Cost in California?

 

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California: Law