Our subsidy calculator provides an estimate of the government funded premium help you may be eligible for when purchasing a medical plan through Covered California. The results from this tool are based on the information you provide. The amount of financial help that one can qualify for depends on age, household income and size, and the cost of affordable health care coverage where you live. 

If you decide to apply for a plan through Covered California, then Covered California will determine your eligibility and actual subsidy amount based on the information you enter in your application. 

If you purchased your plan through Blue Shield and you didn’t qualify for a subsidy when you renewed into your current plan, use our subsidy calculator to check again – you may now qualify. If you qualify, you can re-enroll in a Blue Shield plan sold through Covered California to obtain your subsidy. 

If you still have questions after using our calculator, you can contact your broker, or contact a Customer Care Representative at (888) 256-3650 (TTY: 711).

What type of financial help is available?

There are two types of financial help which are only available for medical plans purchased through Covered California: Cost-sharing reductions and premium help.

Cost-sharing reductions
Cost-sharing reductions (CSRs) are subsidies available when enrolled in an Enhanced Silver plan (Silver 94, Silver 87, or Silver 73) if you qualify based on your income. If you are eligible, you pay less for your out-of-pocket expenses such as deductibles, copayments, and coinsurance when you use your plan.

Premium help
Premium help lowers the cost of your monthly premium, which is your monthly payment amount. One type of premium help that may be available to you is called Advance Premium Tax Credit (APTC).

Advance Premium Tax Credit (APTC) is also called a subsidy. For those who are eligible, it sets a limit on how much one pays based on a percentage of their annual income.

To receive financial help for your medical plan coverage you will need to enroll in a medical plan sold through Covered California. Many of the plans sold through Blue Shield of California are available through Covered California which could make switching plans an easy decision.

If you are thinking about switching or have decided to switch to a Blue Shield medical plan available through Covered California, we have provided tips to make this an easier process.

Having continuous coverage ensures you have access to care when you need it and protects you from unexpected healthcare costs, among other benefits. Having health coverage also helps you avoid the California tax penalty. 

In other words, if you do not have health coverage, you may have to pay more in taxes.  

We are not tax professionals and cannot provide tax advice. If you need help, please get advice from a professional tax preparer or adviser. 

California enacted legislation to restore the individual mandate and tax penalty starting in 2020. Those who choose to go without coverage may be subject to a penalty as part of their annual state tax filing if they have access to affordable coverage within the cost limitations set by the state.

The penalty will be the higher of either a flat amount based on the number of people in the household, or a percentage of the household income.

The California Franchise Tax Board, which administers the state mandate, will assess the penalties for the coverage year when consumers file their taxes. To find out how much your penalty could be, please use the Individual Shared Penalty Estimator tool.

Californians can file for an exemption due to financial or other hardship. Visit Covered California to learn more.

If the federal individual mandate penalty is reinstated at any point, the state tax penalty will be adjusted.