Important changes impacting Individual & Family Plans
Important changes to health coverage and financial assistance are coming soon.
At Blue Shield of California, we understand that any changes to something as important as your health coverage may raise concerns. We appreciate the trust you have placed in us. The information below is provided to help you stay informed.
Read about how Blue Shield is working to protect individual and family health coverage.
Advanced Premium Tax Credit
The Advanced Premium Tax Credit (APTC) is a subsidy from the federal government that helps lower the cost of your health plan’s monthly premium.
How much you qualify for is based on:
- Your household income
- How many people are in your home
- The cost of coverage in your area
What's changing?
The amount of the subsidy was temporarily increased and eligibility expanded because of a bill passed in 2021. This extra help will end on December 31, 2025, unless Congress extends it.
- If your household income is above approximately $60,240 for a single person or above $124,800 for a family of four, you may lose financial support from the APTC. That means you may have to pay the full cost of your monthly plan premiums starting January 1, 2026.
- If your household income is below those amounts, you may still receive assistance from the APTC, but the amount will likely be smaller.
- Click to view the Covered California Program Eligibility by Income chart.
What you can do
Starting October 15, 2025, you can log in to your Covered California account to:
- See how much your plan will cost you in 2026
- Explore other Blue Shield plan options
- Update your income and household information
If you have questions or want to consider other Blue Shield plan options, call Customer Service at the number on your ID card or (855) 836-9705 (TTY: 711).
California’s Enhanced Cost-Sharing Reduction Program
Right now, California gives extra help to lower out-of-pocket costs (like deductibles and copays) for Silver Cost-Sharing Reduction plans. This help from Covered California is scheduled to end on December 31, 2025, unless Congress extends the APTC.
- If your income is above $37,600 for a single person or $78,000 for a family of four and currently enrolled in a Silver 73 plan, you will no longer be eligible for this plan after 2025. Covered California will automatically move you to a Silver 70 plan instead.
- If Covered California moves you to a Silver 70 plan and you don’t qualify for a subsidy, consider enrolling in the Silver 70 Off Exchange plan direct from Blue Shield for nearly identical coverage at a lower monthly cost.
What you can do
Review your plan options during open enrollment to see what works best for your budget.
Bronze and Minimum Coverage Plans through Covered California are now HSA-eligible
Starting January 1, 2026, if you are enrolled in a Bronze-level or Minimum Coverage Plan (also known as a catastrophic plan) through Covered California, you can open and contribute money to a health savings account (HSA). The money you put in can grow tax free, and you can use it any time for eligible medical and dental expenses.
What you can do
- If you are thinking of opening an HSA, talk to your financial institution or financial advisor for more information.
- For more information on these changes and your 2026 financial help, visit Covered California.
Blue Shield of California does not offer legal, financial or tax advice. This is for informational purposes only. For more information about the how these legislative changes may impact you, please consult a legal, financial or tax advisor.
Blue Shield does not determine whether you qualify for a subsidy. If you decide to apply for a plan through Covered California, Covered California will determine your eligibility and actual subsidy amount based on the information you enter in your application.
Page last updated: 10/01/2025