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STAY WITH BLUE SHIELD FOR LESS

SEE IF YOU QUALIFY FOR A SUBSIDY

You may be eligible to get financial help.

This calculator estimates the financial help that may be available to you when enrolling in a medical plan sold through Covered California. This can significantly lower the cost of your coverage.

If you want to keep your current Blue Shield plan, you may be able to keep it and still use the subsidy since most Blue Shield plans are sold through Covered California.

Note: This calculator has been updated to show premium savings for 2024 plans, including increased federally funded subsidies.

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Important: This calculator is a tool for informational purposes only and does not confirm eligibility. It is not a contract. Covered California determines eligibility and the amount of the subsidy. Eligibility requirements are only partially described. It is not intended for personalized financial or legal advice.


Frequently Asked Questions (FAQ)

The topics listed below are intended to help you understand the calculator, how subsidies are calculated, and how to enroll in a new Blue Shield plan once you determine if you qualify for a subsidy.

Our subsidy calculator provides an estimate of the federally 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.


 

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. It is available from the federal government. The 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.

Learn more about how subsidies are calculated.


 

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. 

What is the California tax penalty?

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 or, for additional information, visit the California Franchise Tax Board.

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


 

© California Physicians' Service DBA Blue Shield of California 1999-2024. All rights reserved. California Physicians’ Service DBA Blue Shield of California is an independent member of the Blue Shield Association. Health insurance products are offered by Blue Shield of California Life & Health Insurance Company. Health plans are offered by Blue Shield of California.

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