🚨 Earn below 138% FPL? You may qualify for FREE Medi-Cal instead of a Covered California plan. A single person earning under $21,597/year — or a family of 4 under $44,367/year — should check their California Medicaid eligibility in 2026 before enrolling. See full details below.
Last Updated: February 2026 | Source: CoveredCA.com, Official 2026 FPL Chart (Oct. 2025)
Covered California uses your household income compared to the Federal Poverty Level (FPL) to decide what health coverage you qualify for.
In 2026, the rules changed significantly — the extra federal subsidies that helped millions of Californians from 2021 to 2025 have expired.
This means higher monthly costs for many people, especially middle-income earners.
Here’s what you need to know for 2026:
- Covered California uses your income compared to the Federal Poverty Level (FPL) to decide your health coverage and subsidies
- If you earn under $21,597/year (single) or under $44,367/year (family of 4), you likely qualify for free Medi-Cal — not a Covered California plan
- The enhanced federal subsidies expired December 31, 2025 — middle-income earners will pay significantly more in 2026
- If your income is above $62,600 (single) or $128,600 (family of 4), you receive zero federal financial help — this is called the “Subsidy Cliff”
- Depending on your income, you may qualify for a Silver 94, Silver 87, or Silver 73 plan with lower out-of-pocket costs
- Seniors and people with disabilities face a new asset limit for Non-MAGI Medi-Cal starting January 1, 2026
- If your income goes over the 400% FPL limit mid-year, you could owe back every dollar of subsidy you received — with no repayment cap
What Are Covered California Income Limits?
Covered California uses your Modified Adjusted Gross Income (MAGI) to figure out what help you can get. Your income is measured as a percentage of the Federal Poverty Level (FPL).
The higher your income relative to the FPL, the less financial help you receive.
These limits determine three major things:
- Whether you get free Medi-Cal or a subsidized private plan
- How large your Premium Tax Credit (subsidy) is
- Which Silver plan tier you qualify for
For 2026 plans, Covered California uses the 2025 FPL guidelines. This is important — Medi-Cal uses the current year FPL, but Covered California uses the prior year’s numbers.
📌 Official Source: CoveredCA.com — Program Eligibility by FPL 2026
2026 Covered California Income Limits Table (By Household Size)
Here are the official income thresholds for 2026. These numbers come directly from the Covered California Program Eligibility by FPL chart, published October 2025.
| Household Size | 100% FPL | Medi-Cal Limit (138% FPL) | 150% FPL | 200% FPL | 250% FPL | Subsidy Cliff (400% FPL) |
|---|---|---|---|---|---|---|
| 1 Person | $15,650 | $21,597 | $23,475 | $31,300 | $39,125 | $62,600 |
| 2 People | $21,150 | $29,187 | $31,725 | $42,300 | $52,875 | $84,600 |
| 3 People | $26,650 | $36,777 | $39,975 | $53,300 | $66,625 | $106,600 |
| 4 People | $32,150 | $44,367 | $48,225 | $64,300 | $80,375 | $128,600 |
| 5 People | $37,650 | $51,957 | $56,475 | $75,300 | $94,125 | $150,600 |
| 6 People | $43,150 | $59,547 | $64,725 | $86,300 | $107,875 | $172,600 |
| 7 People | $48,650 | $67,137 | $72,975 | $97,300 | $121,625 | $194,600 |
| 8 People | $54,150 | $74,727 | $81,225 | $108,300 | $135,375 | $216,600 |
| Each Extra Person | +$5,500 | +$7,590 | +$8,250 | +$11,000 | +$13,750 | +$22,000 |
These figures are based on the 2025 FPL guidelines used for 2026 Covered California enrollment.
2026 Quick-Glance: What Do You Qualify For?
Not sure which program fits you? Use this summary chart. Find your income range and see what you get.
| Your Income Level | What You Get in 2026 |
|---|---|
| Under 138% FPL | Free Medi-Cal — $0 premiums, $0 copays |
| 138%–150% FPL | Silver 94 plan + $0 premium + CA state subsidy |
| 150%–165% FPL | Silver 87 plan + low premium + CA state subsidy |
| 165%–200% FPL | Silver 87 plan + federal premium tax credit |
| 200%–250% FPL | Silver 73 plan + federal premium tax credit |
| 250%–400% FPL | Standard Silver plan + federal premium tax credit |
| Above 400% FPL | ❌ No subsidy — you pay full price |
The Biggest 2026 Change: The “Subsidy Cliff” Is Back
This is the most important update for 2026. If you earn above 400% FPL, you now receive zero federal subsidies — not a reduced amount, but nothing at all.
What Happened to the Enhanced Subsidies?
From 2021 to 2025, the American Rescue Plan and the Inflation Reduction Act gave extra help to middle-income households.
These laws removed the hard income cap and limited what anyone pays to 8.5% of their income.
Those laws expired on December 31, 2025 and were not renewed by Congress.
What the Subsidy Cliff Means for You
If you earn even $1 over the 400% FPL limit, you lose all federal premium tax credits. There is no gradual phase-out. This is called the “subsidy cliff.”
- Single person earning $62,600 → Gets help
- Single person earning $62,601 → Gets nothing
- Family of 4 earning $128,600 → Gets help
- Family of 4 earning $128,601 → Gets nothing
How Much Will Premiums Rise?
Health insurance premiums in California are expected to rise 10% to 25% in 2026, depending on your carrier and region. For middle-income families already losing subsidies, this creates a “double hit.”
A family of four earning $150,000 could see their monthly premium jump from around $1,000 to over $1,500 — that’s an extra $6,000 to $9,000 per year.
⚠️ If your income is near $62,600 (single) or $128,600 (family of 4), talk to a certified Covered California enroller before choosing your 2026 plan.
Medi-Cal vs. Covered California: Which One Do You Get?
Many Californians qualify for Medi-Cal (California’s Medicaid program) instead of a Covered California plan. It’s important to know the difference.
Medi-Cal is free — no monthly premiums and no copays for most services. Covered California plans charge monthly premiums, even with subsidies.
If your income is below 138% FPL, you go to Medi-Cal, not Covered California.
Income Limits for Medi-Cal in 2026
| Household Size | Medi-Cal Income Limit (138% FPL) |
|---|---|
| 1 Person | $21,597/year |
| 2 People | $29,187/year |
| 3 People | $36,777/year |
| 4 People | $44,367/year |
To understand how California Medicaid compares to other states, you can review Medicaid income limits by state in 2026 for a full national comparison.
Special Medi-Cal Programs
Not everyone uses the standard adult Medi-Cal income limit. Some groups have different rules:
| Program | Income Limit | Who It Covers |
|---|---|---|
| Medi-Cal for Adults | Up to 138% FPL | Adults 19–64 |
| Medi-Cal for Children | Up to 266% FPL | Children 0–18 |
| Medi-Cal for Pregnant Individuals | Up to 213% FPL | Pregnant persons |
| MCAP (Medi-Cal Access Program) | 213%–322% FPL | Pregnant individuals |
| CCHIP | 266%–322% FPL | Children in select CA counties |
For a deeper look at all programs and thresholds, see our guide to California Medicaid income limits in 2026.
Silver Plan Tiers Explained: 94, 87, and 73
If your income is between 138% and 250% FPL, you qualify for an Enhanced Silver plan. These plans have lower deductibles and lower out-of-pocket costs than a standard Silver plan. This benefit is called a Cost-Sharing Reduction (CSR).
Silver 94 Plan (138%–150% FPL)
The Silver 94 plan gives you the most coverage. You pay only 6% of covered costs after your premium. For a single person, this applies to incomes between $21,597 and $23,475 per year.
California has set aside $190 million in state funds to keep premiums near $0 for enrollees at this level, helping approximately 333,000 Californians.
Silver 87 Plan (150%–200% FPL)
The Silver 87 plan covers 87% of your costs. You pay the remaining 13%. For a single person, this applies to incomes between $23,475 and $31,300 per year.
Those between 150%–165% FPL may still receive California’s state subsidy on top of their federal tax credit.
Silver 73 Plan (200%–250% FPL)
The Silver 73 plan covers 73% of costs. For a single person, this means incomes between $31,300 and $39,125 per year.
⚠️ Important 2026 Update: If you earn above $37,600 (single) or $78,000 (family of 4), you no longer qualify for the Silver 73 plan. Covered California will automatically move you to a Silver 70 plan instead.
California State Subsidy: Who Still Gets Help in 2026?
California offers its own state subsidy program. However, for 2026, this help is narrowly targeted to lower-income households. It does not fully replace the lost federal subsidies for middle-income earners.
Who Qualifies for the California State Subsidy?
- Income from 100% to 165% FPL
- For a single person: up to $25,823/year
- For a family of 4: up to $53,267/year
If your income is above 165% FPL, you receive no California state subsidy. You would only receive a federal premium tax credit — and only if you are below 400% FPL.
2026 Premium Contribution Scale
How much of your income will you pay toward premiums? This table shows the percentage of your income that goes toward the second-lowest-cost Silver plan.
| Income Level | % of Income You Pay |
|---|---|
| Under 138% FPL | 0% |
| 138%–150% FPL | 0% |
| 150%–165% FPL | 3.19%–3.91% |
| 165%–200% FPL | 4.91%–6.60% |
| 200%–250% FPL | 6.60%–8.44% |
| 250%–300% FPL | 8.44%–9.96% |
| 300%–400% FPL | 9.96% |
| Above 400% FPL | Full premium — no subsidy |
Medi-Cal Asset Limit Reinstated for 2026
This is a major change affecting seniors and people with disabilities. California has reinstated the asset test for Non-MAGI Medi-Cal, effective January 1, 2026.
What Are the New Asset Limits?
- Individual: $130,000 in countable assets
- Couple: $195,000 in countable assets
This applies to Non-MAGI Medi-Cal — programs for people aged 65+, blind, or disabled. It does not affect standard MAGI Medi-Cal for adults ages 19–64 who qualify based on income alone.
Why Does This Matter?
From 2022 to 2025, California had eliminated the asset test entirely. Many seniors who owned savings, investments, or property were still eligible. Starting in 2026, those assets count again.
Seniors near the limit should review their California Medicaid eligibility in 2026 carefully.
Full Subsidy Repayment Risk in 2026
In 2026, if you receive more subsidy than you are entitled to, you may have to pay all of it back at tax time. There is no longer a sliding-scale repayment cap for higher earners.
The Danger Zone Example
Imagine you estimated your 2026 income at $60,000 (single person) and received federal subsidies all year. But when you file your 2026 taxes in early 2027, your actual income was $63,000 — just over the $62,600 limit.
You could owe back every dollar of subsidy you received during the year. This could be thousands of dollars in unexpected tax liability.
✅ Tip: If your income is close to the 400% FPL threshold, track your income carefully throughout 2026 and report changes to Covered California right away.
To see how reimbursement rules differ in other states, you can check the Medicaid Fee Schedule 2026 for rate and program-level comparisons.
Other Important 2026 Rule Changes
Several other updates affect how Covered California works this year. It is worth reviewing all of them before picking or changing your plan.
Proof of Eligibility Required Upfront
Starting in 2026, you must prove your eligibility before financial help is applied to your plan. In prior years, you could receive help while your documents were being reviewed.
That is no longer the case. If you do not provide the required documents, you will not receive subsidies — even temporarily.
HSA Eligibility Expanded
Bronze and minimum coverage (catastrophic) plans through Covered California now qualify as High-Deductible Health Plans (HDHPs).
This means you can now open and contribute to a Health Savings Account (HSA) while enrolled in these plans.
This is a new and valuable financial benefit for 2026.
Re-enrollment Warning
If you do not confirm or update your income and household information during open enrollment, Covered California will not automatically re-enroll you with financial help for the next plan year. Always log in and verify your details annually.
How to Apply for Covered California in 2026
Applying is straightforward. Here are your options:
- Online: Visit CoveredCA.com and create or log into your account
- By Phone: Call 1-800-300-1506 (TTY: 1-888-889-4500), available Monday–Friday, 8am–6pm
- In Person: Find a local certified enrollment counselor or insurance agent at no cost to you
- By Mail: Download and mail a paper application from CoveredCA.com
📌 Open Enrollment typically runs from November 1 through January 31. Special Enrollment Periods are available if you lose coverage, move, or have a qualifying life event.
Frequently Asked Questions (FAQs)
1. What is the income limit for Covered California in 2026?
The income limit for subsidies is 400% FPL — $62,600 for a single person and $128,600 for a family of four. Above this, you receive no federal financial help. Below 138% FPL, you qualify for free Medi-Cal instead of Covered California.
2. What happens if I earn over 400% FPL in California in 2026?
You lose all federal premium tax credits. You must pay the full monthly premium yourself. California’s state subsidy does not cover earners above 165% FPL, so there is no backup assistance if you exceed the 400% limit.
3. Did Covered California subsidies change in 2026?
Yes. The enhanced subsidies from the American Rescue Plan and Inflation Reduction Act expired December 31, 2025. The “subsidy cliff” has returned. Middle-income earners above 400% FPL now receive zero federal financial help starting in 2026.
4. What is the Medi-Cal income limit for a single person in California 2026?
A single adult qualifies for free Medi-Cal if their annual income is under $21,597 (138% FPL). This is based on the 2025 FPL guidelines. Income above this level may qualify for a subsidized Covered California plan instead.
5. What are the Enhanced Silver plan income limits in 2026?
Silver 94 applies from 138%–150% FPL ($21,597–$23,475 single). Silver 87 covers 150%–200% FPL ($23,475–$31,300 single). Silver 73 covers 200%–250% FPL ($31,300–$39,125 single). Above $37,600 single income, Silver 73 is no longer available.
6. Can I be penalized if my income goes over the subsidy limit mid-year?
Yes. If your actual 2026 income exceeds 400% FPL but you received subsidies all year, you may owe back the full amount at tax time. There is no longer a repayment cap. Track your income closely and update Covered California if your earnings change.
Summary: Key 2026 Numbers at a Glance
| Key Threshold | Single Person | Family of 4 |
|---|---|---|
| Free Medi-Cal (138% FPL) | $21,597 | $44,367 |
| $0 Premium Silver 94 (150% FPL) | $23,475 | $48,225 |
| CA State Subsidy Cutoff (165% FPL) | $25,823 | $53,267 |
| Silver 73 Income Cap | $37,600 | $78,000 |
| Subsidy Cliff (400% FPL) | $62,600 | $128,600 |
Sources:
- CoveredCA.com — 2026 Program Eligibility by FPL Chart
- HealthCare.gov — Federal Poverty Level Guidelines
- California Department of Health Care Services (DHCS) — Medi-Cal Eligibility 2026
This article is for informational purposes only. Income limits and program rules may change. Always verify your eligibility directly at CoveredCA.com or by calling 1-800-300-1506.
