Many individuals are having to pay back Subsidies received through Covered California because they underestimated their household income! Here is more info about subsidies when you are already covered through your employer so you can better prepare:

  • To qualify for the subsidy and NOT pay it back, you must meet specific household income requirements.
  • In general, most people who have access to employer sponsored health insurance will not qualify for a subsidy if purchased through Covered California.
  • You might qualify for the subsidy IF your premium cost is greater than 9.5% of your household annual income.
  • Any premium less than 9.5% of your household income has been deemed affordable by the government.
  • How to calculate: find the lowest cost plan offered by your employer, now determine the yearly cost of this plan for employee only coverage, now calculate your household income (count your spouse’s income if applicable), lastly take the annual premium number for insurance and divide it by your annual household income number. This will provide you with the percentage.
  • Also note that if your household income is below 138% of the federal poverty level, you will qualify for MediCal. Therefore you don’t have to purchase through Covered California or your employer.

If you have questions or would like more info, please email us.