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What’s new with Covered California

Know your coverage options.

Covered California™ makes it simple and more affordable for millions of Californians to get quality health insurance that can’t be canceled or denied because of a pre-existing medical condition. It offers a range of plans so consumers can choose the one that best meets their health needs and financial situation.

Covered California is the only place to get premium assistance to help you buy health insurance in California. This means you may qualify for financial assistance on a health plan through the marketplace exchange. Our Sharp Health Plan individual plans are available through Covered California. Here is some helpful information to help you find the right plan for you and your family.

Important financial information

Financial assistance

Financial assistance reduces the cost of monthly premiums. If you qualify for financial assistance, Covered California provides the assistance directly to Sharp Health Plan, and you are only responsible for the premium Covered California gives you. To find out more, contact our Individual and Family Plans sales team at 1-858-499-8211 or ifpsales@sharp.com.

The amount of financial assistance you receive depends on your estimated household income and taxable household size. Individuals and families making up to 400% of the federal poverty level can qualify for financial assistance.


Cost-sharing reductions

Cost-sharing reductions are a form of financial assistance that lowers out-of-pocket costs including lower deductibles, coinsurance and copays. Individuals and families who purchase a plan from Sharp Health Plan through the Covered California marketplace — and who have a household income at or below 250% of the federal poverty level — may qualify for cost-sharing reductions.


Your financial help may change in 2026

Some premium subsidies are set to expire at the end of 2025 unless Congress decides to extend them. As we get closer to open enrollment for next year, it's important to know how these changes might affect you.

What are premium subsidies and what could happen to my financial help in 2026?

Premium subsidies are a type of financial help that individuals and families can get based on their income. If you qualify, these subsidies can help lower the amount you have to pay each month for your health insurance, making it more affordable.

During the COVID-19 pandemic, laws were passed to temporarily increase premium subsidies until the end of 2025. These enhanced premium subsidies not only gave more financial help to people who already qualified, they also allowed people with middle incomes to get financial help when they weren't able to before.

At the end of 2025, these enhanced premium subsidies are set to end, which means many people might get less financial help in 2026 or might not get any help at all.

What will happen to my health insurance costs in 2026?

If the enhanced premium subsidies expire on Dec. 31, you will likely see a higher monthly premium cost and/or higher copays, deductibles and out-of-pocket maximums when you renew your plan. You may also get less financial help, or you may not qualify for financial help at all next year.

Your monthly costs also depend on things like your age, where you live, the type of plan you have, and your family's income and size. If any of these things change, it could further affect how much you pay next year.

How can I get more information about my financial help for next year?

When open enrollment starts on Nov. 1, 2025, Covered California™ will share information about the financial help you might qualify for in the next year. You can get that information by logging in or creating a Covered California account.

If you have questions about your financial help, you can contact Covered California at 1-800-300-1506 or visit coveredca.com to start a live chat with a representative. If you have a broker, you can also contact them for support.

What can I do to prepare for open enrollment?

We recommend the following:

  • Open enrollment is from Nov. 1 to Jan. 31, and it's when you can enroll or make changes to your plan.
  • If you're enrolled through Covered California, keep an eye out for mail and digital communications from them as the 2026 open enrollment period gets closer.
  • Start to gather important documents, like your pay stubs, W-2s, 1099s or prior tax returns — especially if you have variable income.
  • If you've gotten premium subsidies to lower your monthly health insurance costs, be sure to file your federal tax return.
  • If you have a Covered California account, make sure it reflects your current household size, dependent status and mailing address.
  • Begin reviewing your health care needs and budget for next year so if you need to shop for a new plan, you know what kind of coverage you'll need.


Sharp Health Plan is here to help

If your financial help changes in 2026, you still have options with Sharp Health Plan. We offer high-quality, affordable health insurance with direct access to Sharp HealthCare. Our certified enrollment specialists can help you find the best plan for your needs.

Send us a message at ifpsales@sharp.com or contact us at 1-858-499-8211 from Monday to Friday, 8 am to 5 pm.

Visit Covered California to see if you qualify and to apply for reduced-cost plans.

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More facts about Covered California

 
Coverage for adult children

Under the Affordable Care Act, adult children cannot be covered on their parent’s health insurance plan after turning 26 years old, unless there is a qualifying reason to require further coverage. Depending on how you’re enrolled in benefits, how long your child can stay covered on your plan will vary.

Coverage Type

How you're enrolled in benefits

Coverage Period

How long your child can stay covered on your plan after turning 26

How to enroll

How your child can enroll in their own coverage
Through your employer (101+ employees) Can stay on your plan until the end of the month of their 26th birthday.

Your adult dependent can enroll in their own plan by applying through Covered California™.

They can also visit Covered California's website to find a certified enrollment counselor or agent in their area. They are also welcome to contact one of our certified enrollment specialists at ifpsales@sharp.com or 1‑858‑499‑8211.

Through your employer (100 employees or less) Can stay on your plan until the end of the benefit year.
Individual or family plan through Sharp Health PlanCan stay on your plan until the end of the benefit year.

If your adult dependent doesn't enroll in their own plan, Sharp Health Plan or Covered California will automatically enroll them into their own plan for the upcoming year.

TIP: If you're enrolled through Covered California, make sure to contact them at 1‑800‑300‑1506, Monday – Friday, 8 am to 6 pm, to remove your adult dependent(s) from your health plan.

Individual or family plan through Covered CaliforniaCan stay on your plan until the end of the benefit year.

 

Important coverage information for totally disabled dependents

If your adult child is disabled and over 26 years old, they may remain on your plan with proof of disability. A totally disabled dependent is both: (A) Incapable of self-sustaining employment by reason of a physically or mentally disabling injury, illness, or condition, and (B) Chiefly dependent upon the primary subscriber for support and maintenance. For your disabled dependent to remain on your plan, you will need to complete and return a Totally Disabled Dependent Form to Sharp Health Plan. Please contact Customer Care for more information.

If you have questions, please contact Customer Care at 1-800-359-2002 or email customer.service@sharp.com. We are available to assist you Monday – Friday, 8 am to 6 pm.


 
Coverage levels

Most health insurance policies sold to individuals and small businesses are classified as one of four tiers of coverage: Bronze, Silver, Gold or Platinum. A minimum essential coverage plan is available to those who are under 30 or are granted a hardship exemption through the federal government. Visit healthcare.gov for more information on hardship exemptions.


 
Dental benefits

All Covered California health insurance plans offer embedded pediatric dental coverage. This means that dental insurance for children is included in the price of all health plans purchased in the exchange. In addition, Covered California now offers supplemental dental coverage for adults, through optional family dental plans.

We partner with top-rated providers to ensure our youngest members have access to high-quality oral care services. Delta Dental is our provider for individual, family and small employer group plans.


 
Difference between Covered California and Medi-Cal

Covered California is the state marketplace for health insurance where individuals and families can shop for plans and receive financial assistance, if eligible.

Medi-Cal is a program that offers free or low-cost health insurance to individuals with low income, and accepts applications year-round. To learn more about Medi-Cal and how to apply, you can find additional information here.


 
Enrolling in a plan

Open enrollment for health coverage begins November 1 and continues through January 31. However, Medi-Cal enrollment is year-round. Browse, compare and purchase health coverage with Covered California.

Outside of open enrollment, you may still be able to enroll in a plan if you’ve had a qualifying event. Qualifying events are certain life changes like getting married, having a baby or moving.


 
Essential health benefits

All health insurance plans offered in the individual and small-group markets must provide a comprehensive package of items and services, known as essential health benefits. These benefits fit into 10 categories, and include services like prescription drugs, mental health care, and emergency services. View all benefits.


 
Preventive care

The Affordable Care Act requires that your preventive services, like your well-woman exam, mammography, and screenings for cancer, are covered with no out-of-pocket costs to you. Some covered preventive care services include:

  • Well-woman exams
  • Tobacco use screenings
  • Immunization vaccines
  • HIV screenings
  • Diet counseling
  • Depression screenings


 
Vision coverage

Covered California offers consumers a pathway to quality vision care. Vision care benefits for children are included in all health plans purchased through the exchange. Vision care for adults is not offered in Covered California health plans, but Covered California works with certain vision insurance companies to offer vision coverage directly to consumers.

We’re proud to partner with Vision Service Plan (VSP) to provide pediatric policies as supplemental riders to individual, family and group plans. Our youngest members under 19 years old have access to the highest-quality eye care services.


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