DACA and Health Insurance in California: Your Coverage Options

Current Status: DACA and Covered California

As of August 31, 2025, DACA recipients are no longer eligible to purchase health insurance through Covered California. This change affects approximately 2,300 DACA recipients who were enrolled in Covered California health plans.

The Centers for Medicare & Medicaid Services (CMS) published a new federal rule in June 2025 that revised the definition of "lawfully present" individuals eligible for marketplace coverage. This federal rule change means that DACA status no longer qualifies someone to enroll in or maintain coverage through Covered California.

What Happened: Timeline of Changes

Understanding the timeline of changes helps clarify your current options:

Medi-Cal Eligibility for DACA Recipients

Good news: DACA recipients have been eligible for Medi-Cal since the creation of the DACA program. This is based on a long-standing California state policy that makes low-income immigrants with "deferred action status"—including but not limited to DACA recipients—eligible for full-scope Medi-Cal benefits.

Who Is Eligible for Medi-Cal?

You may qualify for Medi-Cal if you:

• Are a California resident
• Have valid DACA status (deferred action)
• Meet income requirements (see income limits section below)
• Are a U.S. citizen, U.S. national, or have satisfactory immigration status

What Does Medi-Cal Cover?

Full-scope Medi-Cal provides comprehensive health coverage including:

• Doctor visits and preventive care
• Hospital stays and emergency services
• Prescription medications
• Laboratory and X-ray services
• Mental health services
• Substance abuse treatment
• Dental and vision care
• Family planning services
• Pregnancy and maternity care

How to Apply for Medi-Cal

There are several ways to apply for Medi-Cal coverage:

1. Start with Our Enrollment Tool

Check your eligibility and get guidance on next steps:

• Use our enrollment tool to check your Medi-Cal eligibility
• Enter your household information and income
• Get an instant determination if you qualify for Medi-Cal or Covered California
• Our certified counselors will help you complete your application

2. Apply Online Through a Licensed Agent

You can apply online with free expert assistance:

• Start your free application online
• Start your application and answer questions about your household
• The system will automatically check if you qualify for Medi-Cal based on your income
• If eligible, your application will be transferred to your county Medi-Cal office

3. Apply Through Your County

Contact your local county social services or Medi-Cal office directly:

• Find your county office at DHCS County Offices
• Call to schedule an appointment or request a paper application
• Some counties offer walk-in assistance

4. Get Help From a Certified Enrollment Counselor

Free, confidential assistance is available from certified enrollment counselors who can:

• Help you complete your Medi-Cal application
• Explain your coverage options
• Answer questions about eligibility and documentation
• Provide assistance in multiple languages

Documents You May Need

When applying for Medi-Cal, be prepared to provide:

• Proof of California residency (utility bill, lease, etc.)
• Valid DACA approval notice (Form I-797)
• Employment Authorization Document (EAD card)
• Social Security number (if you have one)
• Proof of income (pay stubs, tax returns, etc.)
• Bank statements or proof of assets

Alternative Health Insurance Options

If you don't qualify for Medi-Cal based on income, you still have other coverage options:

1. Employer-Sponsored Health Insurance

If you work for an employer that offers health benefits, you may be eligible to enroll in their health plan. Many employers offer group health insurance that covers employees regardless of immigration status.

• Check with your employer's Human Resources department
• Ask about open enrollment periods and eligibility requirements
• Compare costs with other options

2. Direct Purchase Health Insurance

You can purchase health insurance directly from insurance companies outside of the Covered California marketplace. While you won't receive federal subsidies, you can still access quality coverage.

• Contact insurance companies directly (Blue Shield, Kaiser, Anthem, Health Net, etc.)
• Compare plans, premiums, and coverage levels
• Work with a licensed insurance agent who can help you find affordable options

3. Community Health Centers

Federally Qualified Health Centers (FQHCs) provide health services regardless of ability to pay or immigration status:

• Services based on a sliding fee scale according to income
• Comprehensive primary care, dental, and mental health services
• Find a center near you at HRSA Health Center Finder

4. County Medical Services Programs

Some California counties offer medical assistance programs for low-income residents who don't qualify for other coverage. Contact your county health department for information about local programs.

Medi-Cal Income Limits for 2025

Medi-Cal eligibility is primarily based on your household income and size. Income limits are calculated as a percentage of the Federal Poverty Level (FPL).

Income Guidelines (138% of Federal Poverty Level)

For adults ages 19-64, Medi-Cal eligibility is generally at or below 138% of the FPL:

Note: These are the Medi-Cal limits in effect now, from the 2026 federal poverty guidelines; they usually rise early each year. For larger households, add about $653/month for each additional person.

What Counts as Income?

For Medi-Cal eligibility, income includes:

• Wages and salaries
• Self-employment income
• Unemployment benefits
• Social Security benefits
• Pensions and retirement income
• Interest and dividends
• Alimony received

Who Can Help You

You don't have to navigate this process alone. Free, confidential assistance is available:

Cover Health CA - Licensed Agents

Certified Enrollment Counselors

Certified enrollment counselors provide free, one-on-one help with:

• Completing your Medi-Cal application
• Understanding eligibility requirements
• Gathering necessary documentation
• Comparing coverage options
• Answering questions in your language

Contact us to get connected with a certified enrollment counselor in your area.

County Medi-Cal Offices

Your local county social services department can provide direct assistance with Medi-Cal applications. Find your county office at the California Department of Health Care Services.

Legal and Community Resources

For immigration-related questions or legal assistance:

• California Department of Social Services: List of qualified nonprofit organizations providing immigrant services
• Legal Aid Organizations: Free or low-cost legal help with immigration and benefits questions
• Community Health Centers: Many offer enrollment assistance and health services

What to Do Next

Taking action now is crucial to securing health coverage. Follow these steps:

If You Had Covered California Coverage

If your Covered California coverage ended on August 31, 2025:

• Apply for Medi-Cal immediately—don't wait until you have a medical need
• Continue any necessary medical care through community health centers
• Keep all documentation from your previous coverage for reference
• Update your contact information so you receive important notices

If You Don't Qualify for Medi-Cal

If your income exceeds Medi-Cal limits:

• Explore employer-sponsored coverage options
• Contact insurance companies about direct-purchase plans
• Work with a licensed insurance agent to compare options
• Consider community health centers for affordable care

Stay Informed

Health care policy changes can happen quickly. Stay updated by:

• Regularly checking the Covered California website
• Following announcements from the California Department of Health Care Services
• Connecting with immigrant advocacy organizations
• Maintaining valid DACA status to preserve eligibility for Medi-Cal