Before you start

California residence
Income information for Medi-Cal or subsidy eligibility
An SSN or ITIN for marketplace applications, though Medi-Cal has its own rules
A qualifying life event, if enrolling outside the annual window

Step-by-step

1
Check Medi-Cal eligibility before buying anything
California expanded Medicaid and then went further: since 2024 Medi-Cal covers all income-eligible adults regardless of immigration status, the only state to do so for every age group. Adults up to 138% of the federal poverty level qualify. A newcomer on a part-year income frequently qualifies and many buy marketplace cover they did not need.
OnlineWho: YouWeek 1–2
2
Enrol through Covered California, on California's calendar
California runs its own marketplace and its own enrolment window, which historically starts earlier and runs later than the federal one. Applying federal dates in California is a well-documented way to lose a year of coverage. Check Covered California's published dates rather than assuming HealthCare.gov's.
OnlineWho: You
3
Enrol in your employer's plan inside the new-hire window
Typically 30 days from your start date. Compare deductibles and out-of-pocket maximums rather than premiums, and check which systems each network includes — MemorialCare, Dignity Health St. Mary and the larger Los Angeles systems do not all appear in every plan, and MemorialCare's Long Beach campus is the one you want in network for anything serious.
Via employerWho: YouFirst 30 days of employment
4
Budget for California's individual mandate penalty if you go uninsured
California reinstated an individual mandate in 2020. Going without minimum essential coverage produces a penalty on your California return administered by the Franchise Tax Board, with exemptions for affordability and short gaps. It is one of only a handful of states with one, and it surprises people who know the federal penalty was zeroed out.
OnlineWho: You
5
Use the CITY health department, not the county one
Birth and death certificates, restaurant inspection records, communicable disease reporting, immunisation clinics, WIC, the public health laboratory and lead poisoning prevention are all City of Long Beach services here — one of only three city-run health departments in California. A form or a website that directs you to LA County Public Health is, in Long Beach, directing you to the wrong office.
In personWho: You
6
Register with a primary care physician while you are well
Your PCP gates specialist access on most plans. Confirm network status with the practice itself rather than the insurer's directory, which is frequently out of date, and expect a wait for a first appointment.
OnlineWho: You

Documents you’ll need

Proof of California residence
Income documentation for Medi-Cal or Covered California subsidies
SSN or ITIN, where applicable
Immigration documents for marketplace eligibility categories — Medi-Cal's rules differ
Evidence of losing prior coverage, if using a special enrolment period

Things most newcomers don’t know

Long Beach is one of only three cities in California with its own health department.

Berkeley, Pasadena and Long Beach run city health departments; everywhere else the county does. For a resident that means birth and death records, restaurant grades, food-poisoning complaints, immunisation clinics, WIC, vector control and lead poisoning prevention all come from City Hall rather than from LA County. The department runs on roughly a $117 million budget with over 500 staff across nine sites. Being sent to the county office is the standard newcomer detour and it wastes a day.

Source: City of Long Beach — Health and Human Services

California runs its own marketplace with its own enrolment dates.

Covered California is a state-based exchange, not a HealthCare.gov storefront, and its open enrolment window differs from the federal one. Someone who reads a national article, notes the federal deadline and turns up in mid-January can find they have missed nothing — or, in the other direction, someone applying the federal close date can miss California's. Check the state's own published dates. Missing an enrolment window costs a year, not a month.

Source: Covered California

Medi-Cal now covers all income-eligible adults regardless of immigration status.

California completed a phased expansion in 2024 making full-scope Medi-Cal available to income-eligible adults of every age regardless of immigration status — the only state to do so. In a city where mixed-status households are common, this is the single most consequential health fact, and it is routinely missed because national coverage explainers describe the federal rules instead.

Source: California Department of Health Care Services — Medi-Cal

The deductible is what actually shocks people from national health systems.

US plans commonly require you to pay the first several thousand dollars of care each year before the insurer contributes. Someone arriving from the UK, Canada or the Philippines reads 'I have insurance' as 'I am covered', then receives a four-figure bill for a scan. Read the deductible and the annual out-of-pocket maximum before the premium — that is where plans genuinely differ.

Source: community-reported

Common mistakes to avoid

Applying HealthCare.gov's enrolment dates in California and missing Covered California's window.
Contacting LA County Public Health for something the City of Long Beach handles.
Going uninsured without realising California levies its own individual mandate penalty.
Buying a marketplace plan without first checking Medi-Cal eligibility.
Choosing a plan on premium alone and meeting a five-figure out-of-pocket maximum.

Some of this may be out of date. Spotted something inaccurate? Help us keep it right for the next newcomer.