Before you start

California residence
Income information for subsidy or Medi-Cal eligibility
An SSN or ITIN for the marketplace application
A qualifying life event, if enrolling outside the annual open-enrolment window

Step-by-step

1
Enrol in your employer's plan within the new-hire window
Typically 30 days from your start date, and missing it can mean waiting for the next open enrolment. Compare the deductible and out-of-pocket maximum, not just the premium. If you are in an hourly role, check the hours threshold that makes you benefits-eligible and how the employer measures it — that number, not your job title, decides whether you have a plan at all.
Via employerWho: YouFirst 30 days of employment
2
Check Medi-Cal eligibility first, and know it means CalOptima here
California expanded Medi-Cal well beyond the federal minimum, and in 2024 extended full-scope coverage to income-eligible adults regardless of immigration status. The 2025 state budget changed the terms for new adult enrolment and added premiums from later years, so confirm the current position with the Department of Health Care Services. In Orange County, Medi-Cal is administered by CalOptima Health as a County Organized Health System — one plan, county-wide. Medi-Cal enrols year-round.
OnlineWho: You
3
Without an employer plan, use Covered California — not HealthCare.gov
California runs a state-based exchange with its own enrolment calendar, which has historically extended past the federal deadline, and its own state subsidies layered on the federal ones. Going to the federal site sends you back.
OnlineWho: You
4
Understand the state individual mandate
California kept an individual mandate after the federal penalty went to zero. Going without minimum essential coverage for a substantial part of the year triggers a penalty on your California return unless you qualify for an exemption. It is administered by the Franchise Tax Board, not by the marketplace, and people who assume the federal repeal ended it get caught at filing.
OnlineWho: You
5
Decide about Kaiser deliberately
Kaiser Permanente is both the insurer and the provider — its own hospitals, its own doctors, its own records — and it has a large Anaheim presence. It is efficient and widely liked and it is a closed system: you get care inside Kaiser or you pay out of pocket. That is a bigger decision than picking between PPO networks, and switching later requires a qualifying life event.
OnlineWho: You
6
Register with a primary care physician in month one
Do it while you are well. An established relationship is what gets you referrals and urgent slots later, and confirming the practice is in your network before the first visit avoids an out-of-network bill for a routine appointment. For children, CHOC in neighbouring Orange is the region's paediatric referral centre and is a short drive from anywhere in the city.
In personWho: YouMonth 1
7
Plan for Santa Ana wind and smoke season
Autumn offshore winds drop humidity into single figures, raise dust and can carry smoke from fires in the canyons and further inland. Anaheim Hills sits in the wildland–urban interface and has burned before. A decent air filter, N95 masks and knowing your address's fire hazard severity zone are ordinary preparedness here rather than anxiety.
In personWho: You

Documents you’ll need

Proof of California residence
Income documentation for subsidies or Medi-Cal
SSN or ITIN
Immigration documents for marketplace eligibility categories
Evidence of losing prior coverage, if using a special enrolment period

Things most newcomers don’t know

Orange County's Medi-Cal is one plan, not a choice.

CalOptima Health is a County Organized Health System created by the Board of Supervisors, and it is the largest of the six in California. Where a Los Angeles or Santa Clara resident picks between commercial managed-care plans, an eligible Orange County resident is enrolled with CalOptima. It simplifies the decision and it means the provider network question is really 'which doctors take CalOptima', which is worth asking before you choose a GP.

Source: CalOptima Health

California still has an individual mandate, and it is enforced through the state tax return.

The federal penalty went to zero in 2019 and most people assume mandates ended everywhere. California, Massachusetts, New Jersey, Rhode Island, Vermont and DC kept theirs. In California it is assessed by the Franchise Tax Board when you file, and a newcomer who arrives mid-year uninsured can owe it without ever having heard of it.

Source: California Franchise Tax Board

In an hourly job, the hours threshold decides whether you have insurance.

Employer coverage in the US is tied to being a full-time employee as the employer measures it, using a look-back period over past hours. In a city where a large share of work is variable-hours, dropping below the threshold across a measurement period can end coverage even though the job continues. Ask what the threshold is and how it is measured before you accept reduced hours.

Source: community-reported

Medi-Cal's rules on immigration status have moved twice in three years.

California extended full-scope Medi-Cal to income-eligible adults regardless of immigration status in 2024, and the 2025 state budget changed the terms for new adult enrolment and added premiums from later years. This is one of the fastest-moving eligibility questions in the country. Anything written more than a year ago is likely wrong in one direction or the other — check with the Department of Health Care Services directly.

Source: California Department of Health Care Services

Common mistakes to avoid

Going to HealthCare.gov instead of Covered California and losing time.
Assuming no coverage means no penalty, when California still levies one.
Missing the 30-day new-hire enrolment window at a new employer.
Losing employer coverage by dropping under an hours threshold you never asked about.
Enrolling in Kaiser without realising it is a closed system.

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