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Understanding Federal Poverty Level (FPL): A Comprehensive Guide.

Updated: Sep 13, 2023

Health insurance is one of the most important decisions you can make for yourself and your family.

It can protect you from unexpected medical expenses, provide access to quality care, and improve your health and well-being. But how do you choose the right health plan for your needs and budget?

In this blog post, we will explain some of the key factors you should consider when shopping for health insurance, such as the federal poverty level, the coverage levels, and the benefits of each plan.

What is the Federal Poverty Level?

The federal poverty level (FPL) is a measure of income level issued annually by the U.S. Department of Health and Human Services. It determines the minimum income needed for individuals or families to meet their basic living expenses, such as food, housing, and healthcare.

The FPL is calculated based on the annual income and the size of the household. It considers the number of people in the household, including adults and children. The FPL guidelines are updated annually, being renewed in March.

The FPL is used as a reference point for determining eligibility for various government programs and benefits, including Covered California. Covered California is the state’s health insurance marketplace, where you can compare and enroll in affordable health plans.

If you are ineligible for Medi-Cal, which is California’s Medicaid program for low-income people, you may qualify for a Covered California health plan with financial help, such as federal tax credits, lower deductibles and co-pays, and other cost-sharing reductions in an Enhanced Silver plan.

What are the Coverage Levels?

Most health insurance plans sold to individuals and small businesses must be classified as one of four levels of coverage: Bronze, Silver, Gold, or Platinum. These levels indicate how much the plan will pay for your medical expenses on average. The higher the level, the more the plan will cover.

Here is a brief overview of each coverage level:

  • Bronze: Bronze plans have the lowest monthly costs among the different coverage levels. However, they also have the highest costs when you receive medical care. These plans are more suitable for individuals who require less medical attention or prefer to pay lower monthly premiums.

  • Silver: Silver plans offer a balance between moderate monthly costs and reasonable costs when receiving medical care. These plans are designed for individuals who use healthcare services moderately. If you qualify for financial help, you may be eligible for an Enhanced Silver plan, which offers lower deductibles and copays than a regular Silver plan.

  • Gold: Gold plans usually have higher monthly costs but offer lower costs when receiving medical care. They are ideal for individuals who require medical care more frequently. These plans provide comprehensive coverage and more extensive benefits, ensuring a high level of medical care.

  • Platinum: Platinum plans have the highest monthly costs but offer very low costs when receiving medical care. They are perfect for individuals who frequently use healthcare services and desire access to premium benefits and extensive coverage.

How to Choose the Right Health Plan for You and Your Family?

Choosing the right health plan for you and your family depends on several factors, such as your income, your health needs, your preferences, and your lifestyle. Here are some questions you should ask yourself before making a decision:

  • How much can I afford to pay each month for my health insurance?

  • How often do I need to see a doctor or use other healthcare services?

  • What kind of benefits do I need or want from my health plan?

  • Do I have any pre-existing conditions or chronic illnesses that require special care or medication?

  • Do I have any dependents who need health insurance as well?

Do I qualify for any financial help or subsidies from Covered California?

Based on your answers to these questions, you can narrow down your options and compare different plans that suit your needs and budget.

You can use Covered California’s online tool to find out if you are eligible for financial help and see what plans are available in your area.

You can also contact EPIA Insurance Services, a certified Covered California agent that can help you enroll in a health plan that meets your expectations.

EPIA Insurance Services has over 20 years of experience in providing quality health insurance solutions to individuals and families in California.

EPIA Insurance Services can help you understand your options, answer your questions, and guide you through the enrollment process. They can also provide ongoing support and assistance after you enroll in a health plan.

We hope this blog post has been helpful and informative for you. Remember that health insurance is not only a legal requirement, but also a smart investment in your future. Don’t wait until it’s too late to get covered.

Choose the right health plan for you and your family today!


EPIA inc. is a private Insurance Agency with no ties with legal entities. The information contained in this article is based on information provided by the Medicare Official Website.

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