State guide
How to pay less for medication in California
The state programs and rules that affect what you pay for prescriptions in California, plus the nationwide help that works everywhere.
| Medicaid expansion | Yes |
| State insulin copay cap | $35 per 30-day supply (state-regulated plans) |
| Health insurance marketplace | Covered California |
| State drug help programs | None listed besides the HIV program (ADAP) |
Medicaid in California
California expanded Medicaid. Adults under 65 with income up to 138% of the federal poverty level can qualify, and most prescriptions cost little or nothing.
You can apply for Medicaid any time of year. Find your state agency through Medicaid.gov.
Insulin
California caps insulin at $35 for a 30-day supply in state-regulated health plans. Applies to large-group plans now and small-group plans starting January 1, 2027. Many job-based plans are self-funded and regulated federally instead, so ask your plan whether the cap applies to you.
HIV medication
California runs an AIDS Drug Assistance Program (ADAP) that helps pay for HIV medication. See HIV.gov to find it.
On Medicare in California?
- Your State Health Insurance Assistance Program (SHIP) gives free, unbiased Medicare help. Find it at shiphelp.org or call 877-839-2675.
- Check whether you qualify for Extra Help, which can cut copays to a few dollars.
- Open enrollment runs October 15 to December 7. Use our checklist.
Help that works in every state
- Look up your medication for its drugmaker program, generics and cash prices.
- Community health centers in California charge by income.
- Six ways to pay less, and what to do with no insurance.
Common questions
Did California expand Medicaid?
California expanded Medicaid. Adults under 65 with income up to 138% of the federal poverty level can qualify, and most prescriptions cost little or nothing.
Does California cap insulin costs?
California caps insulin at $35 for a 30-day supply in state-regulated health plans. Applies to large-group plans now and small-group plans starting January 1, 2027. Many job-based plans are self-funded and regulated federally instead, so ask your plan whether the cap applies to you.
Where do I buy a Marketplace health plan in California?
California runs its own marketplace, Covered California.
Sources: KFF (Medicaid expansion) · American Diabetes Association (insulin caps) · NCSL (state programs) · healthinsurance.org (marketplaces). Last checked October 1, 2026.
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