Can I apply for Covered California if I have Medi-Cal?
Asked by: Caleb Mraz | Last update: August 4, 2025Score: 4.5/5 (24 votes)
Can I have Covered California and Medi-Cal?
These two-program families are called “mixed-program families.” Your family can apply for both through Covered California application. Individuals in a mixed-program family will face different, but typically lower, costs due to their eligibility for both Covered California and Medi-Cal.
How do I transition from Medi-Cal to Covered California?
Moving Between Covered California and Medi-Cal
To report changes, call Covered California at (800) 300-1506 or sign in to your online account.
Who is not eligible for Covered California?
Who is Not Eligible for Covered California? If you are not lawfully present in California, you are not eligible for a Covered California plan. However, you can still apply through Covered California to find out if you are eligible for Medi-Cal or to find coverage for family members who are lawfully present.
What income disqualifies you from Covered California?
The limits are based on both household income and household size. In 2024, an individual in a one-person household is eligible for some degree of Covered California subsidies if they earn up to $33,975 Meanwhile, that limit rises to $69,375 for a household size of 4.
Medical vs Covered CA Eligibility
What are the requirements to apply for Covered California?
- You must be a California resident.
- You cannot be enrolled in Medicare or have employer-sponsored health care.
- You must be a lawfully present immigrant.
Why did I get denied for Covered California?
Covered California stated that your application was incomplete. You do not have other health coverage (such as free Medi-Cal or employer-sponsored insurance) that prevents you from qualifying for insurance through Covered California. Covered California stated that you are not a California resident.
What does Medi-Cal not cover?
Restricted scope Medi-Cal covers limited services. It does not cover medicine or primary care. If you have pregnancy-related limited scope Medi-Cal, you will have the full scope of Medi-Cal benefits, if the service is medically necessary.
Does Covered California check your income?
This is called “income verification.” Covered California does this by electronically asking the Internal Revenue Service (IRS) database and other databases if what you reported is the same as what they have on file. The IRS will not share your personal tax data with Covered California.
Can I apply for Covered California if I have a job?
You may have coverage as a current worker or retiree. You can shop for health coverage through Covered California, but you won't qualify for financial help in the form of premium tax credits if your employer offers a health plan that meets minimum value standards and is considered affordable.
How much does Covered California cost per month?
Apply for health insurance by Jan. 31 — and pay as little as $10 per month if you qualify. How many need coverage? Your Estimate $63 per month for a Silver plan. Bronze as low as $0.
How to get out of Medi-Cal?
If you are in a Medi-Cal health plan and want to choose another health plan for any reason, you may leave the health plan and join a different health plan. You can call Health Care Options (HCO), toll free, at 1-800-430-4263 (TTY 1-800-430-7077), 8 a.m. to 6 p.m. PT, Monday through Friday, except holidays.
What if I can't afford Covered California?
If you or anyone in your tax household has offers of health coverage from a job or through Covered California that you cannot afford, you can apply for an affordability hardship exemption.
What will disqualify you from Medi-Cal?
The Medi-Cal program determines eligibility for benefits on a “means” tested basis. If a Medi-Cal applicant's property/assets are over the Medi-Cal property limit, the applicant will not be eligible for Medi-Cal unless they lower their property/assets according to the program rules.
How long does it take for Covered California to kick in?
Coverage will usually start on the first day of the month following plan selection (for example, if you selected a plan on Dec. 31, your coverage would start on Jan. 1).
Does Covered California offer Kaiser?
You can buy health care coverage on California's health benefit exchange, Covered California. Covered California has Kaiser Permanente plans as well as other health plans for purchase.
What is the income limit for Medi-Cal 2024?
For 2024, the income limits are generally expressed as a percentage of the FPL and vary by the individual's category. For example, an individual may qualify for Medi-Cal if their yearly income is at or below $20,783. A couple may qualify for Medi-Cal if their annual income is at or below $28,208.
Will Covered California affect my taxes?
If you receive a tax credit through Covered California, you must file taxes for that benefit year. You will receive a 1095-A form, which shows how much Covered California paid to your insurance company to help with the cost of your health coverage. You will use the information on your 1095-A to fill out IRS Form 8962.
What kind of money counts as income?
Generally, you must include in gross income everything you receive in payment for personal services. In addition to wages, salaries, commissions, fees, and tips, this includes other forms of compensation such as fringe benefits and stock options.
Can you have Covered California and Medi-Cal?
Most applicants who apply through Covered California and enroll in Medi-Cal will receive care through managed health plans. Medi-Cal eligibility to include low-income adults. When you complete a Covered California application, your eligibility for Medi-Cal will automatically be determined.
What is the disadvantage of Medi-Cal?
The perception that Medi-Cal offered poorer coverage or less respectful treatment than other types of insurance. Concerns among noncitizen respondents that applying for Medi-Cal might affect their immigration status.
How long can you keep Medi-Cal?
Medi-Cal members must renew their coverage each year to keep their health care benefits.
Which health insurance company denies the most claims?
According to the analysis, AvMed and UnitedHealthcare tied for the highest denial rate, with both companies denying about a third of in-network claims for plans sold on the Marketplace in 2023, respectively.