Is Medi-Cal and Covered California the same?

Asked by: Lewis Mitchell  |  Last update: February 11, 2022
Score: 4.4/5 (32 votes)

Medi-Cal offers low-cost or free health coverage to eligible Californian residents with limited income. Covered California is the state's health insurance marketplace where Californians can shop for health plans and access financial assistance if they qualify for it.

Can you have Covered California and Medi-Cal at the same time?

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.

Is Medi-Cal a part of Covered California?

Medi-Cal is health coverage, just like the coverage offered through Covered California. Medi-Cal provides benefits similar to the coverage options available through Covered California, but often at lower or no cost to you or your family. ... Essential health benefits consist of: Outpatient (Ambulatory) services.

Is Covered California Medicare or Medicaid?

Medicare is not part of Covered California and if you are enrolled in Medicare, you cannot purchase a Covered California health plan. Covered California does not offer Medicare supplement insurance, Medigap, or Part D drug plans.

Is Medi-Cal the same as Obamacare?

Obamacare health insurance plans are available through the Covered California insurance marketplace and Health for California. If you sign up for insurance through Covered California, you are covered by Obamacare. Since these two options are the same, you do not have to worry about choosing between the two.

What are the differences between Covered California, health insurance companies, and Medi-Cal?

21 related questions found

Who is eligible for Covered California?

According to Covered California income guidelines and salary restrictions, if an individual makes less than $47,520 per year or if a family of four earns wages less than $97,200 per year, then they qualify for government assistance based on their income.

What is the difference between Medicaid and Medi-Cal?

Actually, the good news is – there is no difference between the two. Medi-Cal health insurance is merely California's Medicaid program, which is paid for with federal and state tax revenues.

Can you be on Medi-Cal and Medicare at the same time?

Medi-Cal can supplement Medicare services and help pay Medicare premiums, deductibles and copayments. In certain cases, Medi-Cal may also be used to pay private health insurance premiums. ... If you have both Medicare and Medi-Cal, be sure the medical providers you choose accept both sources of payment for your care.

Is Medi-Cal Medicare?

Medi-Cal is California's Medicaid health care program. Medi-Cal pays for a variety of medical services for children and adults with limited income and resources. Medicare is a federally funded insurance program for eligible participants 65 or over.

Is CalOptima the same as Medi-Cal?

Medi-Cal — also known as Medicaid — is a public health insurance program for low-income people offered by the state. ... CalOptima provides health care coverage for Orange County residents who are eligible for full Medi-Cal.

Who pays for Covered California?

Coverage Levels

Silver level: On average, the health plan pays 70% of covered health-care costs; the consumer pays 30%. Gold level: On average, the health plan pays 80% of covered health-care costs; the consumer pays 20%.

Does Kaiser accept Medi-Cal?

Kaiser Permanente participates in Medi-Cal in many counties. This means that, if you are a current Kaiser Permanente member and your situation changes, you may be able to keep your same doctor and continue your care with Kaiser Permanente if you qualify for Medi-Cal.

What is Medi-Cal coverage?

Medi-Cal covers most medically necessary care. This includes doctor and dentist appointments, prescription drugs, vision care, family planning, mental health care, and drug or alcohol treatment. Medi-Cal also covers transportation to these services.

How much is Medi-Cal per month?

How much are the premiums? The premiums for Medi-Cal for Families are $13 for each child and no more than $39 per family per month. What can I do if I disagree with paying a monthly premium? Monthly premiums must be paid for the child(ren) to remain eligible for this Medi-Cal program.

Does Medi-Cal check your bank account?

Yes. Asset tests are a part of Medicaid eligibility requirements. Medi-Cal is the State of California's Medicaid program. Bank accounts are one of the easier tests for the government to make.

How much money can you have in the bank and still qualify for Medi-Cal?

You may have up to $2,000 in assets as an individual or $3,000 in assets as a couple. Some of your personal assets are not considered when determining whether you qualify for Medi-Cal coverage.

Do I need to enroll in Medicare if I have Medi-Cal?

If you have Medi-Cal, you must enroll in a Medicare Part D drug plan. ... Medi-Cal pays for your long-term care and care in a nursing home. If you're in a Medicare Advantage plan, you must get all of your medical care from in-network doctors and other medical providers.

How do I qualify for Medi-Cal in California?

You can also get Medi-Cal if you are:
  1. 65 or older.
  2. Blind.
  3. Disabled.
  4. Under 21.
  5. Pregnant.
  6. In a skilled nursing or intermediate care home.
  7. On refugee status for a limited time, depending how long you have been in the United States.
  8. A parent or caretaker relative of an age eligible child.

What are the different types of Medi-Cal?

This guidebook explains the two kinds of Medi-Cal: Regular Medi-Cal and Medi-Cal Health Plans.

What is the income limit for Covered California 2021?

The Covered California income guidelines take into consideration your household income and size. In 2021, if you are a single person earning less than $47,000 per year, you qualify for government assistance. A family of four with an annual household income less than $97,200 qualifies for government assistance.

What is the income limit for Medi-Cal 2021?

Adults are eligible for Medi-Cal if their monthly income is 138 percent or less of the FPL. For dependents under the age of 19, a household income of 266 percent or less makes them eligible for Medi-Cal. A single adult can earn up to $17,775 in 2021 and still qualify for Medi-Cal.

What is the income limit for Covered California 2022?

In general, individuals and families with annual incomes between 138% and 150% of the federal poverty line — $17,775 to $19,320 for an individual and $36,570 to $39,750 for a family of four — can get the lowest level of coverage, known as bronze, for no monthly premium in 2022.

How does Medi-Cal differ from Medicare?

Medicare provides health coverage to individuals 65 and older or those with a severe disability regardless of income, whereas Medi-Cal (California's state-run and funded Medicaid program) provides health coverage to those families with very low income, as well as pregnant women and the blind, among others.

Who is not eligible for covered ca?

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.

How much is Covered California Monthly?

Covered California premiums average about $830 a month for an individual in 2021. But after subsidies from the Affordable Care Act and the American Rescue Plan, the average consumer pays less than $100 a month.