What is the difference between Medi-Cal and Covered California?
Asked by: Prof. Berry Ruecker | Last update: February 2, 2024Score: 4.2/5 (25 votes)
What is the difference in coverage between Medi-Cal and 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.
What is the minimum income to qualify 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 kind of insurance is Covered California?
Covered California is a free service that connects Californians with brand-name health insurance under the Patient Protection and Affordable Care Act. It's the only place where you can get financial help when you buy health insurance from well-known companies.
What benefits does Medi-Cal cover?
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. Read more in “Covered Benefits” on page 12.
Does Medi-Cal cover surgery?
medications. Inpatient hospital services • Anesthesiologist services • Surgical services (bariatric, reconstructive surgery, etc.) Organ & tissue transplantation • Outpatient laboratory and X-ray services o Various advanced imaging procedures are covered based on medical necessity.
What are the differences between Covered California, health insurance companies, and Medi-Cal?
Can I choose Covered California instead of Medi-Cal?
You may be eligible for health coverage through Covered California if you are no longer eligible for Medi-Cal due to an income increase or change in household size. In order to avoid a gap in your health coverage, Covered California can help you select a new plan before your Medi-Cal coverage ends.
Can you have Medi-Cal and Covered California at the same time?
Medi-Cal and Covered California use the same application. This means that once you apply using CoveredCA.com, you'll find out which program you qualify for. Some households qualify for both.
Who gets Covered California?
California residents who don't have an offer of affordable coverage can get a health plan through Covered California. In addition, most immigrants qualify for health coverage, including the following groups: Lawful permanent residents (green card holders). Lawful temporary residents.
Does Covered California cover everyone?
Any Californian can get health insurance through Covered California if he or she is a state resident and cannot get affordable health insurance through a job. Applicants may qualify for a free or low-cost health plan, or for financial help that can lower the cost of premiums and co-pays.
What does Covered California include?
Hospitalization. Maternity and newborn care. Mental health and substance use disorder services, including behavioral health treatment. Prescription drugs.
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.
Is Covered California based on income?
What's the maximum income I can have and be eligible for government assistance through Covered California? A household's size and gross income determines Covered California eligibility. This health insurance marketplace's subsidies are offered to low-income applicants.
What happens if you don't qualify for Covered California?
If you are uninsured and are not eligible for Medi-Cal or a plan through Covered California, you may qualify for limited health services offered by your county. These programs are not insurance plans and do not provide full coverage.
How much can you make to stay on Medi-Cal in California?
Most single individuals will qualify for Medi-Cal if there income is under $1,676 per month. Most couples will qualify if their income is under $2,267 per month. If you have disabilities, your income can be slightly higher. You can qualify for Medi-Cal even if you have assets.
What is the limit for Medi-Cal in California?
On July 1, 2022, Medi-Cal asset limits increased to $130,000 for individuals, $195,000 for couples.
Can you join Covered California at any time?
Open enrollment for Covered California starts in the fall. Even when open enrollment is over, individuals with qualifying life events can enroll at any time of the year. Medi-Cal enrollment is also year-round.
Can you own a home and get Medi-Cal in California?
Property used as a home is exempt (not counted in determining eligibility for Medi-Cal).
What are the different types of Medi-Cal?
- Medi-Cal Dental Program. Dental services are currently provided as one of the many benefits under the Medi-Cal program.
- Fair Hearing. ...
- Health Insurance Premium Payments. ...
- Medi-Cal. ...
- Medi-Cal Eligibility. ...
- Medi-Cal Estate Recovery. ...
- Medi-Cal Managed Care.
Does Medi-Cal cover copays?
Medi- Cal may pay for any co-pays or deductibles you accrue under your private health insurance coverage, Medicare Part A (in-patient hospital), Medicare Part B (out-patient services, including specialty care and lab tests), Veterans Insurance, Tricare or any other public or private insurance plan that allows for such ...
Does Medi-Cal pay Medi-Cal bills?
If you meet the requirements of the program, Medi-Cal will help pay for doctor visits, hospital stays, prescription drugs, rehabilitation, and other medical services.
Is Medi-Cal free?
Medi-Cal offers free or low-cost health coverage for California residents who meet eligibility requirements. Most applicants who apply through Covered California and enroll in Medi-Cal will receive care through managed health plans.