What's the difference between Covered California and Medi-Cal?

Asked by: Makenna Lehner  |  Last update: July 21, 2023
Score: 4.6/5 (13 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.

Is Medi-Cal or covered ca better?

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.

Can I get 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 both 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.

Is Medi-Cal the same as the Affordable Care Act?

Medi-Cal—California's Medicaid program—is a state-federal program that offers free or low-cost health coverage to Californians with low family incomes. Prior to the Affordable Care Act (ACA), Medi-Cal served low-income families and children, the elderly, and people with disabilities.

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

41 related questions found

Is Covered California free?

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.

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.

How much is Medi-Cal per month?

Californians who qualify may be able to receive Medi-Cal by paying a small monthly premium based on their income. Premiums range from $20 to $250 per month for an individual or from $30 to $375 for a couple. To qualify, you must: Meet the medical requirements of Social Security's definition of disability.

Does Medi-Cal check your bank account?

Because of this look back period, the agency that governs the state's Medicaid program will ask for financial statements (checking, savings, IRA, etc.) for 60-months immediately preceeding to one's application date. (Again, 30-months in California).

Do I have to pay back Medi-Cal?

The Medi-Cal program must seek repayment from the estates of certain deceased Medi-Cal members. Repayment only applies to benefits received by these members on or after their 55th birthday and who own assets at the time of death. If a deceased member owns nothing when they die, nothing will be owed.

What is the income limit for Medi-Cal 2021?

A single adult can earn up to $17,775 in 2021 and still qualify for Medi-Cal. A single adult with one dependent can earn up to $46,338 annually and the child will still be eligible for Medi-Cal.

What is the maximum income to qualify for Medi-Cal 2022?

In 2022, the monthly income will increase to $1,564. In other words, an adult can earn up to $1,564 per month and still qualify for no cost Medi-Cal. MAGI Medi-Cal annual amounts for a single adult increased to $18,755, from $17,775 in 2021, for a single adult.

What is the disadvantage of Medi-Cal?

The loss of access to the resources is the primary disadvantage. Since you may have to act in advance, you could create and fund a Medi-Cal trust and ultimately find that you never need long-term care. As a result, you would have less financial flexibility. Some people create income-only Medi-Cal trusts.

Do I get dental with Medi-Cal?

Medi-Cal offers comprehensive preventative and restorative dental benefits to both children and adults.

Does Medi-Cal cover surgery?

With Medicaid for California, if you qualify and apply, can help you pay for doctor's visits, medication, dental screenings, rehabilitation, surgery, visits to the hospital and more.

What disqualifies 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 much money can I make and keep Medi-Cal?

To qualify for free Medi-Cal coverage, you need to earn less than 138% of the poverty level, based on the number of people who live in your home. The income limits based on household size are: One person: $17,609. Two people: $23,792.

Does Medi-Cal cover hospital stays?

Medi-Cal is a program that pays medical expenses for people with low income. This includes people who are aged, disabled, or have high medical costs. 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 good?

In a recent survey of Medi-Cal members, 90% of the members who answered rated Medi-Cal as a good or very good program.

What are the benefits of Medi-Cal?

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 Covered California have Kaiser?

Covered California Kaiser plans are offered in all of California's 19 pricing regions. Kaiser is an “in-house” network which means medical services are provided by a Kaiser medical group, a Kaiser laboratory, a Kaiser pharmacy and a Kaiser hospital.

What is Medi-Cal program?

Medi-Cal is California's Medicaid health care program. This program pays for a variety of medical services for children and adults with limited income and resources. Medi-Cal is supported by federal and state taxes.

Who pays for Covered California?

Gold level: On average, the health plan pays 80% of covered health-care costs; the consumer pays 20%. Platinum level: On average, the health plan pays 90% of covered health-care costs; the consumer pays 10%.

Is Obamacare the same as Covered California?

Covered California is the state's Obamacare exchange. This means your Obamacare plan options are the same as your Covered California options. The plans on Covered California are divided by carrier and into four different metal tiers — Bronze, Silver, Gold and Platinum.