Covered California is the state’s health insurance marketplace where individuals and families can shop for health insurance. If you qualify, you may be able to get health insurance with financial help. Financial help is available to people within a certain income range. The amount of financial help you get depends on your income and the size of your household. For people with very low incomes, free or low-cost health insurance is available through Medi-Cal. Medi-Cal is California’s Medicaid program. This program is administered by the state of California and is funded jointly by the state and federal governments.
Covered California Programs
Covered California is a health insurance marketplace where individuals and families can purchase affordable health insurance plans. It offers a variety of programs, including:
Medi-Cal
Medi-Cal is California’s Medicaid program. It provides health coverage to low-income individuals, families, and children. Medi-Cal is available to individuals who meet certain income and asset requirements. If you qualify for Medi-Cal, you will be able to choose a health plan from a variety of options.
Covered California Health Insurance Exchange
The Covered California Health Insurance Exchange is a marketplace where individuals and families can purchase health insurance plans. The Exchange offers a variety of plans from different insurance companies. You can compare plans and prices to find the one that best meets your needs and budget.
Covered California Premium Assistance Program
The Covered California Premium Assistance Program is a government program that helps individuals and families pay for their health insurance premiums. The amount of assistance you receive is based on your income and family size. If you qualify for the Premium Assistance Program, you will need to choose a health plan from the Exchange.
Covered California Cost-Sharing Reduction Program
The Covered California Cost-Sharing Reduction Program is a government program that helps individuals and families pay for their health insurance deductibles, copayments, and coinsurance. The amount of assistance you receive is based on your income and family size. If you qualify for the Cost-Sharing Reduction Program, you will need to choose a health plan from the Exchange.
Programs Offered By Covered California Enrollees
- Medi-Cal
- Covered California Health Insurance Exchange
- Covered California Premium Assistance Program
- Covered California Cost-Sharing Reduction Program
| Program | Description |
|---|---|
| Medi-Cal | California’s Medicaid program |
| Covered California Health Insurance Exchange | Marketplace where individuals and families can purchase health insurance plans |
| Covered California Premium Assistance Program | Government program that helps individuals and families pay for their health insurance premiums |
| Covered California Cost-Sharing Reduction Program | Government program that helps individuals and families pay for their health insurance deductibles, copayments, and coinsurance |
Eligibility Requirements for Medicaid
To qualify for Medicaid through Covered California, you must meet certain eligibility criteria set by the California Department of Health Care Services (DHCS). These criteria include:
- Income: Your household income must be at or below 138% of the federal poverty level (FPL). You can check your income eligibility using the Covered California Eligibility Calculator.
- Age: You must be under 19 years old, 65 years or older, or pregnant.
- Citizenship status: You must be a U.S. citizen or a qualified immigrant.
- Residency: You must be a resident of California.
- Disability: You may also be eligible for Medicaid if you have a disability that prevents you from working.
In addition to these general requirements, there are also specific eligibility criteria for different types of Medicaid programs. For example, to qualify for Medi-Cal for Children, your child must be under 19 years old and meet certain income and residency requirements.
To apply for Medicaid through Covered California, you can:
- Apply online: You can apply for Medicaid online at the Covered California website.
- Apply by phone: You can apply for Medicaid by calling the Covered California customer service line at 1-800-300-1506.
- Apply in person: You can apply for Medicaid in person at a Covered California enrollment center.
Once you have applied for Medicaid, your application will be reviewed by the DHCS. If you are approved for Medicaid, you will receive a Medi-Cal card in the mail. You can use your Medi-Cal card to get health care services from any provider that accepts Medi-Cal.
| Household Size | Income Limit (138% of FPL) |
|---|---|
| 1 | $19,320 |
| 2 | $26,148 |
| 3 | $32,976 |
| 4 | $39,792 |
| 5 | $46,608 |
| 6 | $53,424 |
| 7 | $60,240 |
| 8 | $67,056 |
Covered California: Health Insurance Financial Assistance
Covered California is a health insurance marketplace that assists you in finding affordable and comprehensive health insurance coverage. The marketplace offers a range of plans from various insurance companies, making it easier for individuals and families to compare plans and choose the one that suits their needs and budget. Additionally, Covered California provides financial assistance to help make health insurance more affordable for eligible individuals and families.
Eligibility for Financial Assistance
- California residents
- US citizens and certain immigrants
- Have a Social Security number or a pending Social Security number application
- Meet income requirements (typically below a certain annual income level)
How to Apply
To apply for financial assistance through Covered California, you can follow these steps:
- Visit Covered California’s Website
- Create an account
- Provide personal information, income information, and citizenship or immigration status
- Select a health insurance plan
- Submit your application
Once your application is processed, you will receive a notice stating whether you are eligible for financial assistance. If you are eligible, the amount of assistance you receive will depend on your income and the number of people in your household.
Using Financial Assistance
If you qualify for financial assistance, your monthly premium payments for health insurance will be reduced. The amount of your reduction will vary based on your financial situation. Here are some key points to remember about using financial assistance:
- Financial assistance is applied directly to your monthly premium payments, making your health insurance more affordable.
- You can choose any health insurance plan offered through Covered California, regardless of whether it is a subsidized plan.
- Your eligibility for financial assistance may change if your income or household size changes.
Benefits of Covered California
Covered California offers several benefits to individuals and families, including:
- Access to a wide range of health insurance plans from multiple insurance companies, giving you more options to choose from.
- Financial assistance for those who meet certain income requirements, ensuring affordable health insurance coverage.
- A user-friendly website and application process, making it easy to enroll in a health insurance plan.
- Ongoing support and assistance to help individuals and families manage their health insurance coverage.
| Annual Income | Monthly Premium Without Assistance | Monthly Premium With Assistance |
|---|---|---|
| $20,000 | $250 | $100 |
| $30,000 | $300 | $150 |
| $40,000 | $400 | $200 |
Thanks for making it to the end of the piece! I know the topic of Covered California Medicaid can be a bit daunting, so I tried to break it down in an easy-to-understand way. This piece only covered basic information about covered Medicaid, so there’s a lot more to learn. Be sure to check out the Covered California website or give them a call if you have any other questions. And don’t forget to come back and visit again soon for more informative articles like this one.