Health insurance is a necessary expense for maintaining good health, but it can be challenging to find the right plan that works for you. In California, there are several different options for health insurance, including the state-sponsored Medi-Cal program and the Covered California marketplace. In this article, we will explore the various California State Health Insurance options available to you.
Medi-Cal
Medi-Cal is California’s state-sponsored health insurance program for low-income families and individuals. It provides healthcare to around 14 million Californians and is the largest Medicaid program in the country. If you meet certain income and residency requirements, you may be eligible for Medi-Cal coverage.
Who is eligible for Medi-Cal?
Medi-Cal is available to individuals and families whose incomes are at or below 138% of the federal poverty level. This includes low-income children, pregnant women, seniors, and people with disabilities. Undocumented immigrants are also eligible for Medi-Cal coverage unless they are incarcerated.
To determine if you are eligible for Medi-Cal, you can check your eligibility online at the Covered California website or by visiting your local county social services office.
What does Medi-Cal cover?
Medi-Cal covers a range of healthcare services, including preventative care, doctor visits, hospitalization, prescription drugs, mental health care, dental care, and vision care. Certain services such as long-term care and home health care may have limitations.
How do I apply for Medi-Cal?
You can apply for Medi-Cal online, by phone, or in person at your local county social services office. The application process requires documentation of your income, residency, and citizenship status. You can also receive assistance with the application process from a certified enrollment counselor.
Covered California
Covered California is the state’s health insurance marketplace, which helps individuals and families find affordable health insurance plans. It was established under the Affordable Care Act and offers a range of plans from several different insurance companies.
Who is eligible for Covered California?
Anyone can purchase a plan through Covered California, but premium subsidies and cost-sharing reductions are available to individuals whose incomes are at or below 400% of the federal poverty level.
What does Covered California cover?
Covered California plans offer essential health benefits, which include preventative care, doctor visits, hospitalization, prescription drugs, mental health care, and maternity care. Plans differ in the level of coverage and cost, so it is important to compare plans before choosing one.
How do I apply for Covered California?
You can apply for Covered California online, by phone, or with the help of a certified enrollment counselor. The application process requires documentation of your income, residency, and citizenship status. Open enrollment for Covered California plans typically starts in November and ends in January.
FAQs
Question |
Answer |
What is the difference between Medi-Cal and Covered California? |
Medi-Cal is California’s state-sponsored health insurance program for low-income individuals and families, while Covered California is the state’s health insurance marketplace that offers subsidized plans to individuals and families. |
Can I have both Medi-Cal and Covered California? |
Yes, you can have both Medi-Cal and a Covered California plan, but you cannot use both forms of coverage for the same service. You will need to inform your healthcare provider which coverage to use for each service. |
What happens if I cannot afford health insurance? |
If you cannot afford health insurance, you may be eligible for Medi-Cal or low-cost Covered California plans. You can also receive assistance from certified enrollment counselors who can help you find the best options for your budget. |
What is the penalty for not having health insurance? |
The penalty for not having health insurance in California is the greater of $695 per adult and $347.50 per child or 2.5% of your household income. |
What if I lose my job and my health insurance with it? |
If you lose your job and your health insurance with it, you may be eligible for COBRA continuation coverage, which allows you to keep your employer-sponsored health insurance for a certain period of time. You can also apply for Medi-Cal or Covered California plans during open enrollment or special enrollment periods. |
In conclusion, California offers several different health insurance options to residents, including the state-sponsored Medi-Cal program and the Covered California marketplace. It is important to research and compare plans to find the best option for your needs and budget.
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