What is the Difference Between Covered California and Medi-Cal?

Health insurance can be confusing in California as there are many different state offerings for healthcare as well as individual insurance agencies offering health insurance and Medicare plans. Understanding the difference between each offering can help you find the right policy for you or your loved ones at the best price.

The main difference between Covered California and Medi-Cal is that Covered California is a marketplace for health insurance and Medi-Cal is a low-cost (or cost free) Medicaid health care plan.

What is Covered California?

Covered California is a health insurance marketplace available for free in California that allows Californians to find affordable health insurance plans. Applying for Covered California may allow you to compare multiple insurers and health insurance policies to qualify for discounts. Through Covered California, you can also find coverage through Medi-Cal.

Qualifications to use Covered California depend on your income. As a rule, individuals earning less than $47,520 a year or four-member families making less than $97,200 a year may qualify for Covered California.

What is Medi-Cal?

Medi-Cal is a Medicaid health care program offered by the state of California to help eligible individuals enroll in Medicaid who may be struggling with lower income. As a state and federally supported program, Medi-Cal helps pay for a portion or total of medical services.

To be eligible for Medi-Cal, you must live in the state of California and have a social security number (SSN) or immigration status. Your immigration status will not effect your eligibility for Medi-Cal, however.

Those who may qualify for Medi-Cal include:

• Children under 19 years of age
• Adults 19 through 64 years of age
• Parents and caretakers of minors
• Pregnant individuals

Eligibility is primarily based on your Modified Adjusted Gross Income (MAGI). If you do not reach these qualifications, you can still qualify for Non-MAGI Medi-Cal. To qualify for Non-MAGI Medi-Cal, you must meet certain property rules along with age and/or disability qualifications. For example, you must provide proof of property such as bank accounts or vehicles and have limited property in the household.

Those who may qualify for Non-MAGI Medi-Cal may include adults or children in long-term care facilities, individuals receiving Medicare, individuals who are blind or disabled, children under 21, adults 65 years of age or older, pregnant individuals and parents or caretakers of an age-eligible child.

Be sure to speak with an insurance agent or representative to discuss your qualifications for Medi-Cal or Covered California.

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