MediCal is a joint federal and California state program that provides free or low-cost health coverage to some low-income people, families and children, pregnant women, the elderly, and people with disabilities. The federal government provides a portion of the funding for MediCal and sets guidelines for the program.
We can help with Medi-Cal
Qualify for Medi-Cal? We can help sign you up. Unlike CoveredCA, if there are errors or certain events that happen when you are on Medi-Cal, Medi-Cal has the authority to reclaim some of that money spent on you, as well as put liens on your homes and paychecks. That is why it is important to have a CalHealth agent help fill out your application and advise you on the risks. Unlike other online CoveredCA service agencies, we’ll help you get Medi-Cal through the CoveredCA application process (which makes it easier when you want to transition to CoveredCA).
How to switch from Medi-Cal to CoveredCA
Thankfully, CoveredCA and Medi-Cal use the same online application process that you can find on MyCalHealth.com. There is no need to fill out a new application. Your eligibility will simnply switch from Medi-Cal to CoveredCA. Usually, it will be a change in income, marital status, or household size, that will re-determine eligibility. Switching from Medi-Cal to CoveredCA is easiest when you are already a CalHealth client. Simply contact us when you are ready to make the switch and we can have you on your way to a new Federal and State subsidized plan in just a few minutes. We can also make change reports for you (changes in income, address, household, or tax filing status), as well as guide you into what plan will work best for you. There is no fee for this service. You’ll pay for an agent whether you use them or not so we invite you to use us as much as you need! If you are not a CalHealth client, switching is still fairly simple, it may simply take a few more minutes. We will review your case number (application), review your eligibility, and then present you with options that are specific to your county/region. It is important to note that Medi-Cal must release your case number to CoveredCA before you can sign up for CoveredCA health insurance.
What to say when speaking to a Medi-Cal enrollment worker when you want to switch to CoveredCA
This is one of our biggest coaching techniques. It is important that you never ask to be voluntarily removed from Medi-Cal. If you choose to voluntarily remove yourself from Medi-Cal you will not qualify for any other subsidies because you can only qualify for one or the other. If you qualify for Medi-Cal, but want CoveredCA, you will pay the unsubsidized rate (full price). If you are on Medi-Cal, but you know that you no longer qualify and want to switch from Medi-Cal to CoveredCA it is important that you call your county DCHS office and ask for an “eligibility re-determination.” This way it is Med-CAL who reruns your eligibility determination, and when they determine that you do not qualify, they will release you to CoveredCA. Be patient, this could take some time. This could take a few phone calls. In short, Medi-Cal has to release you to CoveredCA, you cannot release yourself from Medi-Cal. It may require sending in new financial documents (pay stubs, attestations, tax returns), but they must release you, you cannot release yourself and still expect government subsidies.
How to keep my kids off of Medi-Cal
There is a common scenario where parents will qualify for CoveredCA but their kids will qualify for Medi-Cal. Some welcome this scenario and some truly want to have everybody in the family all on the same plan. The easiest way to keep your kids off of Medi-Cal is to estimate your annual income higher than the Medi-Cal threshold for your income and family size. Since nobody can totally predict the future, CoveredCA will allow you to fill out an affidavit that attest to a higher income that your paychecks may show. Ironically, in many of the cases where we have estimated higher, the individual or family actually did make the higher income they reported and saved themselves the stressful process of trying to get off of Medi-Cal (see above). Again, it is best and safest to have a CalHealth agent walk you through this.
What isn’t covered by Medi-Cal
It is important to note that while Medi-Cal covers many things at little or no cost, there are some prescriptions that are not covered, and there are many medical offices that simply do not take Medi-Cal. In short, Medi-Cal may not always cover your wants, but is designed to cover your needs.