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Medi-Cal and Obamacare: Some Surprising Twists

12/11/2013

1 Comment

 
Q: If my family of six qualifies for Medi-Cal under the Affordable Care Act, do we have to sign up for that? Or can we still buy subsidized health care plans through Covered California? … I have real concerns about the quality of care we would get on Medi-Cal. I’m hoping for a positive answer!

A: Sadly, I’m about to disappoint Beth from Modesto and others in her situation.

Medi-Cal is the state’s publicly funded health program for low-income and disabled residents, and currently provides care to more than 8 million Californians. (It is the state’s version of the federal Medicaid program.)
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Starting in January, Medi-Cal will broaden its eligibility requirements as a result of Obamacare, allowing applicants with higher incomes and those who were previously ineligible, such as childless adults, to get coverage.

But whether you’re eligible for Medi-Cal now or become eligible then, that fact alone disqualifies you from tax subsidies on the health insurance marketplace, which is called Covered California.

Covered California will offer 13 health plans across the state (not all in each region) that cover a standard set of benefits. Individuals and families who earn between 138 percent and 400 percent of the federal poverty level will be eligible for sliding-scale tax credits to purchase those plans.

Theoretically, Beth, you could reject Medi-Cal and buy insurance on the marketplace, but you’d have to pay full price.

“Anyone who is eligible for Medi-Cal but chooses this option would likely incur significant premiums and cost sharing,” says Norman Williams, spokesman for the state Department of Health Care Services, which administers Medi-Cal.

Sorry, Beth.

Article Source: http://blogs.kqed.org/stateofhealth/2013/07/17/medi-cal-and-obamacare-some-surprising-twists/

For information about Covered California and your health insurance alternatives, please call John Caris at  (707) 935-6294 or email him.
1 Comment
Emilia T Macayan
1/29/2014 11:45:44 am

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