State Changes

California has been a leader in the nation in its efforts to expand access to health care for the 7 million uninsured residents in the state.

Medi-Cal

In 2013, Governor Jerry Brown elected to expand eligibility for the state Medicaid program, Medi-Cal. Beginning January 1, 2014, eligibility rules for Medi-Cal have been expanded to ensure more Californians are eligible for the program. Citizens, legal permanent residents and some lawfully present immigrants are eligible to apply. Eligibility for the program will be based on family size and monthly income ONLY.

Who is eligible for Medi-Cal?

  • Adults ages 19- 64 earning up to 138% of the federal poverty line (FPL).

Federal Poverty Line Guidelines for Adult Medi-Cal Eligibility

Family Size

138% FPL – Monthly Adjusted Gross Income

1

 $1,322

2

 $1,784

3

 $2,247

4

 $2,709

5

 $3,171

6

 $3,634
  • Children under the age of 19 whose household income is under 250% FPL

Federal Poverty Line Guidelines for Child Medi-Cal Eligibility

Family Size

266% FPL – Monthly Adjusted Gross Income

1

 $2,547

2

 $3,439

3

 $4,330

4

 $5,221

5

 $6,112

6

 $7,003

 

Covered California

California was the first state in the nation to set up a state-based health exchange, Covered California. Under the directive of the Patient Protection and Affordable Care Act, Covered California offers private health insurance plans to consumers to increase the number of insured Californians, improve quality of care, and lower costs through a competitive, innovative marketplace.

Citizens, legal permanent residents and lawfully present immigrants can apply for insurance through Covered California. The online marketplace contracts with 11 commercial health plans to bring better coverage, better access and better care. Covered California offers health plans based on your county of residence. The following health plans are available through Covered California for Contra Costa and Solano Counties.

Contra Costa County Health Plans                     Solano County Health Plans
Blue Shield                                                                        Blue Shield
Anthem Blue Cross                                                            Anthem Blue Cross
Health Net                                                                          Health Net
Kaiser Permanente                                                            Kaiser Permanente
Contra Costa Health Plan                                                  Western Health Advantage

Health insurance plans are offered on 4 medal-tier levels: Platinum, Gold, Silver and Bronze plans. The medal tiers indicate the amount that consumers and insurance companies split incurred expenses. High medal tiers, like Platinum and Gold plans, have higher premiums and lower out-of-pocket costs. Lower medal tiers, like Silver and Bronze plans, have lower premiums and higher out-of-pocket costs. Understanding your typical use of health care services will help inform the medal-tier plan you select.

Financial help is available to help pay for the cost of coverage. Households with incomes up to 400% FPL can receive up to 2 types of cost assistance when they buy health insurance through Covered California.

  • Premium tax credits – Available to households earning up to 400% FPL. This type of assistance lowers your monthly payment for health coverage.
  • Cost-sharing subsidy – Available to households earning up to 250% FPL AND choose the Silver Plan. This type of assistance reduces your out-of-pocket costs.

 

Eligible residents can now log-on to www.CoveredCA.com to explore their new coverage options. Click here for more information on how to apply.