With this advice, the one thing you won’t need to do is worry.

Getting a letter saying that you no longer qualify for Medi-Cal can be a real shock to the system. But if one of these Medi-Cal Notice of Action letters lands in your mailbox, don’t panic! You can find a new, affordable health plan with the help of Covered California.

How Covered California Can Help

Choosing a new health plan might feel stressful, but support is available. Through Covered California, you can explore your health plan options, receive enrollment assistance when you need it and get matched with financial help if you are eligible.

In fact, Covered California is the only place where you can receive financial help for health insurance — and nearly nine out of 10 Californians who enroll end up qualifying for some form of help. If you qualify, you and your family may receive financial help to decrease the cost of monthly premiums. You may also discover cost-sharing reductions to lower out-of-pocket costs like copays, deductibles, and annual out-of-pocket maximum.

 
Finding a New Plan

The first step to finding the best health plan for you or your family is to get a feel for how different plans work. Most Covered California plans are divided into four categories: Bronze, Silver, Gold and Platinum. The benefits are the same for each category, but they differ in how the cost is split between you and your health plan. A Bronze plan offers the lowest monthly premiums, but typically has the highest out-of-pocket costs when medical care is needed. On the other end, a Platinum plan has the highest monthly premiums, but the lowest out-of-pocket costs. There is also an Enhanced Silver plan that allows members who qualify to receive the benefits of Gold or Platinum plans for the price of a Silver plan.

Residents under age 30 can opt for a minimum coverage plan (also known as a catastrophic plan). Minimum coverage plans through Covered California include three doctor or urgent care visits, as well as free preventive benefits. Additional care is paid out-of-pocket up to an annual limit. Individuals 30 and older may also be able to purchase minimum coverage plans based on a hardship or affordability exemption. Remember: If you ever have questions, free enrollment help is available.

Qualifying for Financial Help

Depending on yourincome and the number of people in your tax household, you may qualify for more than one financial help program. For example, if you are a family of four making $39,000— which puts adults above the cutoff for Medi-Cal — you would be eligible for an Enhanced Silver Plan with lower copays and deductible, as well as a federal tax credit to significantly lower your monthly health insurance premium. You can use our handy quick calculator tool to find out if you qualify for help to lower your health insurance costs. 

Getting Covered Now

But here’s the thing: Remember that Notice of Action letter you received? To prevent a gap in your coverage, you need to sign up through Covered California within 60 days from the last day of your Medi-Cal coverage listed in your notice. If you miss this special enrollment window, you may have to wait until the next open enrollment period to sign up.

 

Not only will missing the 60-day special enrollment window leave you without health coverage, but it may also cost you money. Most residents are required by California state law to have health insurance, so going uninsured could result in a penalty. To avoid this, put signing up for health insurance at the top of your to-do list as soon as you receive that Notice of Action letter.

However, if your annual household income is at or below 150 percent of the federal poverty level, up to $20,385 for a single person, you can enroll in coverage through Covered California any time of year. This new form of special enrollment doesn’t have a deadline but due to state penalties, it’s best not to wait!  

Use our Shop and Compare tool  to understand your options or apply for health insurance today. If you have questions or need assistance, free expert help is available.