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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


Group Insurance or Medi-Cal?

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Question: I have a family of 4 with gross income of $28k. My employer offers me affordable insurance for myself but no contributions to my dependents. Can I and my family go on Medi-Cal? Joe

Answer: Medi-Cal eligibility rules do not conform to the ACA and IRS guidelines regarding access to affordable employer-based coverage. Your $28k income for a 4-person household makes you and your dependents eligible for Medi-Cal. You may opt out of your employer-sponsored coverage and apply for Medi-Cal.

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If your employer is paying 100% of your portion of the premium I would suggest you opt for your company plan and put just your family on medi-cal or your family AND you on medi-cal. It is super hard to find doctors especially specialists like surgeons who will take medi-cal and with so many more people qualifying for medi-cal there are even few providers. For example, I contacted Sutter patient relations for help finding a doctor for my sister and was told they are not taking any new medi-cal patients at least until September 2015.

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