Covered California

Medi-Cal Redetermination Means Many Families Switching to Covered California Health Insurance Plans

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Medi-Cal membership was frozen during the pandemic, with no annual process for redetermining whether people qualified financially for Medi-Cal. Instead, people who were already on Medi-Cal were able to remain on Medi-Cal. Now, Medi-Cal redetermination has resumed. The Department of Social Services is checking whether each Medi-Cal enrollee is still eligible.

Important information to note:
  • For people whose income has increased, causing them to lose Medi-Cal eligibility, Covered California will be mailing information to them about how to maintain health insurance coverage. Covered California will work with Medi-Cal to select the Covered California health insurance plan that provides the most financial help for each person.
  • People will need to confirm their Covered California plan selection in order for their new coverage to take effect. Covered California is urging Medi-Cal members to check their mail and respond quickly by either confirming their new plan, changing their plan, or opting out of coverage. A quick response will prevent a lapse in coverage where the family has no health insurance at all.
  • Both individuals and families can purchase sliding-scale health insurance through Covered California. For example, if a child is covered by Medi-Cal, the parents can purchase insurance through Covered California. Or if an adult has insurance through their employer, insurance for their child can be purchased through Covered California if the employer does not offer dependent coverage and the child does not qualify for Medi-Cal.

There are extra federal subsidies through 2025, so Covered California plans are especially affordable. However, immigrants who are not lawfully present do not qualify for Covered California plans (though they may qualify for coverage through Medi-Cal, depending on their income). (Sept 2023)

Health Navigation

The SLO County Public Health Nurse Navigator Program helps SLO County residents get access to the health care they need.
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If a resident doesn't have health insurance, needs help finding a provider, or something else related to navigating the health care system, contact the Health Care Access and Navigation staff for a free, confidential evaluation at 805-781-4838. Learn more and find a Contact Form here.

Need Help?

Contact an advocate or staff member at a Family Resource Center for support with non-medical needs such as food, clothing, shelter, parent education and navigating social services. A full listing of Family Resource Centers in San Luis Obispo County can be found here: https://sloparents.org/slo-frc-directory/​

Enrollment Assistance

To locate a local Covered CA-certified insurance agent, click here. Certified Insurance Agents may have specialized knowledge about which providers and medications are covered by each plan that would be helpful for people with more complex medical situations. This service is free of charge.

The Covered California online enrollment system is available at www.coveredca.com. Covered California and Medi-Cal can both be applied for at this website. After the client enters information, they find out whether they qualify for Medi-Cal or Covered California. Anyone can determine their eligibility in advance at: https://apply.coveredca.com/lw-shopandcompare/.

For additional local enrollment assistance information, click here.

Additional Information

Open Enrollment takes place each year during the fall. Typically, if you do not have a "qualifying life event" you must wait until open enrollment to enroll in a Covered California Plan. Medi-Cal enrollment is always open year round.

Special Enrollment is always open for people who have a qualifying life event, to enroll in a Covered CA plan or make changes to their current plan. Coverage begins after completing the application process. For information on qualifying life events and how long the special enrollment is available for after the qualifying life event: www.coveredca.com/individuals-and-families/getting-covered/special-enrollment/.

Pediatric Dental coverage is included in Covered CA plans; families should ask their health insurance provider for more information.

Pregnant Women: There are several public and subsidized insurance options for pregnant women, regardless of immigration status. Read more here: www.coveredca.com/individuals-and-families/getting-covered/pregnant-women.