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Medi-Cal to Covered California: Transition Guide

Your income changed and you no longer qualify for Medi-Cal? Learn how to smoothly transition to Covered California without gaps in your health coverage.

What's the Difference Between Medi-Cal and Covered California?

Feature Medi-Cal Covered California
Cost Free or very low cost Varies; subsidies available
Income Limit Up to 138% FPL 138-400%+ FPL
Provider Network Medi-Cal providers only Varies by carrier/plan
Plan Choice Assigned or limited choice Choose from 10+ carriers
Enrollment Year-round Open Enrollment or SEP

Income Limits for Medi-Cal vs Covered California

Your income determines which program you qualify for:

2025 Income Guidelines (Monthly)

Household Size Medi-Cal Max Covered CA Range
1 Person $1,732/mo $1,732 - $5,020/mo
2 People $2,351/mo $2,351 - $6,815/mo
4 People $3,588/mo $3,588 - $10,400/mo
Note: Income limits change annually. Use our Income Calculator for current amounts.

How to Transition from Medi-Cal to Covered California

If your income increases above Medi-Cal limits, follow these steps:

  1. Report your income change to Medi-Cal
    Required within 10 days of the change
  2. Check if you qualify for Covered California subsidies
    Use the income calculator to estimate your help
  3. Apply for Covered California during your SEP
    You have 60 days to enroll after losing Medi-Cal
  4. Coordinate your coverage start date
    Align with your Medi-Cal end date to avoid gaps
  5. Pay your first premium promptly
    Coverage doesn't start until you pay
Important: Don't wait for Medi-Cal to notify you. Apply to Covered California as soon as you know your income increased.

Avoiding Coverage Gaps

To ensure continuous coverage during your transition:

  • Apply early: Start your Covered California application before Medi-Cal ends
  • Note key dates: Know exactly when your Medi-Cal terminates
  • Choose coverage start: Select a start date that aligns with your Medi-Cal end date
  • Pay immediately: Your Covered California coverage only begins after your first payment

Example Timeline

  • March 15: Report income increase to Medi-Cal
  • March 20: Apply for Covered California
  • March 25: Pay first premium
  • March 31: Medi-Cal coverage ends
  • April 1: Covered California coverage begins

Mixed Households: Some on Medi-Cal, Some on Covered California

It's common for family members to qualify for different programs based on individual circumstances.

Common Scenarios:

  • Children on Medi-Cal, parents on Covered California: Children may qualify for Medi-Cal at higher income levels
  • Pregnant women: May qualify for Medi-Cal even with higher income
  • Adults with disabilities: Different eligibility rules may apply
One Application: Apply through Covered California and the system will automatically determine if family members qualify for Medi-Cal.

Need Help with Your Transition?

Our licensed agents can guide you through the Medi-Cal to Covered California transition.

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