Covered California vs Medi-Cal: Understanding What's Best - Watch on YouTube
One of the most common questions in California health insurance is the difference between Medi-Cal and Covered California. They're both ways to get coverage, but they work very differently — and which one you qualify for comes down mostly to your income.
In short: Medi-Cal is California's Medicaid program — free or very low-cost coverage for lower-income residents. Covered California is the state's marketplace where you buy a private plan, often with a subsidy that lowers your premium. Here's how they compare.
| Feature | Medi-Cal | Covered California |
|---|---|---|
| What it is | California's Medicaid program | State health insurance marketplace |
| Cost | Free or very low cost for most | Monthly premium (often reduced by subsidy) |
| Income (adults) | Up to ~138% FPL | Above ~138% FPL, up to 400%+ for subsidies |
| Income (1 person, 2026) | Up to about $22,025 | Roughly $22,025 to $62,600 for subsidies |
| Plan type | Managed care through the state | Private plans (Kaiser, Blue Shield, Anthem, etc.) |
| Enrollment window | Year-round (anytime) | Open Enrollment + Special Enrollment |
| Renewal | Annual redetermination | Annual, with income reconciliation at tax time |
If your household income is at or below about 138% of the Federal Poverty Level, adults generally qualify for free Medi-Cal coverage.
Kids under 19 can qualify for Medi-Cal at higher household incomes than adults — up to 266% of FPL — even if the parents are on a Covered California plan.
Above the Medi-Cal line, you shop Covered California plans, usually with a premium tax credit that lowers your monthly cost.
It's common for kids to be on Medi-Cal while parents are on a subsidized Covered California plan. We sort out these split households all the time.
The two programs don't use the same Federal Poverty Level year. Medi-Cal uses the current year's FPL (from the Department of Health Care Services), while Covered California uses the prior year's. Right at the ~138% line, that can mean the difference between free Medi-Cal and a subsidized private plan — and getting your income estimate right matters.
If you're close to the border, or your income changes during the year, it's worth a quick conversation. This is exactly the kind of thing we help people navigate every day — at no cost. See our income limits page for the full chart.
Yes. If your income rises above the Medi-Cal threshold, you can transition to a Covered California plan (this is a qualifying event for a Special Enrollment Period). If your income drops, you may move to Medi-Cal. Because Medi-Cal enrolls year-round, timing these transitions correctly avoids coverage gaps — something we help clients manage smoothly.