how to avoid medi-cal in covered ca
First, there's a way to do the same process below for adults who don't want medi-cal but we'll focus here on children under age 19.
We see it quite often.
The adults get Covered California and the kids under age 19 get medi-cal.
Sometimes, this is the desired result but many times, it isn't for a variety of reasons including:
- Children's doctors don't work with medi-cal
- Medi-cal is impacted locally
- Parents want one carrier and plan for whole family
So...is this the final word? No!
There is a way to get the Covered California plans with tax credits for the adults and a separate standard plan for the children being offered medi-cal.
We'll cover the process and considerations along these lines:
- Why are kids being offered medi-cal if adults are getting Covered Ca plans?
- Can we get Covered Ca plans for kids eligible for medi-cal
- How to enroll kids in Covered Ca without medi-cal
- Key notes on separate account for kids
Let's get started!
Why are kids being offered medi-cal if adults are getting Covered Ca plans?
It all comes down to income.
The threshold for adults 19 and older for medi-cal eligibility is at 138% of the Federal Poverty level.
The level for children is 266%!
This can lead to "split households" where adults are offered Covered Ca with tax credits and even richer versions of the silver plan (depending on income) while the children under age 19 are offered medi-cal.
It can be very frustrating from families.
Ultimately, California thought it was helping families with this expanded child income threshold but that's not how it's viewed by many families (we head from them daily).
So...is there any around this?
Yes.
Can we get Covered Ca plans for kids eligible for medi-cal
As certified Covered Ca agents (no cost for our assistance), we can help with the whole process (it's not fun otherwise).
Essentially, we create a separate account with at least one adult as the primary and then enroll in such a way that the system doesn't look at income.
This allows children under 19 to get the standard plans. One note....we can't get a tax credit if an child is eligible for medi-cal or enrolling this way.
For some families, this doesn't matter because they really want to keep their children's doctors and operate outside of medi-cal.
So...what's the easiest way to get this done?
How to enroll kids in Covered Ca without medi-cal
First, delegate the current Covered Ca account with these steps below (see our Google Reviews here - there's no cost for our assistance with 1000's of Covered Ca enrollments to date - Check out our Google Reviews here):
- Log-in to your account at
Covered California
(must be logged in)
- Hit the Question picture at top and then
Select "Find Local Help"
- Click on the "Find an Agent" and search for
last name "Jarvis" on the right side.
- Click on "Dennis Jarvis" and hit designate.
Hit "Continue" and check boxes with signature.
Send us an email at
help@calhealth.net and request which family members to be enrolled
separately with no medi-cal.
That's it!
We'll process out the request and send confirmation...generally within 24 hours.
A few key points to make this process smoothly.
Key notes on separate account for kids
- We only need one adult on the account but that person will not be enrolled (since they already have coverage under the primary account)
- There is no tax credit available if we enroll children this way. You can run quotes here (don't put in income info) or we can quote for you with dates of birth and zip code.
- We cannot get the enhanced silver options (73, 87, or 94). Silver 70 is the only option available at that level but bronze, gold, and platinum are also available.
- You will likely have medi-cal through the primary account AND the stand-alone health plan for children. Medi-cal will not "unhook" enrollment unless income goes above the threshold. You can request current income chart at help@calhealth.net
- Open enrollment and special enrollment trigger requirements will
apply so check with us on ability to create new account
Make sure providers have new insurance info for claims
We have enrolled 100's of children in stand-alone plans this way and look forward to helping you.
You can always cancel the stand-alone plan month to month if you choose to.
We're happy to help with any questions!
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We just want to find the best fit for your needs!/p>
