Medi-Cal vs. Covered California: Which One Do You Qualify For?

Medi-Cal is California's Medicaid program, and an adult qualifies with household income up to 138% of the poverty line: $1,836 a month for one person or $3,795 for a family of four in 2026. Apply once at CoveredCA.com today to see which program each person in your household gets: Medi-Cal takes applications all year, and Covered California's 2027 open enrollment runs to January 31. Above the Medi-Cal line, you buy a private plan through Covered California, with a federal tax credit for 2027 coverage up to 400% of poverty ($63,840 a year for one person) and extra state help up to 200% ($31,920). Children qualify for Medi-Cal at almost twice the adult limit, so a family can have the kids on Medi-Cal and the parents on Covered California.

Is Medi-Cal the same as Medicaid?

Yes. Medi-Cal is the name California gives its Medicaid program. The California Department of Health Care Services runs it, your county Medi-Cal office handles applications and renewals, and federal Medicaid law sets the core rules, including the work rules and twice-a-year eligibility checks that reach adults 19 to 64 who qualify by income alone in 2027. California also pays, with state money alone, for full coverage for people whose immigration status federal Medicaid excludes: children of any status, for example, get full-scope Medi-Cal.

Medicare is a different program: federal health insurance for people 65 or older and some younger people with disabilities. People with low income and savings can hold both, with Medicare paying first; see our Medicaid vs. Medicare guide.

Covered California is the state's health insurance marketplace, an independent part of state government. It sells private plans from 12 insurers in 2027 and is the only source of sliding-scale premium help.

Which program each person in your household gets

List everyone in your tax household, applying or not: you, a spouse or domestic partner, and anyone you claim as a dependent.

Medi-Cal judges an applicant on this month's household income, so a layoff or a cut in hours can qualify you right away even when your yearly total runs higher. Covered California works from your household's estimated income for the whole year. Limits for every household size, and the asset limit's drop to $21,000 on July 1, 2027, are on our Medi-Cal income limits page.

You can turn Medi-Cal down, but the person who declines then pays full price for a Covered California plan. A job offer also blocks Covered California's help: an employee-only plan at work that costs you under 10.22% of household income in 2027, and pays at least 60% of costs as most job plans do, counts as affordable and rules out the tax credit. For your spouse and children, the test uses the cost of family coverage, so they can still get help when the family premium runs higher.

What each costs and when you can join

The enhanced federal tax credits ended December 31, 2025, so the 2027 federal credit stops at 400% of poverty, $132,000 for a family of four. California put $300 million into its state subsidy for 2027: from 150% to 200% of poverty, your share of the benchmark silver plan sits 1.5 percentage points below the federal share. Our premium tax credit guide has the full scale.

What to do today

1. Gather income for everyone in your tax household: this month's pay stubs, unemployment and self-employment records, and your best estimate of 2027 income.
2. Apply once. Use CoveredCA.com, call Covered California at (800) 300-1506 (TTY (888) 889-4500), or apply through BenefitsCal or your county Medi-Cal office.
3. Act on each result. For anyone placed in Medi-Cal, watch for the county's notice, then a packet of health plans; pick one within 30 days or Medi-Cal picks for you. For anyone placed in Covered California, compare plans in Shop and Compare, enroll by December 31 for a January 1 start, and pay the first bill to the insurance company.
4. Bring in a free helper if you get stuck. Certified enrollers help free statewide; first-time applicants get a callback within 15 minutes through Help on Demand.

Where it splits

• If your Medi-Cal is ending: if you qualify for financial help, California law has Covered California enroll you in the plan that gives you the most of it. Enter the access code from your notice to keep, change or cancel it. Choose within one month of your Medi-Cal end date to avoid a gap; enrollment stays open for 90 days. See moving from Medicaid to Marketplace coverage.
• If your income changes while you have Covered California: report it in your account within 30 days. A drop after a layoff can move you to Medi-Cal. A raise lowers your help, and starting with the 2026 tax year you repay the full amount of any excess help when you file.
• If you have legal status but no green card: you can buy Covered California plans, but from January 1, 2027, its financial help goes only to green card holders, Cuban and Haitian entrants and COFA migrants. Refugees, asylees, TPS holders and visa holders pay full price. DACA recipients lost Covered California eligibility in August 2025.
• If you are undocumented: Covered California is closed to you; Medi-Cal is your route. Children and pregnant people get full coverage. Adults 19 and older who apply now get restricted scope: emergencies, pregnancy and nursing home care. Adults already on full scope keep it by renewing on time; if it ends, sign up again within three months to keep full scope.
• If the county says you missed the 2027 work rules: answer its letter by the deadline with proof of $580 a month in earnings, 80 hours a month of job training, volunteering or a mix of activities, half-time school, or an exemption such as caring for a child 13 or younger. Medi-Cal lost over the work rules also bars you from the federal tax credit at Covered California, so the fix runs through the county.

Your leverage when a decision is wrong

• Medi-Cal denied, cut or ended: request a state hearing within 90 days, online with the State Hearings Division, by phone at (800) 743-8525, or on the back of the Notice of Action.
• Covered California got your eligibility or financial help wrong: file an appeal within 90 days of the date it mailed the decision, on its appeal form. Check Yes to keep your coverage or financial help during the appeal (Continued Enrollment), and keep paying your premiums. A state administrative law judge hears it, usually by phone, and most appeals are decided within 90 days of a valid request.
• Free help with coverage and immigration questions: the Health Consumer Alliance answers at (888) 804-3536.

If you are applying for a green card through a relative or an employer, talk with an immigration attorney before you take Covered California financial help: under the federal public charge rule in effect since September 18, 2026, help you receive can be weighed against your application. Help your citizen or green-card-holder family members get is generally left out of your case. Green cards based on asylum, refugee status, U or T visas, VAWA or Special Immigrant Juvenile Status are exempt.

Call script for a result that looks wrong

Before you decline or enroll, call Covered California at (800) 300-1506 and say:

"My case number is [number]. The eligibility results put [name] in [Medi-Cal / a Covered California plan], but our household of [size] has [amount] in income this month and expects [amount] for 2027. Please recheck that result and tell me which documents you need."

Today

Apply today with this month's income and your 2027 estimate; each person's result shows when you submit. People placed in Medi-Cal get a county notice and a plan packet by mail; people placed in Covered California pick a plan by December 31, and the insurer's first bill usually arrives in about two weeks. If anyone has medical bills from the last three months, file before January 1 so Medi-Cal's 3-month look-back still covers them.