Coverage Options After COVID-19 Public Health Emergency (PHE)

Learn what the COVID-19 Public Health Emergency (PHE) is and how it could impact your Medi-Cal health coverage when it ends. We’re here to help connect you with the information you need to stay covered.

 

Need help? We can answer your questions and connect you to the best health coverage option for you and your family.

What You Need To Know

During the COVID-19 PHE, all Medi-Cal members kept their coverage, regardless of changes in eligibility or status. When the PHE ends, millions of individuals may lose Medi-Cal and will have to take additional steps to keep their current coverage or find a new plan.  We are here to help you understand your health coverage options, should you lose coverage.

Frequently Asked Questions About Coverage And The PHE

What Is The Public Health Emergency Or PHE?

 

As a result of the COVID-19 pandemic, a Public Health Emergency (PHE) was put into place on January 27, 2020. Federal law addressing the COVID-19 pandemic paused Medi-Cal eligibility reviews due to unemployment and an urgent need for health coverage. During this time, all Medi-Cal members kept their coverage, regardless of changes in eligibility or status.

How Does The PHE Impact Medi-Cal Renewals?

Before the PHE, Medi-Cal eligibility was reviewed by your local county offices. If your county office found you no longer qualified, you would lose your benefits.

Medi-Cal renewals have been put on hold during the PHE, allowing people enrolled in Medi-Cal  to continue their coverage without a  review.

When the PHE ends, you’ll need to complete a Medi-Cal renewal with your local county office to see if you are still eligible for Medi-Cal. If you find out you no longer qualify for Medi-Cal, don’t worry. We can help you maintain coverage when the PHE ends, whether through an Individual and Family plan, Medicare, or your employer.

What Is Medi-Cal Renewal?

Medi-Cal renewal is a review completed by your local county office to check if you’re still eligible for your coverage. You have to renew your Medi-Cal coverage to keep it. Missing your renewal deadline, incomplete paperwork, or forgetting a step in the renewal process all put you at risk of losing coverage. 

If you’ve had a change in income, age, or other qualifying factors, it’s possible you will no longer qualify. The only way to know for sure is to complete your renewal on time.

When it’s time for you to renew, you will receive a notice from the local county office telling you what you need to do. Please follow the steps to renew quickly. If you have questions, call your Customer Care Center number on your ID card.

What Can People Do Now To Prepare For Their Medi-Cal Renewal?

To prepare for Medi-Cal renewal, the first thing you can do is check if your local county office has your current mailing address and contact information. If you’ve moved or your contact information has changed, contact your local county office now to update them. This way, you won’t miss any important notices about your health coverage or your renewal packet when it’s time to renew.

However, if you’ve had major changes to your income, employment, or household, you might want to start looking into what your other coverage options are. You can check your eligibility for other coverage or estimate your costs if you buy through Covered California. Covered California is a free government service that works with Medi-Cal to make sure Californians have access to quality health care.  Covered California is the only place to get federal financial help when buying an Individual and Family health plan. When providing your information to Covered California, enter your best guess of what your income will be in 2023.

If I Am Working, Can I Get Health Coverage Through My Work?

 

If you no longer qualify for Medi-Cal coverage, but are currently employed, you may have access to health coverage through your company. Contact your employer to explore your options.

How Can I Find Affordable Health Coverage If I No Longer Qualify For Medi-Cal?

When the PHE ends, Covered California and the Department of Health Care Services will partner to transition consumers who no longer qualify for Medi-Cal into an Affordable Care Act (ACA) compliant qualified health plan with an approved health plan carrier. When this happens and you’ve been transitioned to an ACA compliant qualified health plan with Anthem, be sure to follow the process to complete your enrollment for coverage with us. Or, if you’ve received information about transitioning to a health plan carrier other than Anthem and have questions, give us a call at 1-866-545-0385 to help.

How Much Does Individual and Family Health Plans Cost?

Individual and family  health plans offered through Covered California are available to anyone who does not have health insurance, including individuals no longer eligible for Medi-Cal coverage. These plans offer comprehensive coverage that cover the 10 essential health benefits, including doctors’ services, hospital care, prescription drug coverage, and mental health services.  You also may be eligible for financial help (a subsidy) that could significantly lower or completely eliminate the monthly amount you pay for an Individual and Family health plan offered through Covered California.

What Are Cost-Sharing Reductions?

In addition to a subsidy, cost-sharing reductions (CSRs) are extra savings that reduce your out-of-pocket costs by lowering your deductible, coinsurance or copays, and your out-of-pocket maximum. If your income qualifies you for CSRs, you must enroll in a plan in the Silver tier to receive the extra savings.

Are There No-Cost Premium Health Plan Options?

Yes, while you may now be earning too much to qualify for Medi-Cal coverage, you could qualify for an Individual & Family health plan offered through Covered California that has a monthly premium as low as $0 (after subsidy applied).1

When Can I Enroll In An Individual Health Plan After Losing Medi-Cal Coverage?

If you no longer qualify for Medi-Cal coverage, you are eligible for a special enrollment period. You typically have 60 days from the date you lose Medi-Cal to apply for an Individual & Family health plan offered through Covered California, or 30 days from the date you lose Medi-Cal to enroll in employer-sponsored coverage.

How Do I Apply For A New Individual and Family Health Plan?

We can guide you through the application process and help you find an Individual and Family health plan offered through Covered California that fits your specific needs and budget. This will help ensure you don’t have a gap in health coverage for you and your family. We’re here to help.

You Can Feel Confident That You Have Health Insurance Options

You have other healthcare plan options if you lose Medi-Cal coverage. We can help you make the transition and find a plan that fits your needs and your budget.

Shop Plans

Understand Your Options

Medi-Cal Plans

If you need information about Medi-Cal, call the number on the back of your ID card.

Individual & Family Plans

If you’re no longer eligible for Medi-Cal and need new health coverage, we offer affordable plan options for you and your family.

Medicare Plans

If you’re 65 or older, find information about Medicare health plans.

Plans Available Through Your Work

If you’re employed, ask your employer what health plans are available to you.

If you are an employer, a producer, or healthcare provider, click below for more information.

For Producers 

For Employers 

For Providers 

Additional Information

Stay informed by checking these useful resources for additional information on Medi-Cal renewals and more.

1 Based on federal and/or state exchange requirements and subject to change. Anthem Blue Cross is a Qualified Health Plan issuer that in certain geographic areas offers some health plans with a $0 premium option (after subsidy applied) through Covered California. Health plans with a $0 premium option are not available in all areas and eligibility for these plans is based on federal annual income guidelines. Call us for information because not everyone will qualify. For example, singles earning up to $19,140, and couples earning up to $25,860 may be eligible. Family income eligibility varies based on number of family members.