California Program Eligibility by Federal Poverty Level for 2024
Your eligibility for various Covered California or Medi-Cal programs depends on your income, which is determined based on the Federal Poverty Level (FPL). Let’s break down the key points:
Medi-Cal Eligibility:
1) Most consumers with incomes up to 138% FPL are eligible for Medi-Cal.
2) If you’re ineligible for Medi-Cal, you may qualify for a Covered California health plan with financial assistance. These plans include:
Federal premium tax credit
- Silver (94, 87, 73) plans
- Zero Cost Sharing and Limited Cost Sharing AIAN plans.
- Silver 94, 87, and 73 plans have no deductibles and lower co-pays and out-of-pocket maximum costs.
Premium Tax Credit:
- Consumers with incomes at 400% FPL or higher may receive a federal premium tax credit.
This credit helps lower their premium to a maximum of 8.5% of their income based on the second-lowest-cost Silver plan available in their area.
American Indian / Alaska Native (AIAN) Programs:
Zero Cost Sharing (100%-300%): For AIAN individuals within this income range.
Limited Cost Sharing (over 300%): For AIAN individuals with higher incomes.
Eligibility Ranges:
Medi-Cal Programs (shaded column headings):
Medi-Cal for Adults: Up to 138% FPL.
Medi-Cal for Children: Up to 266% FPL.
Medi-Cal for Pregnant Individuals: Up to 213% FPL.
MCAP (for Pregnant Individuals): Over 213%–322% FPL.
Federal Premium Tax Credit: 100%–400%+ FPL.
Silver 94: 100%–150% FPL.
Silver 87: Over 150%–200% FPL.
Silver 73: Over 200%–250% FPL.
AIAN Zero Cost Sharing: 100%–300% FPL.
AIAN Limited Cost Sharing: Over 300% FPL.
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