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Covered California is the health insurance marketplace in the U.S. state of California established under the federal Patient Protection and Affordable Care Act (ACA). The exchange enables eligible individuals and small businesses to purchase private health insurance coverage at federally subsidized rates.
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The California Medical Assistance Program (Medi-Cal or MediCal) is the California implementation of the federal Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults with incomes below 138% of federal poverty level.
Here’s what you need to know as the deadline approaches.
Qualified claims must be described in the HRA plan document at inception: before reimbursing employees for the medical expenses. Arrangements (medical services, dental services, co-pays, coinsurance, deductibles, participation) may vary from plan to plan, and an employer may have multiple plans in place, allowing much flexibility.
California was one of the states to expand its Medicaid program. [6] As of 2018, about one-third of California was covered by Medi-Cal. It is administered by the California Department of Health Care Services, which operates it in accordance with California's Medicaid State Plan and Title XIX of the Social Security Act. [7]
In 2014 the payment amount was 1% of income or $95 per adult ($47.50 per child) limited to a family maximum of $285 (national average premium for a bronze plan), whichever is greater. [4] In 2015 the penalty increased to $285 per adult or 2% of income above the limit. [5]
Traditional Medicare’s Part B doesn’t cover most dental care, eye exams, routine physical exams, hearing aids, cosmetic surgery, concierge care or nursing home care.