Citizen/LPR >5 years*
Citizen/LPR >5 years*
Pregnant
Age 19-65
Age 65+
Pregnant
Disabled
Aged
Any
No cost Medi-Cal for these AIM-linked infants, ages 0-2
Medi-Cal for Access for Infants and Mothers (AIM)
linked infants, ages 0-2
Exchange with subsidy (sliding scale by need) or
private/employer health insurance
Any
>138% - 250+ % FPL
0-138% FPL
SSI/SSP
0-100+ % FPL
0-100+ % FPL
Medicare - depends on earnings
Depends on income; Share of Cost if over 100% FPL
Medicare - depends on earnings
Depends on income; Possible Share of Cost if over 100% FPL
~1.5% of household income
TBD if eligible for full-scope coverage on the Exchange
No cost Medi-Cal
HealthPAC co-pays depend on income
HealthPAC
Medi-Cal
HealthPAC
Call for screening info
Kaiser Child Health Plan
Call for screening info
No cost Medi-Cal
AIM
Call, Mail, or Online
* As of legislation passed in June 2013, recent legal immigrants (LPRs with < 5 years residency) without children
who are otherwise eligible for Medi-Cal will instead enroll in a Covered California plan and the state will cover
their premium costs, cost-sharing, and any Medi-Cal benefits not offered through their plan. If a recent immigrant
without children misses the open-enrollment, they will be eligible for state-only Medi-Cal. Recent legal immigrants
with Medi-Cal eligible children will still be eligible for state-only Medi-Cal (same as current policy).
This information is subject to change as additional rules become available.
Medicare only
Medicare & Medi-Cal (Dual)
Medicare (if on SSDI for 2 years) & Medi-Cal
AIM (for Mothers)
Medi-Cal
0 - 138% FPL
>200% - ~300% FPL
HealthPAC
>138 - 200% FPL
No cost Medi-Cal for Pregnancy Services Only
Health PAC & Emergency/Restricted Medi-Cal 1
0 - 138% FPL
>138 - 200% FPL
Exchange or Private/Employer Health Insurance
>400% FPL
Exchange/Private Premium & Plan Rates
Exchange Plan Rates with Tax Credit
Medi-Cal (parents & non-parents)
0 - 138% FPL
>138 - 400% FPL
No cost Medi-Cal
Medi-Cal
0 - 138% FPL: no cost
>138 – 250% +: share of cost depends on income
HealthPAC co-pays depend on income
1
Emergency/Restricted Medi-Cal eligibility depends on age of
children and income. Details for 2014 eligibility still TBD.
Linked to Foster Care
HealthPAC & Emergency/Restricted Medi-Cal 1
May be $8 or $15 per child, per month - depends on income.
Kaiser Child Health Plan (CHP) may be available if
child is denied full-scope (no-cost) Medi-Cal. May
be available to undocumented children.
< 300% FPL
0 - 200% FPL
Exchange/Private Premium & Plan Rates
Exchange or Private/Employer Health Insurance
> 250% FPL
>250-300% FPL
0 - 138% FPL: no cost
>138 – 250%: costs depends on age of children and income
Medi-Cal
0 - 250% FPL
No cost Medi-Cal
What Will I Have to Pay for Covered Services?
Medi-Cal
Healthcare Eligibility in 2014
Medicare
Walk-in, Call, or Online
Who Do I
Contact for
Enrollment?
For Provider Enrollment Questions, Contact [email protected]
Linked to CalWORKS,
SSI, or Adoptions
Income
Covered CA / Exchange
Call or Online
During first 8 months
Legal Permanent Residents (LPRs)
with Less than 5 years Residency
County Resident
(Undocumented)
Alameda County Social Services
Walk-in, Call, or Online
Refugee
Citizen/LPR >5 years*
Age 19-65
Adult
Citizen/LPR >5 years*
Citizen/LPR >5 years*
Age 0-26
Foster Child/
Youth
County Resident
(Undocumented)
Age 0-18
Citizen/LPR >5 years*
Residency
Child
Status
Version as of September 11, 2013
Eligibility Chart | Health Care in Alameda County: 2014