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Medi-Cal vs Obamacare - What's the difference?

  Sanjiv Gupta CPA  Published 
Medi-Cal vs Obamacare - What's the difference?

First, let's see what is Obamacare (at least what is left of it).

During the presidency of Obama, a bill was signed that was known as the Affordable Care Act or ACA. President Obama promoted it as Obamacare and this phrase quickly caught on.  This act provided numerous benefits to those who were uninsured and those with pre-conditions.  However, it also came with a penalty for those who didn't have insurance.  Penalty clause was repealed by the Trump administration (GOP Tax Bill that was enacted in December 2017).   Just to clarify, if you were uninsured in 2018, the penalty will still be assessed. 

Obamacare is usually referred to health insurance plans that are sold in the health insurance exchanges. 

Now, let's take a quick look at Medical.

What is Medi-Cal?

This is a government health insurance program. 

It is often FREE or low-cost.  Almost everyone with lower income can meet the criteria for Medical. Seniors, children, adults, people with disabilities, Kids in foster parents care can qualify for Medical. 

Do they cover all the services?

No, they do not.  These low-cost insurance plans usually only cover essential health benefits. For example:

  • Emergency services
  • Ambulatory patient services.
  • Hospitalization
  • Preventive and wellness services and chronic disease management.
  • Laboratory services
  • Rehabilitative and habilitative services and devices
  • Prescription drugs
  • Mental health and substance use disorder services
  • Behavioral health treatment

We recommend that you carefully check what services are covered or NOT covered by Medi-Cal when you enroll. Rules are often changing.

Medi-Cal or Obamacare - Getting Approved

Obamacare is easier to get. It is private and subsidized by the Government for those with lower income.  On the other hand, criteria to get the Medical is strict. It varies by the state.

So, what should I get?

Start with Health Insurance Exchange -  They will check to see if you qualify for medical. If they determine that you do qualify, it will forward that information to the right department. If you are not eligible then you can continue the process of getting Obamacare.

In the State of California, you will go to Covered California Website. They will determine your eligibility and process your application.

If you qualify for a subsidy by the government, you will be notified.

Lastly, what if you don't qualify for Medi-cal or Covered California. You are NOT OUT OF LUCK.

You can check with your county. Most counties run special health clinics and insurance programs for those who do not qualify for other programs.