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Login To PrismDoes someone with income below 138% always qualify for Medi-Cal?
If the individual meets all the eligibility requirements. See pages 8-12 in the Eligibility for Individuals and Families participant guide.
If so, why are they included in Covered California premium assistance tables?
The tables apply to states that did not opt to expand Medicaid, hence Medicaid coverage is limited to those up to 100% of the federal poverty line.
Note: To qualify for Medi-Cal, an individual must meet both financial and non-financial criteria, such as citizenship and immigration requirements. For example, most individuals who are not citizens but are lawfully present in the United States are not eligible for Medicaid for the first five years that they are in the United States. Hence, the individual may be eligible for premium assistance and cost-sharing reductions.
There may be a more recent answer to this question. Contact Claremont for an update.
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