Why does the Income Chart show the income level of 138% $16,244 – $17,644
to obtain Enhanced Silver 94 and the Covered Ca explanation says

“Enhanced Silver 94: If you have an income between $15,857 ($11,490 if not eligible for full-scope Medi-Cal) and $17,235, you would qualify for an Enhanced Silver-level plan 94, which has a 94 actuarial value.”

138-percent
Excerpt of Covered CA MAGI Income Chart – This is from an earlier chart…

We are working on making this page more readable in plain English…

 

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***The income levels based on Federal Poverty Level, benefits and premiums change every year.  The best way to see what fits for you is to get a complementary quote and subsidy calculation.  Then we can discuss your situation more intelligently.

It appears than not everyone under 138% of MAGI qualifies for Medi-Cal and some that do, can still get Silver 94.

“the eligibility level (federal poverty level) BEGINS AT 100% (instead of 138%) if you are NOT eligible for full-scope Medi-Cal.” As stated on  Page 1 Covered CA Tax Credit FAQ’s 2014 

***the Medi-Cal definition of ‘full-scope’ means all medically necessary medical services, preventive services and dental services

Does this mean men (18 – 64) having 100% of FPL get the Enhanced Silver plans OR what does it mean

***CA has Medi-Cal Expansion  thus it’s only theoritical that one can get Silver 94 if their MAGI income is between 100 and 138% of FPL

 

Why 100% is theoretical for most Californian's
Why 100% is theoretical for most Californian’s

 

Here’s the most recent page on Covered CA’s site about it.

San Diego County Outreach – Medi-Cal Expansion under ACA
 ObamaCare - Expansion to 138% of FPLObamaCare – Expansion to 138% of FPL
Health Coverage for those with Low Income
Health Coverage for those with Low Income

What is ‘full-scope” of benefit no cost  Medi-Cal?

 

See also our share of cost Medi-Cal Page

4 comments on “Full Scope Medi-Cal vs Silver 94?

  1. would be beneficial to me to switch to the enhanced 94 plan when I’m currently Under full scope of benefits Medi-Cal and denti-cal for about $7,000 worth of dental work that denti-cal won’t cover that needs to be performed?

    Are there any available plans Under The Inn at Silver 94 which offer Dental Care better than what is normally offered through denti-cal?

    • Click here, get a quote and then when the plans show up, click compare on both of them and it will show them side by side.

      Here’s HMO, PPO & EPO Definitions

      When you get the quotes, click on provider list and you can see if the plan includes your doctors and hospitals.

      To see the side by side comparison, you have to do it for a November or December effective date. January rates will be out 11.1.2018, but you won’t see the Blue Cross plans.

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