On April 1, California began the annual Medi-Cal redetermination process, for each Medi-Cal enrollee to ensure that they are still eligible for Medi-Cal benefits. During this process, some enrollees will lose eligibility and as a result, lose their Medi-Cal coverage.

If a Medi-Cal enrollee is determined no longer eligible, the state will automatically assign the enrollee to an ACA plan. They will still need to take action within 60 days to enroll in the new plan. Enrollees who are auto assigned can still change their coverage to a different plan or carrier if they choose. Visit Covered California for more information.

Coverage options

For those individuals who no longer qualify for Medi-Cal, they still have choices for quality, affordable coverage. Coverage options may include:

• Employer-sponsored health plans
  
  • Once Medi-Cal coverage terminates, if employer coverage is an option, the individual will have 60 days to enroll in alternate coverage.
• Individual ACA plans through Covered California or directly through carriers, like Kaiser Permanente
  • Financial assistance could be available to those enrolling through Covered California, depending on their income. In 2023, it is estimated that 90% of marketplace consumers will receive financial assistance through Advanced Premium Tax Credits (APTC), and on average, these consumers saved over $800 in premiums per year.¹
  • All of Kaiser Permanente’s Individual and Family plans cover things like prescription drugs, doctor visits, urgent care, hospital visits, and more.
  • Kaiser Permanente Medi-Cal members who transition to another Kaiser Permanente plan can continue seeing their Kaiser Permanente doctors, for a seamless care experience regardless of their coverage type.
• Medicare for those over 65

How employers can support employees during the redetermination process

Employers play an important role in helping their employees navigate the complex world of health care coverage.

Employers can support their employees by:

1. Communicating details around the redetermination process and sharing options to stay covered.
   
2. Helping them prepare for the special enrollment period that’s triggered by the loss of Medi-Cal coverage.

Below are resources you can share with your employees who have lost Medi-Cal coverage:

• Employee flyer - How to stay covered if you lose your Medi-Cal coverage
  
• Medicaid Renewal Guide for individuals
• How to keep your Kaiser Permanente coverage webinar
• Kaiser Permanente’s continuation of coverage website
• Medicaid redetermination process explanation video
  

¹CMS Press Release, 3/23/2023: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-celebrates-affordable-care-acts-13th-anniversary-and-highlights-record