Is Covered California the Same as Medicare?

Covered California and Medicare are two separate programs

Covered California is not Medicare. Covered California is California's health insurance marketplace where people under 65 can shop for private health plans. Medicare is the federal program for people 65 and older, regardless of where they live. They are run by different agencies, use different rules, and cover different groups of people.

If you are 65 or older, you enroll in Medicare through Social Security or Medicare.gov, not through Covered California. If you are under 65 and live in California, you may shop for plans through Covered California. Some people may have access to for both programs at the same time — this happens when someone turns 65 while already enrolled in a Covered California plan — but the two programs do not merge or replace each other.

Key Takeaways

Covered California is for people under 65 in California; Medicare is for people 65 and older nationwide.
Covered California plans are private insurance sold through a state marketplace; Medicare is a federal program with its own enrollment process.
If you turn 65 while on a Covered California plan, you must enroll in Medicare and can keep your Covered California plan temporarily during the transition.
Some people under 65 with low income may may have access to for both Medi-Cal (California's Medicaid program) and Covered California at the same time.
You cannot use a Covered California plan to delay Medicare enrollment after 65 without facing penalties.

Who each program covers

Medicare covers people age 65 and older, some younger people with disabilities, and people with end-stage renal disease. It is the same program everywhere in the United States. You become may be able to access on the first day of the month you turn 65, and you enroll through Social Security or Medicare.gov.

Covered California covers people of any age under 65 who live in California and are U.S. citizens or lawfully present immigrants. You enroll through Covered California's website during the open enrollment period (usually November through January) or if you have a may have access to life event like losing other coverage, moving to California, or having a baby.

How enrollment works for each program

To enroll in Medicare, you contact Social Security or visit Medicare.gov. You do this once, around the time you turn 65. Medicare has three main parts — Part A (hospital), Part B (doctor visits), and Part D (prescription drugs) — and you choose which parts you need. Enrollment happens on a federal timeline with specific important date.

To enroll in Covered California, you visit CoveredCA.com, create an account, and enter your household income and family size. Covered California then tells you which plans you can see and whether you may be may be able to access for subsidies that lower your monthly cost. You can change plans once a year during open enrollment or when ready if you have a may have access to event.

What happens if you turn 65 while enrolled in Covered California

When you turn 65, you must enroll in Medicare Part A and Part B. You can do this while keeping your Covered California plan temporarily, but you cannot stay on Covered California permanently once you are may be able to access for Medicare. Most people drop their Covered California plan once Medicare starts, since Medicare becomes the primary coverage.

If you miss the Medicare enrollment window when you turn 65, you may face a permanent penalty on your Medicare Part B and Part D premiums. Covered California coverage does not count as "creditable coverage" that protects you from this penalty, so delaying Medicare enrollment to stay on Covered California is not a safe strategy.

The relationship between Covered California and Medi-Cal

Medi-Cal is California's Medicaid program — free or very low-cost coverage for people with low income. When you explore through Covered California, the system automatically checks whether you may have access to for Medi-Cal. If you do, you are enrolled in Medi-Cal instead of a Covered California plan, at no cost to you.

Some people may have access to for both Medi-Cal and Covered California subsidies in the same year, depending on their income. Medi-Cal is always free if you may have access to, so you would be placed in Medi-Cal first. This is different from Medicare, which is a separate federal program that does not interact with Covered California's enrollment system.

Cost differences between the programs

Covered California plans have monthly premiums that vary by age, income, and which plan you choose. If your household income is below a certain level, you may receive a subsidy that reduces your premium. You also pay a deductible, copays, and coinsurance when you use care.

Medicare has different costs depending on which parts you enroll in. Part A is usually free if you or your spouse paid Medicare taxes while working. Part B has a monthly premium (the standard amount is set each year by Social Security). Part D (prescription drugs) has a monthly premium that varies by plan. Medicare also has deductibles and copays, but they work differently than Covered California plans.

When to contact each program with questions

If you have questions about Covered California, contact Covered California directly at 1-800-300-1506 or visit CoveredCA.com. They can tell you whether you may have access to for subsidies, help you compare plans, and answer questions about enrollment important date.

If you have questions about Medicare, contact Medicare at 1-800-MEDICARE (1-800-633-4227) or visit Medicare.gov. Social Security can also answer questions about Medicare enrollment if you are approaching age 65. If you are already on Medicare and considering a Covered California plan, ask Medicare whether doing so would affect your coverage or your penalties.

Frequently Asked Questions

Can I use Covered California instead of Medicare after I turn 65?

No. Once you are 65, you must enroll in Medicare. You can temporarily keep a Covered California plan while you transition to Medicare, but you cannot use Covered California as your main coverage after 65. Missing the Medicare enrollment important date can result in permanent premium penalties.

If I am on Covered California, do I automatically get Medicare at 65?

No. You must actively enroll in Medicare yourself through Social Security or Medicare.gov. Covered California does not transfer you to Medicare automatically. You should enroll about three months before you turn 65 to avoid gaps in coverage.

Can I have both Medi-Cal and a Covered California plan at the same time?

If you may have access to for Medi-Cal, you will be enrolled in Medi-Cal instead of a Covered California plan, since Medi-Cal is free. You cannot have both at the same time. However, some people may have access to for Medi-Cal in some months and Covered California in others, depending on income changes.

What should I do if I am turning 65 and currently on Covered California?

Contact Medicare at 1-800-MEDICARE or visit Medicare.gov to enroll in Part A and Part B about three months before your 65th birthday. Let Covered California know you are turning 65 so they can help you understand what happens to your current plan. You may be able to keep your Covered California plan briefly while Medicare starts.

Does Covered California cover the same things Medicare does?

Covered California plans and Medicare cover similar services — doctor visits, hospital care, prescription drugs — but the details are different. Covered California plans are private insurance with their own rules about deductibles and copays. Medicare has standardized coverage rules set by the federal government. The best way to compare is to look at the specific plan documents.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.