How is income calculated for Medi-Cal?

Asked by: Cristobal Eichmann  |  Last update: March 4, 2025
Score: 4.6/5 (63 votes)

Income is considered when determining Medi-Cal eligibility. Income includes things such as, earnings from a job, unemployment benefits, disability benefits, self-employment income, retirement benefits, interest on assets, child or spousal support, and other means of income or support.

How does Medi-Cal determine income?

The Modified Adjusted Gross Income (MAGI) Medi-Cal method uses Federal tax rules to decide if you qualify based on how you file your taxes and your countable income.

What is deducted to income for Medi-Cal?

Examples of Medi-Cal income deductions include: child or dependent care, work expenses, court-ordered child support, alimony, educa- tional expenses, and health insurance premiums for other family members. The kind of docu- mentation required for income deductions varies based on the type of deduction and the source.

What is the income limit for Medi-Cal 2024-2023?

For 2024, the income limits are generally expressed as a percentage of the FPL and vary by the individual's category. For example, an individual may qualify for Medi-Cal if their yearly income is at or below $20,783. A couple may qualify for Medi-Cal if their annual income is at or below $28,208.

How much money can I have in the bank and still qualify for Medi-Cal?

asset information? eligibility for Medi-Cal. For new Medi-Cal applications only, current asset limits are $130,000 for one person and $65,000 for each additional household member, up to 10. Starting on January 1, 2024, Medi-Cal applications will no longer ask for asset information.

Medi-Cal Monthly vs. Covered California Annual Income Issues

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What disqualifies you from Medi-Cal?

To qualify, you must: Meet the medical requirements of Social Security's definition of disability. Be working and earning income (this can be part-time work). Have countable income less than 250% of the federal poverty level (in 2024, this equates to $3,158/mo.

What is the new law for Medi-Cal in 2024?

Beginning January 1, 2024, a new law in California will allow adults ages 26 through 49 to qualify for full-scope Medi-Cal, regardless of immigration status. All other Medi-Cal eligibility rules, including income limits, will still apply.

How do I check Medi-Cal eligibility?

Who is eligible? Qualify for Medi-Cal if your income is up to 138 percent of the Federal Poverty Level (FPL) for adults, and up to 266 percent FPL for children. Check Shop and Compare to see if you qualify. Learn more on the Department of Health Care Services website.

What is the highest income to qualify for Medicaid 2024?

Parents of Dependent Children: Income limits for 2024 are reported as a percentage of the federal poverty level (FPL). The 2024 FPL for a family of three is $25,820. Other Adults: Eligibility limits for other adults are presented as a percentage of the 2024 FPL for an individual is $15,060.

What is the minimum income to qualify for Covered California 2024?

For 2024, your expected income is less than $21,870 as a single person, less than $29,580 for a household of two people, less than $37,290 for a household of three people, or less than $45,000 for a household of four people.

What is the 3 month rule for Medi-Cal?

You may be able to receive a reimbursement if:

You received a Medi-Cal covered service on a date that you were eligible for Medi-Cal. The three periods of eligibility that are included are the following: RETRO: The 3-month period prior to the month you applied for the Medi-Cal program.

What happens if you make too much for Medi-Cal?

What can I do if I make too much money for Medi-Cal? You may get a private health plan through Covered California. You could also get financial assistance. If you qualify, your local Medi-Cal office will share your information.

Can I own a house and get Medi-Cal in California?

First, if you own a home, you can still qualify for Medi-Cal. California has one of the best health services in this regard because California does not ask that you sell your home and pay for your medical needs, but rather it will front all the medical bills for you while you are alive.

What happens if my income increases while on Medi-Cal?

You will not lose your Medi-Cal coverage while the continuous coverage requirement is in place if your income goes up or your household changes.

Do loans count as income for Medi-Cal?

For MAGI Medi-Cal, the loan is not considered taxable income and is excluded from the eligibility determination. For Non-MAGI, loans are considered property, and business property is exempt for the eligibility determination.

How does Medi-Cal verify income?

Earned Income Most recent pay stub, written statement from employer, completed employer's income verification letter. All verification must show gross income, pay period, date received and hours worked.

Is my income too high for Medicaid?

The income limits for Medicaid applicants can change depending on the state where they live, their marital status and the Medicaid program. In general, however, the income limits are low. In most states in 2025, the income limit for receiving long-term care at home or in a nursing home through Medicaid is $2,901/month.

Do I have to pay back Medi-Cal?

The Medi-Cal program must seek repayment from the estates of certain deceased Medi-Cal beneficiaries. Repayment only applies to benefits received by these beneficiaries on or after their 55th birthday and those who owned assets at the time of death.

Can you be denied Medi-Cal?

Common Reasons for Medi-Cal Coverage Denials

Eligibility Issues: Denials can occur due to discrepancies in income, residency, or documentation, leading to questions about eligibility.

Does Medi-Cal ask for bank statements?

No, asset information is not required. In 2024, renewal forms will no longer ask for asset information. That means you can keep your savings and assets and still keep your Medi-Cal coverage. It is important to open and review any mail received from your county about your Medi-Cal coverage.

How much is Medi-Cal per month?

How much does Medi-Cal cost? For many individuals who enroll in Medi-Cal, there is no premium, no co-payment, and no out of pocket cost. Effective July 1, 2022, all monthly premiums were reduced to $0.00.

Can I get Kaiser with Medi-Cal?

At Kaiser Permanente, you have a wide network of doctors and specialists to choose from. All of our doctors accept Kaiser Permanente Medi-Cal members. Get care from a doctor or specialist – including appointments, exams, and treatment. Your child can get regular check-ups – including shots and vaccines.

Does interest count as income for Medi-Cal?

CalABLE account earnings, including interest and dividends, are not counted as income for Medi-Cal eligibility purposes. Distributions from a CalABLE account are not counted as income for Medi- Cal eligibility purposes if used for a “qualified disability expense” (QDE).