How often do you have to apply for Medi-Cal?

Asked by: Xzavier Ortiz III  |  Last update: August 16, 2023
Score: 4.8/5 (14 votes)

If I already have Medi-Cal benefits, do I need to reapply? No. If you already have Medi-Cal coverage, your Medi-Cal benefits will continue until your next regularly scheduled annual redetermination date. Your local county will contact you to get any updated information they need.

Do I have to re enroll in Medi-Cal every year?

Medi-Cal members must renew their coverage each year to keep their health care benefits. For most members, coverage is renewed automatically. Sometimes the county will send you a renewal form that you must review and return, along with any additional required information. Want to get started with Covered California?

How often must Medi-Cal be renewed?

Local Medi-Cal offices review each member's eligibility once a year or when they report changes to their household. Everyone's renewal date is different.

Is there a limit to Medi-Cal?

Phase I, to be implemented July 1, 2022, will increase the asset limit to $130,000 per individual, and $65,000 for each additional household member. Phase II, to be implemented no sooner than January 1, 2024, will eliminate the asset test entirely.

What income disqualifies you from Medi-Cal?

Adults qualify for Medi-Cal with a household income of less than 138% of FPL. However, according to the Covered California income guide, children who enroll on Obama Care California plans may qualify for Medi-Cal when the family has a household income of 266% or less.

What Is Medi-Cal? (Part 2) Eligibility Requirements

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What determines Medi-Cal eligibility?

Medicaid income eligibility in California is based on household size. To qualify for free Medi-Cal coverage, you need to earn less than 138% of the poverty level, based on the number of people who live in your home.

Can you be denied Medi-Cal?

If you don't apply for or keep no-cost health coverage or state-paid coverage, your Medi-Cal benefits and eligibility will be denied or stopped. 11. If you do not give necessary information or if you give information that you know is false, your Medi-Cal benefits may be denied or stopped.

What is California Medi-Cal changing to in 2023?

Starting January 2023, Medi-Cal health coverage for most remaining dually eligible beneficiaries changed from Fee-For-Service (FFS) Medi-Cal to Medi-Cal Managed Care.

Will I lose my Medi-Cal if I get a job?

If you get Medi-Cal coverage and then get a job, you have a couple of options for keeping your Medi-Cal benefits. If you got Supplemental Security Income (SSI) cash benefits before you got your job, Social Security's 1619(b) program lets you earn up to $56,758 annually and still keep Medi-Cal coverage at no cost.

What age does Medi-Cal stop?

All California residents under the age of 26 who meet the eligibility requirements can qualify to receive Medi-Cal, regardless of U.S. citizenship or immigration status.

What happens if I don't renew Medi-Cal?

Your Medi-Cal coverage will end if you don't turn in your renewal form or you are missing proof of things like income that the county asked you to send. Your local Medi-Cal office will mail you a letter (Notice of Action) to let you know if you didn't turn in your renewal form or are missing information.

How do I know if I already have Medi-Cal?

You can visit your local county human services office. You can use your information to confirm your Medi-Cal eligibility and get a temporary identification card.

Is Medi-Cal always secondary?

If a child has multiple insurance plans, Medi-Cal is always the payer of last resort — in other words, the last provider to be billed. The child's private insurance bears the primary responsibility for health care coverage.

What is changing in Medi-Cal in 2024?

Pending approval from the Centers for Medicare and Medicaid Services, beginning January 1, 2024, the second phase of this new law in California will eliminate the asset limit for all Non-MAGI Medi-Cal programs. Additional information about this change will be posted to this website at a future date.

Is Medi-Cal free?

Medi-Cal offers free or low-cost health coverage for California residents who meet eligibility requirements. Most applicants who apply through Covered California and enroll in Medi-Cal will receive care through managed health plans.

Can I choose Covered California instead of Medi-Cal?

You may be eligible for health coverage through Covered California if you are no longer eligible for Medi-Cal due to an income increase or change in household size. In order to avoid a gap in your health coverage, Covered California can help you select a new plan before your Medi-Cal coverage ends.

Is Medi-Cal income based?

Income-based Medi-Cal counts most types of earned and unearned income you have. However, some income is not counted, including Supplemental Security Income (SSI) benefits and some contributions to retirement accounts. Learn more about what types of income affect income-based Medi-Cal eligibility.

How does Medi-Cal confirm income?

Proof of Income. Income can be verified by providing various types of documents such as the acceptable list below. One of the most common proofs is a pay stub. If you submit a pay stub, make sure that it is current and within the last 45 days; otherwise, Covered California may not accept it.

What happens after you qualify for Medi-Cal?

When you qualify for Medi-Cal, you will receive a packet in the mail with health plans you can choose from. If you do not choose a health plan within 30 days, Medi-Cal will choose a plan for you. Your choices will depend on the county you live in.

What is the out of pocket maximum for 2023 Medi-Cal?

For the 2023 plan year: The out-of-pocket limit for a Marketplace plan can't be more than $9,100 for an individual and $18,200 for a family. For the 2022 plan year: The out-of-pocket limit for a Marketplace plan can't be more than $8,700 for an individual and $17,400 for a family.

What is regular Medi-Cal?

Medi-Cal is California's Medicaid program. This is a public health insurance program that provides free or low cost medical services for children and adults with limited income and resources.

What is the highest income to qualify for Medicaid?

Federal Poverty Level thresholds to qualify for Medicaid

The Federal Poverty Level is determined by the size of a family for the lower 48 states and the District of Columbia. In 2023 these limits are: $14,580 for a single adult person, $30,000 for a family of four and $50,560 for a family of eight.