Is Medi-Cal means tested?

Asked by: Prof. Liza Boyle  |  Last update: December 12, 2023
Score: 4.7/5 (3 votes)

The Medi-Cal program determines eligibility for benefits on a “means” tested basis. If a Medi-Cal applicant's property/assets are over the Medi-Cal property limit, the applicant will not be eligible for Medi-Cal unless they lower their property/assets according to the program rules.

Can I qualify for Medi-Cal if I have savings?

4. How to Qualify. To find out if you qualify for one of Medi-Cal's programs, look at your countable asset levels. As of July 1, 2022, you may have up to $130,000 in assets as an individual, up to $195,000 in assets as a couple, and an additional $65,000 for each family member.

How is income determined for Medi-Cal?

You are 19-64 years old and your family's income is at or below 138% of the Federal Poverty Level (FPL) ($20,120 for an individual; $41,400 for a family of four). You are a child 18 or younger and your family's income is at or below 266% of FPL ($79,800 per year for a family of four).

Is there an asset limit for Medi-Cal?

Phase I, implemented on July 1, 2022, increased the asset limit to $130,000 per individual and $65,000 for each additional household member. (The previous limits were $2,000 for an individual, $3,000 for a couple, and $150 for each additional household member.)

How much income is too much for Medi-Cal?

Most single individuals will qualify for Medi-Cal if there income is under $1,676 per month. Most couples will qualify if their income is under $2,267 per month. If you have disabilities, your income can be slightly higher. You can qualify for Medi-Cal even if you have assets.

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41 related questions found

Is Medi-Cal based on gross income?

The most common form of Medi-Cal is Modified Adjusted Gross Income (MAGI) Medi-Cal. It uses tax rules to see if you qualify. Non-MAGI Medi-Cal is Medi-Cal that uses other rules to count property, household income, and size to see if you qualify.

Does 401k count as income for Medi-Cal?

You meet assets requirements for Medi-Cal. This Medi-Cal program exempts all Internal Revenue Service (IRS) approved retirement accounts, such as employer sponsored 401k, 403b accounts, or individual retirement accounts (IRAs) authorized in the IRS codes.

Can an IRA affect Medi-Cal eligibility?

In some circumstances, Medi-Cal does not count funds held in an IRA, Keogh, or other work-related retirement arrangement. To find out if Medi-Cal would count your IRA, Keogh, or work-related retirement arrangements, you may contact your local county welfare department.

How many cars can you own on Medi-Cal?

ONE car. Insurance policies. Whole life (if total face value is $1,500 or less) and term life.

Can you have Medi-Cal and work insurance at the same time?

Note: You can choose to get Medi-Cal even if you have employer-sponsored coverage. If you have both at the same time, Medi-Cal may decide it is cost-effective for them to pay your portion of your employer-sponsored health insurance's premium.

Does Medi-Cal cover copays?

Medi- Cal may pay for any co-pays or deductibles you accrue under your private health insurance coverage, Medicare Part A (in-patient hospital), Medicare Part B (out-patient services, including specialty care and lab tests), Veterans Insurance, Tricare or any other public or private insurance plan that allows for such ...

Does Medi-Cal cover surgery?

medications. Inpatient hospital services • Anesthesiologist services • Surgical services (bariatric, reconstructive surgery, etc.) Organ & tissue transplantation • Outpatient laboratory and X-ray services o Various advanced imaging procedures are covered based on medical necessity.

Does social security count as income?

Some of you have to pay federal income taxes on your Social Security benefits. This usually happens only if you have other substantial income in addition to your benefits (such as wages, self-employment, interest, dividends and other taxable income that must be reported on your tax return).

What assets are exempt from Medicare?

Non-countable resources include the following:
  • Primary Residence. Generally speaking, an applicant's primary residence is a non-countable (exempt) resource. ...
  • Household Goods and Personal Effects. ...
  • Motor Vehicle. ...
  • Burial Spaces and Irrevocable Burial Reserves. ...
  • Life Insurance Policies. ...
  • Property Essential to Self-Support.

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.

Does Medi-Cal report to IRS?

DHCS will only report a person's coverage to the IRS and FTB if that person receives coverage from Medi-Cal. Every person in the home enrolled in Medi-Cal will get their own Form 1095-B. If you have family members enrolled in Covered California, they should receive Form 1095-A.

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.

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.

What is modified adjusted gross income for Medi-Cal?

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. Property rules: No property limits. Non-MAGI Medi-Cal includes many special programs.

What is the asset limit for Medi-Cal 2024?

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.