What counts as income for Medi-Cal in California?

Asked by: Gaylord Schumm  |  Last update: August 17, 2023
Score: 4.9/5 (42 votes)

Nearly all income that a Medicaid applicant receives is counted towards the income limit. Countable income includes employment wages, alimony payments, pension payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends.

What does Medi-Cal consider income?

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.

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.

Is Medi-Cal based on income or assets?

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 assets less than $130,000 for an individual and $195,000 for a couple.

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.

What is the monthly income limit for Medi-Cal in California?

40 related questions found

Is Medi-Cal means tested?

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.

Does Covered CA verify income?

How will Covered California check my income? Covered California will check the income you reported on your application and compare it to what the IRS has on file for you.

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.

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.

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).

Does Covered California use gross or net income?

What's the maximum income I can have and be eligible for government assistance through Covered California? A household's size and gross income determines Covered California eligibility. This health insurance marketplace's subsidies are offered to low-income applicants.

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.

Is Medi-Cal free in California?

Medi-Cal is California's version of the Federal Medicaid program. Medi-Cal offers no-cost and low-cost health coverage to eligible people who live in California.

What's the difference between Covered California and Medi-Cal?

What is the difference in coverage between Medi-Cal and Covered California?​​​​ Medi-Cal is health coverage, just like the coverage offered through Covered California. Medi-Cal provides benefits similar to the coverage options available through Covered California, but often at lower or no cost to you or your family.

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?

Does Medi-Cal renew every year?

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.

What is the income 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.

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 to avoid Medi-Cal estate recovery in California?

Federal regulations prevent the DHCS from pursuing recovery for Medi-Cal services in the following circumstances:
  1. The deceased's spouse is still alive, whether they live in California or not.
  2. A disabled underaged child of the deceased resides in the deceased's home.