What happens if Medi-Cal expenses exceed income?
Asked by: Harley O'Kon | Last update: April 11, 2025Score: 4.2/5 (2 votes)
What if my Medi-Cal expenses exceed my income?
You are allowed to deduct all qualified medical expenses if they are more than the annual adjusted gross income (AGI) limit. The IRS does not have a gross cap on medical deductions because you must itemize all medical expenses and deductible expenses on Form 1040, Schedule A.
Do you have to repay Medi-Cal after your income increases?
If your income is more than what you told us on your application, you may have to repay some or all of the advanced premium tax credits that you got. There are limits to the amount you may need to repay, depending on your income and if you file taxes as “Single” or another filing status.
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.
What is the income limit for the Medi-Cal share of cost?
If your countable income is higher than 138% of the federal poverty level for Medi-Cal, currently $1,732 for an individual or $2,352 for a couple as of April 1, 2024, you may owe a shared monthly cost. This is calculated by deducting the maintenance need for the household from countable income.
Medi-Cal Monthly vs. Covered California Annual Income Issues
What will disqualify you from Medi-Cal?
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.
How to get rid of Medi-Cal share of cost?
Extra health insurance premium costs can be used to lower your countable income and may help you get rid of your share of cost. Some examples of extra health insurance premium costs are dental and vision plans, or Medicare Part D prescription plans.
Does Medi-Cal check your income?
Most people who apply for Medi-Cal can find out if they qualify based on their income. For some types of Medi-Cal, people may also need to give information about their assets and property.
Why is my Medi-Cal share of cost so high?
This dollar amount is called Share of Cost (SOC). A Medi-Cal subscriber's SOC is similar to a private insurance plan's out-of-pocket deductible. Generally, a subscriber's SOC is determined by the county welfare department and is based on the amount of income a subscriber receives in excess of “maintenance need” levels.
Can Medi-Cal ask for money back?
Involuntary Provider Reimbursement/Recoupment: If the provider does not voluntarily agree to reimburse the entire payment you made for a service that should have been covered by Medi-Cal. In this case, the payment of the entire expense you paid for that service will be recovered/recouped from the provider by Medi-Cal.
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.
Does Medi-Cal look at your bank account?
Starting on January 1, 2024, Medi-Cal applications will no longer ask for asset information.
How can I avoid paying back my premium tax credit?
Report any changes in your income during the year to the Marketplace, so your credit can be adjusted and you can avoid any significant repayments at the end of the year.
What if my expenses exceed my income?
If your expenses are more than your income, the difference is a net loss. You usually can deduct your loss from gross income on page 1 of Form 1040 or 1040-SR. But in some situations your loss is limited. See Publication 334, Tax Guide for Small Business (For Individuals Who Use Schedule C), for more information.
What happens if medical bills exceed policy limits in California?
If medical bills exceed the at-fault driver's policy limits, you can pursue compensation through other sources, such as underinsured motorist coverage. California drivers must carry a minimum of $30,000 in coverage per accident, which may not cover serious injuries.
Is it worth claiming medical expenses on taxes?
The medical expense deduction covers a wide variety of expenses. However, because of the high Standard Deduction and the 7.5% of AGI threshold requirement, it can be difficult to benefit unless you have a lot of out-of-pocket costs.
What if my income is too high for Medi-Cal?
Yes. If you make too much to qualify for Medi-Cal, you can apply for Covered California. Covered California is a state-run health care insurance exchange that offers financial assistance to reduce your premiums payments.
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.
Can I pay out-of-pocket if I have Medi-Cal?
There are also no co-payments or out-of-pocket costs associated with receiving benefits under MAGI Medi-Cal. Non-MAGI Medi-Cal: The amount that a family or an individual must pay for Medi-Cal benefits is determined by the amount of available income that remains after appropriate exclusions and deductions are allowed.
How much can you make before you lose 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.
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.
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.
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.
How do I protect my assets from Medi-Cal?
Proper elder law Medi-Cal planning is having all assets held in a decedent's revocable living trust to avoid both probate and Medi-Cal recovery. It is very important to plan for your loved ones by having a revocable living trust.