What happens if you make too much for Medi-Cal?
Asked by: Prof. Brennon Kihn | Last update: September 6, 2025Score: 5/5 (37 votes)
What if my income is too high for Medi-Cal?
If your income is too high for Medi-Cal, you may qualify to purchase health insurance through Covered California. Covered California offers “premium assistance.” It helps lower the cost of health care for individuals and families who enroll in a Covered California health plan and meet income rules.
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.
How much can you make and stay on Medi-Cal?
You are 19-64 years old and your family's income is at or below 138% of the Federal Poverty Level (FPL) ($21,597 for an individual; $44,367 for a family of four). You are a child 18 or younger and your family's income is at or below 266% of FPL ($85,519 per year for a family of four).
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.
Too Much Income for Medicaid? What Can I Do?
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.
Can I work while on Medi-Cal?
Medi-Cal Coverage and Employment. A number of factors go into qualifying for Medi-Cal — but having a job isn't one of them. In fact, many people are employed and stay on Medi-Cal. Eligibility for the program is based on income and other variables.
How much money can I have in my bank account if I have 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. » I was not eligible in the past.
Does Medi-Cal verify income?
In order to determine your eligibility for Medi-Cal benefits, you may be required to submit information verifying your identity, income and/or property.
How can I lower my income for Medi-Cal?
Some examples of common deductions that may apply to you are: • Health insurance premiums (such as health, dental, vision, Medicare prescription drug and supplemental plans), • Upkeep of your home (for people who can return home within 6 months), and your spouse, registered domestic partner, or family are not living in ...
Do I have to pay back Medicaid if I get a job?
After you start working, your Medicaid coverage can continue, even if your earnings (alone or in combination with your other income) become too high to receive SSI.
What happens if I overestimate my income for healthcare gov?
If you overestimate your income and end up claiming less help than you are entitled to, the difference will be refunded to you when you file your income taxes the following year.
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.
What income do I report to Medi-Cal?
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 often does Medicaid check your income?
Yes, income and assets have to be verified again for Medicaid Redetermination. After initial acceptance into the Medicaid program, redetermination is generally every 12 months. The redetermination process is meant to ensure the senior Medicaid beneficiary still meets the eligibility criteria, such as income and assets.
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 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.
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 are the restrictions for Medi-Cal?
If you apply for Medi-Cal in 2023:
The current asset limit is $130,000 for one person. Each additional household member adds $65,000 to the asset limit. Up to 10 members can be in a household. Medi-Cal will also consider income information (including income from property).
What happens if I make too much money while on Medicaid?
If your income is too high for Medicaid, a spend down will let you use extra money on medical expenses until you qualify. Not all states have a spend down program for Medicaid eligibility. Those that do often have different income limits and rules. Not all states offer a spend down option.
What happens if I don't report my income change to Medi-Cal?
If you do not report changes to your personal information right away, and then receive Medi-Cal benefits that you do not qualify for, you may have to repay DHCS.
Do I have to cancel Medicaid when I get a job?
After you start working, your Medicaid coverage can continue, even if your earnings (alone or in combination with your other income) become too high to receive SSI.