What if my income is too high for Medi-Cal?
Asked by: Effie Zulauf | Last update: November 22, 2025Score: 4.4/5 (33 votes)
What is the maximum income to qualify for Medi-Cal California?
You are 19-64 years old and your family's income is at or below 138% of the Federal Poverty Level (FPL) ($20,783 for an individual; $43,056 for a family of four). You are a child 18 or younger and your family's income is at or below 266% of FPL ($82,992 per year for a family of four).
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.
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.
Can I still get Medicaid if my income is too high?
Since Obamacare, Medicaid eligibility is based on household income, not assets, except for nursing home care. If your family income is too high for Medicaid you might be eligible for subsidized Obamacare. And if it is too high for subsidies then you shouldn't be trying to cheat the system.
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.
Does Medicaid actually check your income?
Some states use a computerized system to cross reference a Medicaid applicant's reported income. For instance, in California, an electronic database, the Income Eligibility Verification System (IEVS), is used to match the income information provided by the applicant to other databases to verify it is accurate.
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.
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.
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.
What is the disadvantage of Medi-Cal?
The perception that Medi-Cal offered poorer coverage or less respectful treatment than other types of insurance. Concerns among noncitizen respondents that applying for Medi-Cal might affect their immigration status.
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.
Can I have money in the bank and still get Medi-Cal?
➢ Do assets affect my eligibility? Starting on January 1, 2024, assets, such as bank accounts, cash, a second vehicle, and homes, will no longer be counted when determining Medi-Cal eligibility. Income and income from assets, such as income from property, will continue to be counted.
What is the maximum income to qualify for Covered California in 2024?
For 2024, your expected income is less than $21,870 as a single person, less than $29,580 for a household of two people, less than $37,290 for a household of three people, or less than $45,000 for a household of four people.
What does Medi-Cal not cover?
Restricted scope Medi-Cal covers limited services. It does not cover medicine or primary care. If you have pregnancy-related limited scope Medi-Cal, you will have the full scope of Medi-Cal benefits, if the service is medically necessary.
What is the income limit for Medi-Cal 2024?
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.
Will I lose Medicaid if I get a raise?
Many caregivers worry that their family members will lose healthcare if they earn more money. The good news is Medicaid coverage will not be taken away just because you take a job or become your own boss.
Will I lose my Medi-Cal if I get a job?
Starting a job marks a new chapter — and if you have health insurance through Medi-Cal, you might be worried about losing your eligibility. Rest assured, you have options. For starters, eligibility for Medi-Cal isn't based on employment status. It depends on factors like income, age, and disability status.
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.
What if my income is too high for 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.
Do I need to pay back Medi-Cal?
What is Estate Recovery? The Medi-Cal Estate Recovery program must seek repayment from the estates of certain Medi-Cal members after they die. Repayment only applies to benefits received by these members on or after their 55th birthday and who own assets at the time of death.
How do I protect my income from Medicaid?
One such option to protect assets is a Medicaid Trust. By placing some of your assets in an appropriate trust, you can protect them from Medicaid and have them not be counted when you are applying for benefits.
Does Medicaid consider your bills?
Some states require you to submit receipts or bills to Medicaid to show your monthly expenses. Other states may let you pay a monthly premium directly to Medicaid for the amount that your income is over your state's Medicaid spend-down level.
Will I lose my Medicaid if I get Medicare?
People who have both Medicare and full Medicaid coverage are “dually eligible.” Medicare pays first when you're a dual eligible and you get Medicare-covered services. Medicaid pays last, after Medicare and any other health insurance you have.