What income disqualifies you from Medi-Cal?

Asked by: Devyn Reilly  |  Last update: November 25, 2023
Score: 4.4/5 (15 votes)

Medi-Cal is the health care insurance program for low-income individuals who live in California. Other states call their program Medicaid. You must financially qualify for Medi-Cal. Most single individuals will qualify for Medi-Cal if there income is under $1,676 per month.

How much can one person make to qualify for Medi-Cal?

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. The income limits based on household size are: One person: $17,609. Two people: $23,792.

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 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 Social Security income count for Medi-Cal?

Unearned Income

This type of income relates to interest on savings and retirement accounts, pensions, annuities, veteran's benefits, etc. Social Security counts as unearned income as well.

How much income can you have for Medicaid?

29 related questions found

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.

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.

Can I have a savings account and still qualify for Medi-Cal?

For example: A Medi-Cal applicant whose total non-exempt property consists of a savings account with a balance of $3,300 in a month must reduce the savings account to $2,000 in that month. In this same situation, where there is a couple, the savings must be reduced to $3,000.

Does Medi-Cal look at your savings account?

Medi-Cal limits seniors and people with disabilities to assets of no more than $2,000 for individuals and $3,000 for couples — a restriction that has not changed since 1989. Assets include cash on hand, money in a checking or savings account, a second car, and other resources.

What is the max age for Medi-Cal?

Beginning May 1, 2022, a new law in California will give full scope Medi-Cal to adults 50 years of age or older and immigration status does not matter. All other Medi-Cal eligibility rules, including income limits, will still apply.

Do you have to apply for 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.

What is the highest income to qualify for Medicaid 2023?

Parents of Dependent Children: Eligibility levels for parents are presented as a percentage of the 2023 FPL for a family of three, which is $24,860. Other Adults: Eligibility limits for other adults are presented as a percentage of the 2023 FPL for an individual, which is $14,580.

Do you pay monthly for Medi-Cal?

Medi-Cal monthly premium amounts have been reduced to $0.00 effective July 1, 2022. Monthly billing and collection of premiums for the Optional Targeted Low Income Children's Program (OTLICP), formally known as Medi-Cal for Families program, will no longer be required.

Does Medi-Cal pay for everything?

Medi-Cal covers most medically necessary care. This includes doctor and dentist appointments, prescription drugs, vision care, family planning, mental health care, and drug or alcohol treatment. Medi-Cal also covers transportation to these services. Read more in “Covered Benefits” on page 12.

Is Medi-Cal for poor families?

This is a public health insurance program that provides free or low cost medical services for children and adults with limited income and resources.

What happens if you don't report income 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.

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 you have a job and be on Medi-Cal?

If you get Medi-Cal coverage and then get a job, you have a couple of options for keeping your Medi-Cal benefits. If you got Supplemental Security Income (SSI) cash benefits before you got your job, Social Security's 1619(b) program lets you earn up to $56,758 annually and still keep Medi-Cal coverage at no cost.

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.

How do I switch to straight Medi-Cal?

You can call Health Care Options (HCO), toll free, at 1-800-430-4263 (TTY 1-800-430-7077), 8 a.m. to 6 p.m. PT, Monday through Friday, except holidays. Or visit a HCO presentation site for help changing your health plan. You may also complete and mail an Enrollment Choice Form to Health Care Options.

What is federal poverty level 2023?

You qualify for federal aid for 2023 if you make one to four times the 2022 federal poverty level for your household size. For a family of four, that range is from $26,200 to $104,800.