What is Medi-Cal annual redetermination?

Asked by: Antwan Runolfsson  |  Last update: December 21, 2023
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What is the Medi-Cal annual renewal redetermination process? Every 12 months, DPSS will conduct a review of a Medi-Cal beneficiary's information to determine if they are still eligible to continue receiving Medi-Cal benefits.

Do I need to renew 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 happens if I don't renew Medi-Cal?

Your Medi-Cal coverage will end if you don't turn in your renewal form or you are missing proof of things like income that the county asked you to send. Your local Medi-Cal office will mail you a letter (Notice of Action) to let you know if you didn't turn in your renewal form or are missing information.

How often do you have to apply for Medi-Cal?

If I already have Medi-Cal benefits, do I need to reapply? No. If you already have Medi-Cal coverage, your Medi-Cal benefits will continue until your next regularly scheduled annual redetermination date. Your local county will contact you to get any updated information they need.

How does Medi-Cal check income?

The Modified Adjusted Gross Income (MAGI) Medi-Cal method uses Federal tax rules to decide if you qualify based on how you file your taxes and your countable income. Property rules: No property limits. Non-MAGI Medi-Cal includes many special programs.

How to Complete a Medi-Cal Renewal!

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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.

What age does Medi-Cal stop?

All California residents under the age of 26 who meet the eligibility requirements can qualify to receive Medi-Cal, regardless of U.S. citizenship or immigration status.

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.

Is Medi-Cal automatically renewed?

During the COVID-19 Public Health Emergency (PHE), your Medi-Cal was renewed automatically – even if you had changes in your household. But now Medi-Cal members like you must again renew coverage each year to keep your health care benefits.

How do I check my Medi-Cal renewal status?

How Do I Check My Medicaid Status? Contact your local county social services office to learn about your Medi-Cal status and eligibility. The California Department of Health Care Services has a full directory of each county's agency.

Will I lose my Medi-Cal if I get a job?

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 there a limit to Medi-Cal?

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.

How do I submit my Medi-Cal redetermination online?

Beneficiaries can submit information online by logging in or creating an online account at benefitscal.com. To submit information by phone, beneficiaries can call DPSS at 1-866-613-3777 Monday – Friday from 7:30 a.m. – 6:30 p.m. (excluding holidays). How can Medi-Cal beneficiaries receive alerts on their Medi-Cal case?

How do I know if I already have Medi-Cal?

You can visit your local county human services office. You can use your information to confirm your Medi-Cal eligibility and get a temporary identification card.

What is changing in Medi-Cal in 2024?

Pending approval from the Centers for Medicare and Medicaid Services, beginning January 1, 2024, the second phase of this new law in California will eliminate the asset limit for all Non-MAGI Medi-Cal programs. Additional information about this change will be posted to this website at a future date.

What are the benefits of Medi-Cal for seniors?

Medi- Cal provides many of the state's poorest seniors with vital health insurance coverage, including wrap- around coverage for medical services Medicare does not cover. It also provides a safety net for seniors re- quiring long-term care who have exhausted their own financial resources.

What is the out of pocket maximum for 2023 Medi-Cal?

For the 2023 plan year: The out-of-pocket limit for a Marketplace plan can't be more than $9,100 for an individual and $18,200 for a family. For the 2022 plan year: The out-of-pocket limit for a Marketplace plan can't be more than $8,700 for an individual and $17,400 for a family.

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.

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.

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 Medi-Cal cover surgery?

medications. Inpatient hospital services • Anesthesiologist services • Surgical services (bariatric, reconstructive surgery, etc.) Organ & tissue transplantation • Outpatient laboratory and X-ray services o Various advanced imaging procedures are covered based on medical necessity.