What is the 3 month rule for Medi-Cal?
Asked by: Geovanny Kessler | Last update: March 23, 2025Score: 4.9/5 (51 votes)
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.
What are the new rules for Medi-Cal 2024?
Basic Information. 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.
Does Medi-Cal cover 3 months back?
You may be able to receive a reimbursement if:
You received a Medi-Cal covered service on a date that you were eligible for Medi-Cal. The three periods of eligibility that are included are the following: RETRO: The 3-month period prior to the month you applied for the Medi-Cal program.
How much can I make a month and still qualify 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.
Medicaid Eligibility - Medicaid Income and Asset Limits – 2024
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.
What is the time limit for Medi-Cal?
Original (or initial) Medi-Cal claims must be received by the FI within six months following the month in which services were rendered. This requirement is referred to as the six-month billing limit.
Does Medi-Cal renew automatically?
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. Medi-Cal renewals can be completed online.
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.
Can I get Kaiser with Medi-Cal?
At Kaiser Permanente, you have a wide network of doctors and specialists to choose from. All of our doctors accept Kaiser Permanente Medi-Cal members. Get care from a doctor or specialist – including appointments, exams, and treatment. Your child can get regular check-ups – including shots and vaccines.
How much money can you have in the bank if you're on Medicare?
There is no limit on the amount of cash you can have with Medicare Part A. You do have to have paid taxes for 40 quarters (10 years) during your working lifetime and you have to be age 65 unless otherwise qualified due to a social security eligible disability.
How do I check Medi-Cal eligibility?
Who is eligible? Qualify for Medi-Cal if your income is up to 138 percent of the Federal Poverty Level (FPL) for adults, and up to 266 percent FPL for children. Check Shop and Compare to see if you qualify. Learn more on the Department of Health Care Services website.
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 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.
What is the new law for Medi-Cal in 2024?
Beginning January 1, 2024, a new law in California will provide adults 26 through 49 years of age access to full scope Medi-Cal services and immigration status does not matter. All other Medi-Cal eligibility rules, including income limits, will still apply.
Does Medi-Cal check bank accounts?
➢ 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 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.
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.
How do I know when my Medi-Cal expires?
If DPSS has the information they need, they will send you a notice to tell you whether or not you still qualify for Medi-Cal coverage. If you do still qualify, the letter will indicate that your Medi-Cal is renewed for one year. If you do not still qualify, the letter will indicate when the your Medi-Cal coverage ends.
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).
How far back does Medi-Cal look at assets?
The 30 month period in California (or 5 year period in other states) is known as the “look-back period.” In essence, state Medicaid agencies are “looking back” for assets transferred at less than fair market value.
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.
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.