Who needs Medi-Cal?

• 65 or older.
• Blind.
• Disabled.
• Under 21.
• Pregnant.
• In a skilled nursing or intermediate care home.
• On refugee status for a limited time, depending how long you have been in the United States.
• A parent or caretaker relative of an age eligible child.

What's the difference between Covered California and Medi-Cal?

What is the difference in coverage between Medi-Cal and Covered California?​​​​ Medi-Cal is health coverage, just like the coverage offered through Covered California. Medi-Cal provides benefits similar to the coverage options available through Covered California, but often at lower or no cost to you or your family.

Is Medi-Cal based on income or assets?

To qualify, you must: Meet the medical requirements of Social Security's definition of disability. Be working and earning income (this can be part-time work). Have assets less than $130,000 for an individual and $195,000 for a couple.

Is Medi-Cal based on gross income?

The most common form of Medi-Cal is Modified Adjusted Gross Income (MAGI) Medi-Cal. It uses tax rules to see if you qualify. Non-MAGI Medi-Cal is Medi-Cal that uses other rules to count property, household income, and size to see if you qualify.

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.

Are college students eligible for Medi-Cal?

Students can opt out of their student health plans and purchase coverage through Covered California. Depending on income, students may receive tax credits to help pay for a private health plan through Covered California or receive low- or no-cost coverage through Medi-Cal.

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 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 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.

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.

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.

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 maximum out of pocket for Medi-Cal in 2023?

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 are the benefits of having Medi-Cal?

​​​​What are the Medi-Cal Benefits? ​​Medi-Cal currently provides a core set of health benefits, including doctor visits, hospital care, immunization, pregnancy-related services and nursing home care. The Affordable Care Act ensures all Medi-Cal health plans offer what are known as Essential Health Benefits (EHB).

How much does Medi-Cal cost California?

For most families, Medi-Cal coverage for kids is free, with no premium, deductible or copays. For CCHIP coverage and sometimes for Medi-Cal, there is a fee of $13 per month per child, up to $39 per family. Want to get started with Covered California?

Can I choose Covered California instead of Medi-Cal?

You may be eligible for health coverage through Covered California if you are no longer eligible for Medi-Cal due to an income increase or change in household size. In order to avoid a gap in your health coverage, Covered California can help you select a new plan before your Medi-Cal coverage ends.