How to calculate Medi-Cal Household Size
How to calculate Medi-Cal Household Size

Is Medi-Cal changing its criteria to receive benefits, under ObamaCare?

Yes. Medi-Cal eligibility is now simpler than ever. For most individuals, Medi-Cal eligibility will be based on your household size and your MAGI – Income.

Income and FPL Federal Poverty Level Chart     

Chart on Medi-Cal’s Website

Disability Benefits 101  – Excellent explanation!

Pregnant women count as two people    

Premium Tax Credit Definitions  CFR 36 B 1

Dependent Defintion

Covered CA Medi-Cal Overview

Harbor UCLA Torrance – Explanations

Paper Application   *  More languages

Los Angeles ONLINE Enrollment – Contact Information for other counties

2015 Health Reform Facts Question 54 Page 41 – if one is “allowed” the deduction

Husbands and Wives must file jointly.   dhcs.ca.gov/ 

Historical information pre Obama Care.

Medi-Cal will also attempt to verify your information electronically so you may be found eligible for benefits without ever having to provide paper verifications.

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getting-keeping-coverage
MAGI Medi-Cal Qualification Page 2.31

Child, Other FAQ and Main Medi-Cal Pages

Request for Verification CW 2200

Property Supplement  MC 210 PS

 

CFR – Code of Federal Regulations

45 CFR 155.305 Eligibility Standards

 

 

 

 

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13 comments on “Eligibility for Medi-Cal

  1. I’m a 45 year old male who is single and on medi-cal. I have a Roth worth $11,000 and a car. My earnings this year will be $20,000 approximately. If I contribute $5,000 to a traditional IRA this year to bring my MAGI to below 138% of the poverty level, will I be able to requalify for Medi-cal?

    • Assets are no longer a factor in MAGI based Medi-Cal qualification. An IRA deduction on line 32 of your 1040 would lower line 37 which is the basis of MAGI income, as most taxpayers don’t have foreign income, social security or tax exempt interest to add back in.

      Please be sure to double check with competent tax counsel, the answer appears to be yes.

      On the other hand, you are nearing age 55 at which point, the Medi-Cal premiums can be deducted from your estate.

      Is there any way you can look for a better job or take another part time job to get your earnings up?

      Send us a private email, we can help you set up your IRA.

      • Using the link in the upper right-hand corner and getting a free quote and subsidy calculation you may find that covered California with subsidies will look very appealing

      • Thanks Steve – much appreciated. Two more questions regarding your answer:
        At 55 can medical seek premiums from an estate that I am a beneficiary?
        Are interest or dividends that are received within a ira considered untaxable intrest/dividends, and therefore added to MAGI?

        • I don’t think Medi-Cal would have a lien of what you inherit. Their lien would be on what remains in your estate when G-d forbid, you pass away.

          On my estate recovery page I’ve done say 20 hours of research putting together the links and information. I’m not an attorney, so I suggest you contact one or read through all the links and brochures that I’ve thought were good enough to make it to my website.

          IRA interest is also tax exempt until you withdrawn the money. I’m not a CPA and don’t know your full situation. Learn More ===> IRS Publication 590

  2. Hello Mr. Shorr,

    I wanted to tell you I’ve two modes of resolution now for the dilemma I’d been fighting w/BS thru Covered CA. First and this was my initial thought I should have just done on the outset was dispute the charge with my bank. They gave BS what they were owed and returned my overpayment to me immediately as I’d proof I no longer had need for their service and was being enrolled in Medi-cal. It took about ten minutes and I already have my money back.

    After spending twenty days and three hours on the phone (mostly holding or educating inexperienced employees) the resolution Blue Shield sought was simply finalizing enrollment in Medi-cal. The Medi-cal Ombudsman had told me to bring my issue back to the county and ask for a hearing and all this run around and I threatened them with a lawsuit so they called me somewhat immediately at least ten times. I’d not answered any of the calls as the caller ID was blocked and so I’d not answered the phone. I couldn’t figure out who’d be so rude to call and not leave a message so many times that I finally answered the call mostly as I wasn’t on another call. Every other time they’d called I was already on with one agency or another getting nowhere. The unknown caller was the actual Ombudsman who said they couldn’t help me and again said to file for a hearing at the county. Then she’d noted I’d not enrolled in Medi-cal yet and I told her in response I’d had no time. She said well let me at least do that for you. I chose the same Medi-cal program as my son and immediately everything fell into place. A letter was issued to Blue Shield with correct ending and beginning dates (that would initiate a refund if appropriate) and I’d met the 20 Sept deadline so I wasn’t just thrown into an unknown plan. All that was required to activate the refund. It’s likely that tomorrow on the deadline it would have also been “magically” solved yet I likely would not have known why if the Ombudsman had not told me all that completing enrollment would entail and not realizing herself that she’d issued the statement to Blue Shield that they’d been awaiting and I’d asked for… It’s almost too crazy to believe…

    There are so many gaps in these systems and so many people who don’t understand what they’re supposed to do or what they are doing yet their actions often lead to success unknowingly and it must happen often enough that I’m rare if not the only one who had to suffer for weeks all because I’d not had time to phone and select a plan out of all the horrible plans they offered as I was trying to gain a refund first and the clock kept ticking. I don’t really care what I choose as I’m going to keep paying to see my neurologist in cash and only want my medication to still be covered by ins as it’s quite expensive.

    I realize you don’t wish to work in this area any longer yet it’s possible you may encounter this in a transitional phase. Please note if any of your customers had other insurance they must complete signup in every way to close out the current coverage that then initiated a number of automatically generated forms and communications. The same is true for people on Medi-cal who seek different ins if they’re able to afford it. Someone must finish the entire enrollment process completely or Medi-cal won’t terminate itself even though a refund wouldn’t be an issue in that case. I won’t likely be needing nor receiving anything from Blue Shield as my bank paid for August and I’m enrolled retroactively so I owe them nothing for Sept. Amazing that no one knew this. Amazing that no one else asked me to complete enrollment given that the deadline is tomorrow. I was only made aware of it yesterday. Thought it might be of some value as this wasn’t a minor undertaking.

    Jennifer M

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