How does MediCal determine your
“Net Non-Exempt Income”?
We are sorry for the confusing way this Q & A goes. Please read through it as best you can and be sure to follow the links we have as sources for our research. If you still have a question, you can post it here.
I submitted ALL relevant information to continue to keep her on the specific medi-cal program; the A & D FLP – Aged & Disabled Federal Poverty Level program.
However they had to have messed something up, because I received a letter (on 5/31) from MediCal which states as follows;
“Beginning 07/01/2017 you will no longer receive MediCal Benefits under the ‘A&D FPL’ program, because your income “exceeds” the amount allowed for living expenses” (which is absolutely ridiculous & makes me very irritated) …
Which I’m not quite sure HOW they’re determining these numbers. I submitted all relevant info that was request by Medi-Cal for the redetermination form;
• Rent : $779
•Secondary Health ins ($297.90mo)
•Medicare Premium ($57.10, medi-cal pays part B + some of part D equaling $120 per mo.)
• bank statements, ect…
(* also., Her only income is SSI *)
• GROSS INCOME = $1633.00
Our Research & Reply
***The Aged & Disabled Program only allows $1,235 in countable monthly income (income left after allowable deductions Disability Rights) for an individual DB 101 * CA Health Care Advocates * Our webpage
• NET NON EXEMPT INCOME = $1321.50
• MAINTAINENCE NEEDS = $ 600.00
• “Extra Income” / Share of Cost = $ 663.90
SO, here’s what I’m asking you:
How did they determine my grandmothers “NET NON-EXEMPT INCOME” $1,321.05 ?
I thought (according to db101.org)
***Please use the full URL. Is this it? https://ca.db101.org/ca/programs/health_coverage/medi_cal/program2a.htm
Please send me your actual paper work. It looks like the page above explains how to do the calculation and it’s in your favor.
that “net non exempt income” should be calculated (at roughly) 1/2 of your income,
***I don’t see that anywhere
& that her countable income would be based upon $768 (or so) then SUBTRACT DEDUCTIONS & MAINTENANCE NEEDS of the standard issue for a “single person”. Which then she would have ZERO a share of cost, just as before!
#2.) where the hell are they coming up with the number of $663.90 for her “excess income / Share of cost”??
I am thinking it’s maybe “extra income” because Medi-Cal pays her Part B + Part D ins. Premium – B+D monthly totaling $124.80 (which leaves her only paying $57.10 for part D which is deducted from her SSI for Part D)
Can you help me determine where the hell They went wrong and screwed up!? I am hoping that this isn’t confusing & I wrote this in a way that is understandable & doesn’t make you go cross-eyed lol
Links & Resources
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