Medi-Cal Aged &/or  Disabled Federal Poverty Level
(A&D FPL) Program

The Aged and/or  Disabled Federal Poverty Level Program (A&D FPL) serves individuals aged 65 and older, and persons with disabilities. The program makes

Full-Scope Medi–Cal

(i.e., health coverage for medically necessary services such as physician visits, hospital care, ambulances, prescription drugs, and in-home care) available with no Share of Cost (SOC). To qualify for this program, individuals

must meet all of the following three criteria:

  1. Be aged (65+) or disabled (meet Social Security’s definition of disability, even if your disability is blindness).
    1. Listing of Impairments
  2. Have less than $2,000 in Countable assets for an individual ($3,000 for a couple).
    1. Medi-Cal property limitations.
    2.  asset questionnaire
    3. CANHR simpler list
    4. CANHR Fact Sheet
    5. Understanding Medi-Cal’s Asset Test for Seniors and People With Disabilities
    6. Western Poverty Law 
  3. Have less than $1,271 – 123% of FPL  in countable monthly income for an individual ($1,719 for a couple). ca health advocates.org ADFPL    *  AB 715 Fact Sheet * Western Poverty Law  * 

This Medi-Cal program uses SSI countable income rules  as well as a few extra rules you should know. For more information, visit or webpage on the  SSI program, the Medi-Cal section of the Disability Benefits 101 websiteCA Health Care Advocates Archive

This is practically my first day analyzing this and I don’t get paid for Medi-Cal work.  Please review the above links.  It doesn’t seem that the income qualification does one any better, than just MAGI Income Qualification.

Would an immediate annuity help your situation?

Medi-Cal Trumps Covered CA Subsidy Programs

Please help us out

We've developed the Medi-Cal portion of our website, as many of our Covered CA clients end up here, if their income drops below 133% of FPL, Federal Poverty Level, see the income chart.   

We do not get a nickel, for this site or for helping people enroll in Medi-Cal, nor answering complex questions.  We ask that when you have other questions or need coverage, that you visit our other websites:

Links – Resources

CA Health Advocates – Medi-Cal for People who have Medicare

CANHR.org  *   Aged & Disabled

Disability Benefits 101 

LA County DPSS

Orange County Social Services Agency

Chart – MAGI and NON-MAGI Qualification for Medi-Cal

See also our site on Medi-Medi – both Medi-Cal and Medicare

Social Security  & Social Security Disability

Insure Me Kevin.com – Friendly Competitor

How to Report Income Change

MC 239 Denial of Benefits

Medi-Cal Eligibilty Procedures Manual Article 22 Disability 179 pages

Medically Needy Program

Program for All Inclusive Care For The Elderly

PACE creatively coordinates the care of each participant enrolled in the program based on his or her individual needs with the goal of enabling older individuals to remain living in their community. 

 

Welfare & Instituions Code  General Provisions [14000 – 14042]

Qualification for Elderly and Disabled

This video was done in 2009 – I’m not sure how it applies to MAGI Medi-Cal Qualification – check with www.youtube.com for the other video’s in this series

True Freedom Plans

"Prepaid Home Health Care?"

Watch 3 minute simple plain English Video

True Freedom Video

 

Email us for more information  [email protected] 

FAQ’s

Question

My tax person informed me that claiming my 81 year old father-in-law as a dependent on my taxes would not affect his eligibility for A&D – Aged & Disabled FPL Full Scope – Federal Poverty Level Medical-cal. Is this true?

Similar situation in regards to claiming my mother. She receives SSI/SSDI and receives medical Medi-Cal . Would claiming her as a dependent affect her eligibility for medi-cal

Answer

See Chapter 3 – Western Poverty Law Center on Health Insurance for Low Income.   See also Social Security’s website on SSI

Does your Mom get SSI or SSDI, it makes a difference. SSI is dealt with here.   See also Social Security’s website on SSI  for income & resource information.

SSI

Eligibility
blue arrowBenefits
blue arrowResources
blue arrowIncome
blue arrowLiving Arrangements

SSDI gives one Medicare after two years.

We don’t get paid to help people with Medi-Cal, SSI or SSDI. When you read the manual, be sure to read it 3x and when you think you understand it, read it again. We’ve only skimmed the material

Question

I am 70 years of age and have been on medi cal due to low income. I recently applied for my ex husbands social security and my income increased to $1,379.10. Can I still qualify for medi cal?

***Sorry, it looks like you are now over the income limit.  See excerpt below.   Losing Medi-Cal would give you a Special Enrollment Period into a Medicare Advantage Plan where there are generally no premiums and very little co-pays that we can help you with.  You might also qualify for low income subsidies for your prescriptions.

****

Question

What if one qualified for Medi-Cal because of a disability, but wants to opt out and get subsidies in Covered CA or just pay full price during Open Enrollment?

Excerpt of email…

[Covered CA] was advised that since member has disability even if he doesn’t want to be on Medi-cal, he will still be referred to them. … Medi-cal caters for people with disability.  The member should ask Medi-cal for possibility of releasing him, unfortunately, it’s not under our control .

Maybe shouldn’t argue with Medi-Cal to say not disabled – could hurt Medicare and Social Security Disability Claim

Term Life Quotes

Get term life insurance quotes

Set up a phone, skype or face to face consultation 

Tools to help you figure out how much you should get

Life Insurance Buyers Guide

CA Department of Insurance

NAIC Buyers Guide

Video on how much coverage for death protection you need

Google Ad Sense




Related Pages

19 comments on “Aged and Disabled Federal Poverty Level Program

  1. Question

    My grandma earns 1096 through social security and then she ears $586 through her pension for a total of 1682.47

    They have calculated her net non exempt income at 1400.55 beginning 12/2017

    Minus her $600 maintenance need means she has a share of cost of $801 beginning 12/2017.

    The wierd thing is my grandma was approved for medi-cal and IHSS last year with the same income.

    I’m thinking somehow the non exempt income might have been calculated differently.

    Can you please help me figure out how they determine non exempt income?

    I looked at the link above https://ca.db101.org/ca/programs/health_coverage/medi_cal/program2a.htm but it didn’t help me.

    My grandma cannot pay for any share of cost. Her rent alone is over $800 per month not counting any bills etc.

  2. The A&D FPL program is connected to income.

    Do you perhaps know of another program that may help my wife Linda, who is incapactated due to a brain tumor and that does not have us ratcheting up insurance premiums every year to cover the share of cost?

  3. We suppose to call to renew mom’s financial aid 1 week before March 29.

    With all this corona virus thing… we totally forgot.

    What do we do

  4. I have been approved for full Medi-Cal services under the Aged & Disabled Federal Poverty Level Program ,

    Can I safely discontinue a policy for a supplemental insurance that covered the 20% that medicare didn’t cover.

  5. I’m 78, never worked, not disabled. I have a reverse mortgage with my sister whom I live with and we file taxes together. Our income is too low for Covered CA. What can I do to get Insurance. Buying into Medicare is way too expensive, especially since I’d have to pay late enrollment penalties. What can I do?

  6. My 83 year father was forced to stop working due to his ailing health.

    As his daughter, I am extremely over whelmed right now trying to get my dad financial assistance, and, care. Nothing is coming to fruition and all of the agencies (non-profit) won’t return my calls or help, it’s very discouraging.

    My dad receives a modest sum of $1,48 from Social Security and has expenses of rent $964 & utilities $400. He has nothing left over for food/medication/other items or help and desperately needs it.

    He has over $3k in medical bills that are mounting. He goes to 4-6 appointments per month (including for his eye).

    He had cataract surgery on both eyes last year and the surgeon messed up the right eye, leaving him blind in the right eye. He had has gallbladder removed right before the Christmas holiday. It’s been one thing after another.

    We are out of money and yet, he cannot qualify for any assistance. I do not understand.

    I cannot find anyone who is willing to help us. He sits at home all day alone.

    Medicare is providing some nurse assistance 1 day per week but that too will end at the end of the month.

    I applied for Medi-Cal on November 1, 2017 but the application is pending a “shared” cost approval.

    It goes on and on. I do not know where to turn to for help.
    He is a Vet but trying to get those benefits could take months; and, too trying to find help has been too difficult.

  7. What counts as MAGI Income & how are household members counted? annuity trust of 24,000 per year, In home support service of 32,000 – supporting my parents my youngest son 14,years old.
    Do we still qualify for Medical.?

    See our new page where we’ve answered this question for you.

Leave a Reply

Your email address will not be published.