Can Medi-Cal MAGI income
qualification be based monthly or annual MAGI Line 37 – 7 – 8b just like Covered CA Subsidies?
Medi-Cal determines eligibility based on monthly, not annual income. Thus, even you you make $100k per year, but have a month with no income, you would qualify. This can even get you around the Open and Special Enrollment restrictions. That is, if you have a bad month, enroll, then when you get kicked out of Medi-Cal for making too much money, thank G-d, you have a special enrollment into Covered CA or direct with an Insurance Company. No extra charge for us to help you! Insure Me Kevin.com * Western Poverty Law * DHCS ACWDLS * 2015 Medi-Cal Eligibility Division Information Letters (MEDILs) * 15-03 *
Plain English from Covered CA Broker Department Email
In regards to Medi-cal, they review monthly income.
So if a client has been making $2000 a month and they do a report a change and it goes now to $1000 a month for 1 person, they will now be eligible for medi-cal.
If the income goes back up to $2000 a month, they contact [report a change] Medi-cal and they are dis-enrolled from medi-cal and now are eligible for Covered CA. Response By Email (Argelia) (09/08/2016 11:56 AM)
We are not just Medi-Cal
We've developed the Medi-Cal portion of our website, as many of our Covered CA clients unfortunately 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. When you have other questions or need coverage, take a look at our other websites:
Western Poverty Law - Exact Legal Rules on Coverage for Low Income Californian's
Our Webpage on
Report Changes Promptly
VIDEO on Reporting Changes
Report Changes as they happen # 5152
Changes should be reported within 30 days.
If you've appointed us - instructions - as your broker, no extra charge, we can do it for you.
Denial of benefits and possible criminal charges if you don't report changes in income!
FAQ’s on Premium Subsidy & Projected Income
I am not getting APTC, and will get PTC next year, at tax time,
does it matter what I make monthly; in other words, if one month I make under $1,833, is that relevant?
Although, Medi-Cal wants to write everyone and their calculations are based on monthly.
only the annual sum is important.
***Right. See MAGI Definition
monthly under 1833 for the month.
***Please talk to me in the bottom line MAGI income for the end of the year. I don’t know how many are in your household. Now I have to multiply 12 x $1,833 = $21,996 if you have a household of 2 it’s borderline, but you are right, that would put you in Medi-Cal.
Should we make it a point to have at least that much monthly income for the remainder of the year?
***The monthly amounts are all hocus – pocus with smoke and mirrors. What counts is the annual. Please use our quote engine and see what happens with your income on an annual basis. Some people at Medi Cal might disagree.
Did you want to look at getting Enhanced Silver – Cost Sharing Reductions?
Do you sell health insurance not run through covered california?
***Yes. Get quotes here. If you want the subsidy though, you must have Covered CA. Click here for instructions on how to appoint us as your agent, no extra charge. Did you like our answer better than calling Covered CA?
income from the IRA – Annuity,
***Line 15 A of the 1040
Are you saying that I would drop into Medical [Medi-Cal] if the monthly income dropped below $1,833 for the next month or even four months, despite the fact that the annual quota has already been surpassed.
***No, not at all. It’s all annual MAGI. This monthly is for people who want subsidies and can’t figure out the annual amount they will put on line 37* Medi-Cal does want to write everyone and not let them out.
You said the annual income is what matters,
***Right. But please do not quote me. I only read the official IRS publications, namely publication 974 and Covered CA bulletins.
but the part I described above and your response confused me. Are you saying that the annual is what matters as long as you make a minimum of 1833 for each month of the year?
***Yes. Please, forget the monthly amount. It’s just crap for those who can’t figure out what their MAGI* incomewill be on line 37.
How about appointing us as your agent so that we can get paid to help you. Sure, Covered CA says find free help, but it’s not free. It’s slave labor until I get appointed. There is no extra cost to you.
Since you are not taking the advance premium tax credit and if I understand you correctly, are not taking it in advance next year, just put that down and you shouldn’t have to enter an income amount.
***Please use our quote and subsidy calculator. You will note, it only asks for annual income.
As I understand it, insurance sign up starts in November.
***Right, now it’s October for a January effective date.
I have not gotten a subsidy this year, because my projected income is above 63k.
***That’s what the chart shows for a household of two, but it’s best to get a complementary quote and subsidy calculation.
I did not want to drop into medicare [Medi-Cal] if I made less than $1,833 in a month).
***MAGI Income is ANNUAL – what shows on line 37 of your 1040.
However, I definitely do not want APTC. [Advance Premium Tax Credit]
***That’s what the brochures on the above right and on this page talk about. Take the credit now or later? If your income drops below $34k you may qualify for Enhanced Silver Cost Sharing Reductions.
If I renew for CC in November and I indicate that I don’t want APTC, would I still have to provide a breakdown of projected income, along with documentation?
***No, note the new rule I just found that says Covered CA – the Exchanges MUST vette everyone who asks for Premium Credits. (42 U.S. Code § 18081 * CFR § 155.320)
When you asked if I would give up the subsidy, did you mean APTC, or do you mean the PTC that one gets as a refund on taxes.
***You have to stay in Covered CA to get either subsidy.
Does one have to fill out the financial part of the [Covered CA] application for next year in order to get the PTC on the tax refund following the benefit year?
Again, I have heard different opinions on this.
***That’s because very few people actually read the CFR’s, actual IRS documents and the documents don’t always refer to the other relevant rules, codes & laws. Check our main page on take it (APTC or PTC) now or later.
Covered CA Certified Agent
No extra charge if you qualify for Covered CA Subsidies.
We don't get compensated to help you with Medi Cal. Here's Medi-Cal's contact information.
Get a Covered CA Quote, including subsidy calculation
Video on why you should have an agent
Life Insurance Buyers Guide
Video on how much coverage for death protection you need
Child Pages, Links & References
LA County.Gov Income Chart – It’s all monthly amounts!
Related Pages inSection