What is the monthly income limit for Medi-Cal?
Medi-Cal does have the option to review an applicant's income on an annual basis. For a single adult, the monthly Medi-Cal income was $1,482. In 2022, the monthly income will increase to $1,564. In other words, an adult can earn up to $1,564 per month and still qualify for no cost Medi-Cal.
The size of your household affects the maximum income you can earn to qualify. For example, if you lived on your own in 2022, earning $18,755 annually would put you at 138% of the FPL. This number changes for a family of five, making you ineligible if you earned more than $44,809 that year.
According to Covered California income guidelines and salary restrictions, if an individual makes less than $47,520 per year or if a family of four earns wages less than $97,200 per year, then they qualify for government assistance based on their income.
How does Medi-Cal confirm income? The way the government confirms people's income in order to deem them eligible or not is by using the Covered California Income Guidelines chart. Pregnant women, children, and disabled people are the ones allowed to have a higher income on the Federal Poverty Level scale.
Aged & Disabled Federal Poverty Level (A&D FPL) Program
Have less than $1,752 in countable monthly income for an individual ($2,371 for a couple). These figures include the $20 disregard. For more information, see our Medi-Cal Programs – Qualification at a Glance chart (above).
Californians under 26 years of age, or over 50 years of age, are already eligible for full Medi-Cal. You do not need to fill out a new application for full Medi-Cal.
| Income-Based | |
|---|---|
| Must have: | Low to moderate income |
| Income Limits: | Countable Income less than 250% of the Federal Poverty Level ($3,038 per month for individuals, $4,108 for couples) |
| How Income is Counted: | SSI's countable income calculation, but any disability income is not considered income |
If you apply for Medi-Cal in 2023:
The current asset limit is $130,000 for one person. Each additional household member adds $65,000 to the asset limit. Up to 10 members can be in a household. Medi-Cal will also consider income information (including income from property).
People with costly medical needs who make more than the income limit to qualify for free Medi-Cal may still access the program by paying a share of cost, but it's often unaffordable. Advocates are requesting funding in this year's budget to help those people qualify.
Does Medi-Cal look at 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.
Note: Medi-Cal disregards property for individuals whose eligibility is determined utilizing your Modified Adjusted Gross Income (MAGI). If you do not know if you are eligible using MAGI rules, you may ask your eligibility worker.
How much does Medi-Cal cost? For many individuals who enroll in Medi-Cal, there is no premium, no co-payment, and no out of pocket cost. Effective July 1, 2022, all monthly premiums were reduced to $0.00.
Beginning in 2024, Medi-Cal health plans will have new requirements to advance quality, access, accountability, health equity, and transparency. Some Medi-Cal members in 21 counties may need to transition to a new health plan on January 1, 2024. This change does not affect members' Medi-Cal coverage or benefits.
| Household Size | Very-Low Income | Low-Income |
|---|---|---|
| 1 | $11,550 or less | $11,551 - $19,300 |
| 2 | $13,200 or less | $13,201 - $22,050 |
| 3 | $14,900 or less | $14,901 - $24,800 |
| 4 | $16,550 or less | $16,551 - $27,550 |
Who is eligible for CalFresh? You have a current bank balance (savings and checking combined) under $3,001 and share your household with one of the following: a person or persons age 60 and over or. a person with a disability (a child, your spouse, a parent, or yourself).
You do not need to tell us about non-income assets. These include bank accounts, homes, and vehicles.
Definitions. Parents of Dependent Children: Eligibility levels for parents are presented as a percentage of the 2023 FPL for a family of three, which is $24,860. Other Adults: Eligibility limits for other adults are presented as a percentage of the 2023 FPL for an individual, which is $14,580.
| Filing Individual Tax Return | Filing Joint Tax Return | Total Monthly Premium |
|---|---|---|
| $97,000 or less | $194,000 or less | $164.90 |
| $97,001 – $123,000 | $194,001 – $246,000 | $230.80 |
| $123,001 – $153,000 | $246,001 – $306,000 | $329.70 |
| $153,001 – $183,000 | $306,001 – $366,000 | $428.60 |
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.
Who determines Medi-Cal eligibility?
Medi-Cal Eligibility Division
The Medi-Cal Eligibility Division (MCED) is responsible for the development, coordination, clarification, and implementation of Medi-Cal regulations, policy, and procedures to assure Medi-Cal eligibility is determined accurately and timely by the 58 county human services agencies.
Medi-Cal is available to California residents who are U.S. citizens, permanent residents, legal aliens or U.S. nationals. There are several ways to qualify for the program. Some individuals qualify based on their household income level.
If you get Medi-Cal coverage and then get a job, you have a couple of options for keeping your Medi-Cal benefits. If you got Supplemental Security Income (SSI) cash benefits before you got your job, Social Security's 1619(b) program lets you earn up to $58,638 annually and still keep Medi-Cal coverage at no cost.
Medi-Cal eligibility is based on the amount of your monthly income and your assets. Even if you own a $700,000 house free and clear of any mortgage you can still qualify for Medi-Cal.
Unlike Medicare, which does not require repayment from those who receive benefits, Medi-Cal can and will seek to hold individual beneficiaries or their estates responsible for any disbursem*nts made on their behalf. Every cent paid out on behalf of a Medi-Cal recipient is subject to collection efforts.
