How Does Medi-Cal Determine Income For Eligibility?

How Does Medi-cal Determine Income for eligibility? Medi-Cal, California’s Medicaid program, provides vital healthcare coverage to millions of residents. Understanding how Medi-Cal assesses income is crucial for determining eligibility and accessing these essential services. To explore partnership opportunities that can help you navigate the complexities of income determination and potentially increase your eligibility, visit income-partners.net. Let’s delve into the specific criteria Medi-Cal uses to evaluate income, ensuring you’re well-informed about eligibility requirements.

1. What Types of Medi-Cal Programs Are Available?

Medi-Cal offers a range of programs tailored to different needs and circumstances. These programs include income-based Medi-Cal, Medi-Cal for families and children, and programs for individuals with disabilities or those requiring long-term care.

Medi-Cal provides various pathways to coverage, designed to accommodate the diverse needs of California residents. Understanding the different types of Medi-Cal programs available is essential for identifying the best fit for your individual circumstances. Here are some of the primary categories:

• Income-Based Medi-Cal: This program is designed for individuals and families with low to moderate incomes. Eligibility is primarily determined by household income relative to the Federal Poverty Level (FPL). This is often referred to as Modified Adjusted Gross Income (MAGI) Medi-Cal.
• Medi-Cal for Families and Children: This includes programs like Medi-Cal Access Program (MCAP) for pregnant women and Medi-Cal for children under the age of 19. Income limits are generally higher than those for adults, reflecting the state’s commitment to ensuring healthcare access for its youngest residents.
• Aged & Disabled Federal Poverty Level (A&D FPL) Medi-Cal: This program caters to individuals who are 65 or older or have a disability, and who are not eligible for Supplemental Security Income (SSI). Eligibility is determined based on a higher income threshold than standard Medi-Cal, recognizing the unique healthcare needs of this population.
• SSI-Linked Medi-Cal: Individuals who receive Supplemental Security Income (SSI) benefits automatically qualify for Medi-Cal. SSI provides financial assistance to aged, blind, and disabled individuals with limited income and resources.
• Medi-Cal’s Working Disabled Program (WDP): This program allows individuals with disabilities who are employed and have incomes that exceed the standard Medi-Cal limits to still qualify for coverage. WDP is designed to support and encourage employment among individuals with disabilities by providing access to healthcare services.
• Aged, Blind, & Disabled – Medically Needy (ABD–MN) Medi-Cal: This program is for individuals who meet the age, blindness, or disability criteria but have incomes that are too high to qualify for other Medi-Cal programs. ABD-MN Medi-Cal requires beneficiaries to pay a “share of cost,” which is the amount they must pay for medical expenses each month before Medi-Cal coverage begins.

Navigating these different programs can be complex, but understanding their specific eligibility criteria is key to accessing the healthcare you need.

2. How Does Income-Based Medi-Cal Determine Eligibility?

Income-based Medi-Cal uses the Modified Adjusted Gross Income (MAGI) methodology to determine eligibility. This approach considers taxable income and certain deductions.

Income-based Medi-Cal, also known as MAGI Medi-Cal, is the most common pathway to healthcare coverage for low-income individuals and families in California. Understanding how this program determines eligibility is crucial for anyone seeking access to its benefits.

Modified Adjusted Gross Income (MAGI) Methodology

MAGI is the primary method used to determine eligibility for income-based Medi-Cal. MAGI is a federal standard that simplifies income assessment by focusing on taxable income and certain deductions. This approach aligns with the income tax system, making it easier to verify and track income data.

What is Included in MAGI?

MAGI includes various sources of income, such as:

• Wages and Salaries: All earnings from employment, including full-time, part-time, and temporary work.
• Self-Employment Income: Profits from businesses, freelance work, and independent contracting.
• Investment Income: Dividends, interest, and capital gains from stocks, bonds, and other investments.
• Rental Income: Income from rental properties after deducting allowable expenses.
• Social Security Benefits: Retirement, disability, and survivor benefits.
• Unemployment Compensation: Payments received while unemployed.
• Alimony: Payments received as spousal support.

What Deductions are Allowed?

While MAGI includes most forms of income, certain deductions are allowed, which can lower your MAGI and potentially increase your eligibility for Medi-Cal. Common deductions include:

• Student Loan Interest: Payments made on student loans.
• IRA Contributions: Contributions to traditional Individual Retirement Accounts (IRAs).
• Self-Employment Tax: The deductible portion of self-employment tax.
• Alimony Paid: Payments made as spousal support.
• Health Savings Account (HSA) Contributions: Contributions to a health savings account.

Income Limits for Income-Based Medi-Cal

To qualify for income-based Medi-Cal, your MAGI must fall within specific income limits, which are based on the Federal Poverty Level (FPL) and your household size. These income limits are updated annually. As of 2024, the income limits are approximately 138% of the FPL for adults aged 19-64. For children under 19, the income limit is higher, around 266% of the FPL.

Household Size	Annual Income Limit (138% FPL)
1	$21,597
2	$29,174
3	$36,751
4	$44,367

How to Calculate Your MAGI

Calculating your MAGI involves several steps:

1. Determine Your Gross Income: Add up all sources of income, including wages, self-employment income, investment income, and other taxable income.
2. Subtract Allowable Deductions: Deduct any eligible expenses, such as student loan interest, IRA contributions, and self-employment tax.
3. The Result is Your MAGI: This is the figure used to determine your eligibility for income-based Medi-Cal.

Understanding how income-based Medi-Cal determines eligibility can help you assess your potential eligibility and take steps to ensure you have access to healthcare coverage.

3. What Income Is Not Counted by Medi-Cal?

Some income sources are excluded from Medi-Cal’s income calculations, such as Supplemental Security Income (SSI) benefits and certain retirement account contributions.

When determining eligibility for Medi-Cal, not all income is treated the same. Certain types of income are excluded from the calculation, which can significantly impact whether an individual or family qualifies for coverage. Knowing what income is not counted can help you better understand your potential eligibility.

Supplemental Security Income (SSI) Benefits

SSI is a federal program that provides financial assistance to aged, blind, and disabled individuals with limited income and resources. Because SSI recipients already have very low incomes, these benefits are not counted when determining eligibility for Medi-Cal. This ensures that individuals receiving SSI can also access healthcare coverage through Medi-Cal.

Certain Retirement Account Contributions

While distributions from retirement accounts are generally counted as income, contributions to certain retirement accounts may be excluded. This encourages individuals to save for retirement without negatively impacting their Medi-Cal eligibility. Examples of retirement account contributions that may be excluded include:

• Traditional IRA Contributions: Contributions to a traditional IRA may be deductible, which reduces your adjusted gross income (AGI) and, consequently, your MAGI.
• 401(k) Contributions: Pre-tax contributions to a 401(k) plan can also reduce your AGI.

However, it’s important to note that the specific rules regarding retirement account contributions can be complex and may vary depending on the type of account and individual circumstances.

Other Excluded Income

In addition to SSI benefits and certain retirement account contributions, other types of income may also be excluded from Medi-Cal’s income calculations. These can include:

• Child Support Payments: Payments received for the support of a child are generally not counted as income for the parent receiving the payments.
• Certain Educational Grants and Scholarships: Funds received for educational purposes may be excluded, depending on the specific grant or scholarship and how the funds are used.
• Federal Tax Credits: The earned income tax credit (EITC) and child tax credit (CTC) are generally not counted as income.
• Some Contributions to Retirement Accounts: Contributions to certain retirement accounts may not be counted toward your income.

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Importance of Knowing Excluded Income

Understanding what income is not counted by Medi-Cal is crucial for accurately assessing your eligibility. By excluding certain income sources, Medi-Cal aims to provide coverage to those who need it most, while also encouraging individuals to save for retirement and support their families.

If you are unsure whether a particular source of income will be counted by Medi-Cal, it’s best to consult with a healthcare benefits specialist or contact your local county social services agency for clarification.

4. What Are the Income Limits for Medi-Cal in 2024?

In 2024, the income limits for income-based Medi-Cal are approximately 138% of the Federal Poverty Level (FPL) for adults aged 19-64. For children under 19, the income limit is around 266% of the FPL.

To qualify for Medi-Cal, it is crucial to understand the income limits set for each year, as these determine your eligibility for coverage. The income limits are based on the Federal Poverty Level (FPL) and vary depending on the Medi-Cal program and household size.

Federal Poverty Level (FPL)

The FPL is a measure of poverty issued annually by the Department of Health and Human Services (HHS). It is used to determine eligibility for various federal and state programs, including Medi-Cal. The FPL is based on income and household size, with higher FPL thresholds for larger households.

Income Limits for Income-Based Medi-Cal (MAGI)

For income-based Medi-Cal, also known as MAGI Medi-Cal, the income limits are typically set at 138% of the FPL for adults aged 19-64. This means that to qualify for Medi-Cal, your household income must be at or below 138% of the FPL for your household size.

Household Size	Annual Income Limit (138% FPL)	Monthly Income Limit (138% FPL)
1	$21,597	$1,799.75
2	$29,174	$2,431.17
3	$36,751	$3,062.58
4	$44,367	$3,697.25

For children under 19, the income limits are generally higher, around 266% of the FPL. This reflects the state’s commitment to ensuring healthcare access for its youngest residents.

Income Limits for Other Medi-Cal Programs

The income limits for other Medi-Cal programs vary depending on the program and its specific eligibility criteria. For example, the Aged & Disabled Federal Poverty Level (A&D FPL) Medi-Cal program has higher income limits than standard Medi-Cal, while the Medi-Cal’s Working Disabled Program (WDP) has its own set of income limits.

Importance of Staying Updated

It is important to stay informed about the current income limits for Medi-Cal, as these can change annually. You can find the latest income limits on the California Department of Healthcare Services (DHCS) website or by contacting your local county social services agency.

Example Scenario

Let’s say you are a single adult living in California. In 2024, the income limit for income-based Medi-Cal for a single individual is approximately $21,597 per year. If your annual income is at or below this amount, you may be eligible for Medi-Cal coverage.

Understanding the income limits for Medi-Cal is essential for determining your eligibility and accessing the healthcare you need.

5. How Does Medi-Cal Verify Income?

Medi-Cal verifies income through various methods, including reviewing pay stubs, tax returns, and other financial documents. They may also use electronic data matches with other government agencies.

Verifying income is a crucial step in the Medi-Cal eligibility determination process. The California Department of Healthcare Services (DHCS) employs several methods to ensure that the income reported by applicants is accurate and consistent. This helps prevent fraud and ensures that Medi-Cal benefits are distributed to those who truly qualify.

Common Methods of Income Verification

Medi-Cal utilizes a variety of methods to verify income, including:

• Pay Stubs: Applicants are often required to submit recent pay stubs to verify their current income. These pay stubs provide details about gross income, deductions, and net income.
• Tax Returns: Medi-Cal may request copies of your most recent federal and state tax returns. Tax returns provide a comprehensive overview of your income from various sources, including wages, self-employment, investments, and rental properties.
• W-2 Forms: W-2 forms, which are provided by employers at the end of each year, summarize an employee’s earnings and taxes withheld. Medi-Cal may request W-2 forms to verify income reported on tax returns.
• 1099 Forms: 1099 forms are used to report various types of income, such as self-employment income, contract labor, and investment income. Medi-Cal may request 1099 forms to verify income reported on tax returns.
• Bank Statements: Bank statements can provide evidence of income deposits, such as paychecks, Social Security benefits, and other forms of income.
• Self-Employment Records: If you are self-employed, Medi-Cal may request records of your business income and expenses, such as profit and loss statements, invoices, and receipts.
• Social Security Administration (SSA) Data: Medi-Cal may verify your Social Security benefits by accessing data from the Social Security Administration.
• Electronic Data Matches: Medi-Cal may use electronic data matches with other government agencies, such as the California Employment Development Department (EDD) and the Internal Revenue Service (IRS), to verify income information.

Importance of Accurate Reporting

It is essential to report your income accurately and honestly when applying for Medi-Cal. Providing false or misleading information can result in denial of coverage, termination of benefits, and even legal penalties.

What to Do If You Have Difficulty Verifying Income

If you have difficulty verifying your income, such as if you are self-employed or have irregular income, contact your local county social services agency for assistance. They can provide guidance on what documentation is needed and may be able to offer alternative methods of verification.

Example Scenario

Let’s say you are applying for Medi-Cal and are employed as a part-time cashier. Medi-Cal may request your most recent pay stubs to verify your income. If you also receive Social Security benefits, Medi-Cal may verify this income through data from the Social Security Administration.

By verifying income through various methods, Medi-Cal ensures that benefits are distributed fairly and accurately.

6. What Happens If My Income Changes?

If your income changes while you’re enrolled in Medi-Cal, you must report the change to your local county social services agency. This could affect your eligibility or the type of Medi-Cal program you qualify for.

Reporting income changes is a critical responsibility for Medi-Cal beneficiaries. Significant changes in income can impact your eligibility for coverage and the type of Medi-Cal program you qualify for. Failing to report these changes can lead to complications and potential penalties.

Why Report Income Changes?

Reporting income changes is essential for several reasons:

• Maintaining Accurate Eligibility: Medi-Cal eligibility is based on income. If your income increases significantly, you may no longer qualify for the same level of benefits or may become ineligible altogether. Conversely, if your income decreases, you may become eligible for additional benefits or programs.
• Preventing Overpayments: If your income increases and you continue to receive benefits you are no longer entitled to, you may be subject to overpayment recovery. This means you will be required to repay the excess benefits you received.
• Avoiding Penalties: Failing to report income changes can be considered fraud, which can result in penalties, including fines and legal action.

How to Report Income Changes

To report income changes to Medi-Cal, follow these steps:

1. Contact Your Local County Social Services Agency: Contact the county social services agency in the county where you reside. You can find contact information on the California Department of Healthcare Services (DHCS) website.
2. Provide Documentation: Be prepared to provide documentation of your income change, such as pay stubs, tax returns, or other financial records.
3. Complete Required Forms: You may need to complete specific forms to report the income change. Your county social services agency can provide you with the necessary forms.

What Types of Income Changes Should Be Reported?

You should report any significant income changes, including:

• Job Loss: If you lose your job, report the date of termination and any unemployment benefits you are receiving.
• New Employment: If you start a new job, report your employer’s name, your start date, and your expected income.
• Wage Increase: If you receive a raise or promotion, report the amount of the increase and the date it took effect.
• Changes in Self-Employment Income: If your self-employment income increases or decreases significantly, report the changes and provide supporting documentation.
• Changes in Other Income: Report any changes in other income sources, such as Social Security benefits, retirement income, or rental income.

Example Scenario

Let’s say you are enrolled in Medi-Cal and receive a promotion at work that results in a significant increase in your income. You should report this income change to your local county social services agency as soon as possible. They will review your case and determine if the income change affects your eligibility for Medi-Cal.

Reporting income changes is a critical responsibility that helps ensure the integrity of the Medi-Cal program and protects your access to healthcare coverage.

7. Can I Still Qualify for Medi-Cal If I Have Assets?

For most Medi-Cal programs, there are no asset limits. However, some older programs, like SSI-linked Medi-Cal, may have asset restrictions.

The role of assets in determining Medi-Cal eligibility has evolved significantly over time. Understanding the current rules regarding assets is essential for individuals and families seeking access to healthcare coverage.

Historical Context

In the past, Medi-Cal eligibility was often based on both income and assets. This meant that individuals with significant assets, such as savings accounts, investments, and real estate, may have been ineligible for Medi-Cal, even if their income was relatively low.

Current Asset Rules

Today, the asset rules for Medi-Cal have changed significantly. For most Medi-Cal programs, including income-based Medi-Cal (MAGI), Aged & Disabled Federal Poverty Level (A&D FPL) Medi-Cal, and Medi-Cal’s Working Disabled Program (WDP), there are no asset limits. This means that you can qualify for these programs regardless of the value of your assets.

Exceptions to the Rule

There are some exceptions to the no-asset-limit rule. For example, SSI-linked Medi-Cal, which is for individuals who receive Supplemental Security Income (SSI) benefits, still has asset limits. As of 2024, the asset limit for SSI is $2,000 for an individual and $3,000 for a couple.

Additionally, some long-term care Medi-Cal programs may have asset limits. These programs provide coverage for individuals who require nursing home care or other long-term care services.

Importance of Understanding the Rules

Understanding the asset rules for Medi-Cal is essential for accurately assessing your eligibility. If you are unsure whether your assets will affect your eligibility, it’s best to consult with a healthcare benefits specialist or contact your local county social services agency for clarification.

Example Scenario

Let’s say you are a single adult with a low income but have $50,000 in savings. Under the current rules, you can still qualify for income-based Medi-Cal, as there are no asset limits for this program.

The elimination of asset limits for most Medi-Cal programs has made it easier for low-income individuals and families to access healthcare coverage.

8. What Is the Difference Between Gross Income and Countable Income?

Gross income is your total income before any deductions. Countable income is the income used to determine Medi-Cal eligibility after certain deductions are applied.

Distinguishing between gross income and countable income is essential for understanding how Medi-Cal determines eligibility. While gross income represents your total earnings before any deductions, countable income is the specific amount used to assess your eligibility for Medi-Cal.

Gross Income

Gross income is the total amount of money you earn before any deductions are taken out. It includes wages, salaries, self-employment income, investment income, rental income, and other forms of income. Gross income is often referred to as your “top-line” income.

Countable Income

Countable income is the amount of income that Medi-Cal uses to determine your eligibility for coverage. Countable income is calculated by subtracting certain deductions from your gross income. These deductions can include:

• Student Loan Interest: Payments made on student loans.
• IRA Contributions: Contributions to traditional Individual Retirement Accounts (IRAs).
• Self-Employment Tax: The deductible portion of self-employment tax.
• Alimony Paid: Payments made as spousal support.
• Health Savings Account (HSA) Contributions: Contributions to a health savings account.
• Impairment-Related Work Expenses (IRWEs): For individuals with disabilities, certain expenses related to work may be deducted.
• Blind Work Expenses (BWEs): For individuals who are blind, certain expenses related to work may be deducted.

Importance of Countable Income

Countable income is the key factor in determining your eligibility for Medi-Cal. The income limits for Medi-Cal are based on countable income, not gross income. This means that even if your gross income exceeds the income limits, you may still be eligible for Medi-Cal if your countable income is below the limits.

Example Scenario

Let’s say you are a single adult with a gross income of $25,000 per year. However, you also have $3,000 in student loan interest and $2,000 in IRA contributions. Your countable income would be:

$25,000 (Gross Income) – $3,000 (Student Loan Interest) – $2,000 (IRA Contributions) = $20,000 (Countable Income)

In this scenario, even though your gross income is $25,000, your countable income is $20,000. If the income limit for Medi-Cal for a single adult is $21,597, you would likely be eligible for coverage based on your countable income.

Understanding the difference between gross income and countable income can help you accurately assess your eligibility for Medi-Cal.

9. How Does Self-Employment Income Affect Medi-Cal Eligibility?

Self-employment income is counted towards Medi-Cal eligibility. However, you can deduct business expenses from your gross self-employment income to arrive at your countable income.

Self-employment presents unique considerations when determining Medi-Cal eligibility. While self-employment income is counted towards eligibility, individuals can deduct business expenses to arrive at their countable income, which can significantly impact their access to healthcare coverage.

Counting Self-Employment Income

Self-employment income includes profits from businesses, freelance work, independent contracting, and other forms of self-employment. This income is considered when determining your eligibility for Medi-Cal.

Deducting Business Expenses

One of the key differences between self-employment income and wage income is the ability to deduct business expenses. Self-employed individuals can deduct ordinary and necessary expenses related to their business, which can reduce their countable income. Common business expenses include:

• Office Supplies: Costs for pens, paper, computers, and other office supplies.
• Business Equipment: Costs for machinery, tools, and equipment used in your business.
• Advertising and Marketing: Expenses for advertising, marketing, and promoting your business.
• Rent and Utilities: Costs for renting office space and paying for utilities, such as electricity, water, and internet.
• Business Insurance: Premiums paid for business insurance policies.
• Vehicle Expenses: Costs for operating a vehicle for business purposes, such as gas, maintenance, and insurance.
• Professional Fees: Payments for professional services, such as accounting, legal, and consulting fees.

Calculating Countable Self-Employment Income

To calculate your countable self-employment income, follow these steps:

1. Determine Your Gross Self-Employment Income: Calculate the total amount of money you earned from your business.
2. Deduct Allowable Business Expenses: Subtract all ordinary and necessary business expenses from your gross self-employment income.
3. The Result is Your Countable Self-Employment Income: This is the amount used to determine your eligibility for Medi-Cal.

Importance of Record Keeping

Accurate record keeping is essential for self-employed individuals seeking Medi-Cal coverage. You should keep detailed records of all income and expenses, as Medi-Cal may require documentation to verify your self-employment income.

Example Scenario

Let’s say you are a self-employed graphic designer with a gross income of $30,000 per year. You also have $10,000 in business expenses, including software subscriptions, equipment costs, and advertising fees. Your countable self-employment income would be:

$30,000 (Gross Self-Employment Income) – $10,000 (Business Expenses) = $20,000 (Countable Self-Employment Income)

In this scenario, your countable self-employment income is $20,000. If the income limit for Medi-Cal for a single adult is $21,597, you would likely be eligible for coverage based on your countable self-employment income.

Understanding how self-employment income affects Medi-Cal eligibility can help entrepreneurs and freelancers access the healthcare coverage they need.

10. Where Can I Get Help Understanding Medi-Cal Income Requirements?

You can get help understanding Medi-Cal income requirements from your local county social services agency, healthcare benefits specialists, or community organizations.

Navigating the complexities of Medi-Cal income requirements can be challenging, especially for those unfamiliar with the program. Fortunately, there are numerous resources available to provide guidance and support.

Local County Social Services Agency

Your local county social services agency is an excellent resource for understanding Medi-Cal income requirements. These agencies are responsible for administering Medi-Cal at the local level and can provide information about eligibility criteria, income limits, and application procedures. They can also answer specific questions about your individual circumstances.

Healthcare Benefits Specialists

Healthcare benefits specialists are professionals who specialize in helping individuals and families navigate the healthcare system. They can provide expert guidance on Medi-Cal eligibility, income requirements, and other related topics. They can also help you understand your options and make informed decisions about your healthcare coverage.

Community Organizations

Many community organizations offer assistance with Medi-Cal enrollment and eligibility. These organizations often provide free or low-cost services to help individuals and families access healthcare coverage. They can provide information about income requirements, assist with the application process, and connect you with other resources.

Online Resources

The California Department of Healthcare Services (DHCS) website is a valuable resource for information about Medi-Cal. The website provides information about eligibility requirements, income limits, and application procedures. It also has a searchable database of Medi-Cal providers.

Example Scenario

Let’s say you are unsure whether your income qualifies you for Medi-Cal. You can contact your local county social services agency for assistance. They can review your income and expenses and determine if you are eligible for coverage.

Seeking help from these resources can make the process of understanding Medi-Cal income requirements much easier and ensure you have access to the healthcare coverage you need.

Understanding how Medi-Cal determines income is essential for accessing healthcare coverage in California. By familiarizing yourself with the income requirements, excluded income, and verification methods, you can confidently navigate the eligibility process. For those seeking additional support in maximizing their income and exploring partnership opportunities, income-partners.net provides valuable resources and connections.

FAQ: Understanding Medi-Cal Income Determination

1. What is Modified Adjusted Gross Income (MAGI) and how is it used for Medi-Cal eligibility?

MAGI, or Modified Adjusted Gross Income, is a federal standard used to determine eligibility for income-based Medi-Cal. It includes taxable income and certain deductions, aligning with the income tax system for easier verification.

2. What types of income are included in the MAGI calculation for Medi-Cal?

MAGI includes wages, salaries, self-employment income, investment income, rental income, Social Security benefits, unemployment compensation, and alimony. It encompasses most sources of taxable income.

3. What deductions are allowed under MAGI that can reduce my countable income for Medi-Cal?

Allowable deductions include student loan interest, IRA contributions, self-employment tax, alimony paid, and Health Savings Account (HSA) contributions. These deductions can lower your MAGI and potentially increase your eligibility.

4. Are there any types of income that Medi-Cal does not count when determining eligibility?

Yes, Medi-Cal does not count Supplemental Security Income (SSI) benefits, certain retirement account contributions, child support payments, certain educational grants and scholarships, and federal tax credits like the Earned Income Tax Credit (EITC).

5. What are the income limits for income-based Medi-Cal in 2024?

In 2024, the income limits for income-based Medi-Cal are approximately 138% of the Federal Poverty Level (FPL) for adults aged 19-64, and around 266% of the FPL for children under 19.

6. How does Medi-Cal verify my income when I apply for coverage?

Medi-Cal verifies income through various methods, including reviewing pay stubs, tax returns, W-2 forms, 1099 forms, bank statements, and self-employment records. They may also use electronic data matches with government agencies.

7. What should I do if my income changes after I am already enrolled in Medi-Cal?

If your income changes, you must report the change to your local county social services agency. This can affect your eligibility or the type of Medi-Cal program you qualify for. Provide documentation of the income change, such as pay stubs or tax returns.

8. Can I still qualify for Medi-Cal if I have assets, such as savings or investments?

For most Medi-Cal programs, including income-based Medi-Cal, Aged & Disabled Federal Poverty Level (A&D FPL) Medi-Cal, and Medi-Cal’s Working Disabled Program (WDP), there are no asset limits. However, some older programs, like SSI-linked Medi-Cal, may have asset restrictions.

9. What is the difference between gross income and countable income for Medi-Cal eligibility?

Gross income is your total income before any deductions, while countable income is the amount used to determine Medi-Cal eligibility after certain deductions are applied. The income limits for Medi-Cal are based on countable income, not gross income.

10. How does self-employment income affect my Medi-Cal eligibility, and what deductions can I take?

Self-employment income is counted towards Medi-Cal eligibility. However, you can deduct business expenses from your gross self-employment income to arrive at your countable income. Common business expenses include office supplies, business equipment, advertising, rent, and utilities.

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