California Medicaid Guide

During the pandemic, the federal government paused redetermination reviews for low-income people enrolled in Medicaid, known as Medi-Cal in California. Now, these checks are restarting, and thousands of residents face the threat of losing their coverage.

Medi-Cal, or California Medicaid, California’s Medicaid program, pays for a variety of health services for children and adults with limited income and resources. The program is supported by federal and state taxes. It serves more than 13 million people in California, a third of the population. Enrollees receive a wide range of benefits, including dental and vision coverage, medical devices, and long-term care.

A person’s eligibility for Medi-Cal is determined primarily by their income. The amount of their countable income is deducted from a predetermined maintenance need allowance to determine their share of cost (SOC). People with disabilities comprise only 9% of the program’s enrollees but account for 31% of spending.

Unlike Obamacare, Medi-Cal is a joint federal and state program. The state develops specific rules and policies for the program, and the federal government sets broad guidelines for coverage. Each state must cover mandatory populations to receive federal funding. However, the state may choose to cover additional populations.

California Medicaid Eligibility

The eligibility requirements for california Medicaid vary by state, but most programs have the same basic requirements. To be eligible, individuals must have a Modified Adjusted Gross Income that is below 138% of the Federal Poverty Level or 250% for a family of five.

Applicants for Medi-Cal must provide certain information to establish eligibility. This includes federal tax information for the head of household and all family members, employment verification (check stubs, payroll statements, award letters), immigration documents for non-citizens, and a current address for everyone in the household.

The federal government defines the broad guidelines for Medicaid, but each state determines eligibility rules and benefits. In California, the program is called Medi-Cal and provides health care coverage for low-income residents. It covers a wide range of services, including prescription drugs, doctor visits, and surgery.

Applicants may experience challenges in navigating the Medi-Cal enrollment process, especially during significant life events such as leaving foster care, aging out of a parents’ insurance, or getting married. Covered California can help individuals navigate these changes and make the best decision for their needs.

California Medicaid Asset Limits
California Medicaid Guide 1

California Medicaid Asset Limits

With the elimination of the asset limit, many seniors who had saved money for long-term care will now be able to access Medi-Cal coverage. This policy change will be especially beneficial to those who had been forced to spend down their savings to qualify for the program.

However, despite the removal of the asset test, some people may be afraid that the state will take their house and other assets to recoup what they have spent on long term care services. In reality, however, the state can only claim up to what is spent on medical services.

While the asset limit and Look-Back Period disappear, it is expected that there will still be a high need for professional Medi-Cal Planners since there will be new rules regarding how assets can be transferred. Some of the assets that will not be counted are personal bank accounts, household furnishings, a primary residence, an automobile, and irrevocable burial trusts.

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