Kevin Knauss: Health, History, Travel, Insurance
Posts related to California's Medi-Cal program, specifically MAGI based, income eligibility, enrollment, costs, children, Covered California.
If an individual is terminated from Medi-Cal because they failed to verify the work requirement, they are ineligible for the Advance Premium Tax Credit (APTC). The APTC is the subsidy through Covered California that reduces the monthly premiums of a private health plan.
For decades, Medi-Cal has verified the income for applicants and renewing beneficiaries using federal and state databases. The process known as the Income and Eligibility Verification System (IEVS). The California Department of Health Care Services has provided county Medi-Cal offices with a reminder of the IEVS process in an All County Welfare Directors Letter, 25-16. […]
The 2026 asset test will be $130,000 and $65,000 for each additional household member. In other words, a single adult with assets over $130,000 will not qualify for Non-MAGI Medi-Cal. A married couple with assets over $195,000 will be ineligible for Non-MAGI Medi-Cal for either individual.
Upon learning that CMS or the federal Department of Health and Human Services (HHS) may have shared personally identifying information with the Department of Homeland Security, the California Department of Health Care Services asked CMS if any individual Medi-Cal member information has been shared. As of June 13, 2025, there has been no response to the inquiry.
For a married couple, they can earn up to $2,433 per month and still qualify for MAGI Medi-Cal. This represents a 3.44 percent increase from 2024. MAGI Medi-Cal is the expanded Medi-Cal for low-income adults between the ages of 19 and 64 years of age.
If California congressional Republicans vote to repeal the Affordable Care Act and with its expanded adult Medi-Cal access, they will be irrevocably injuring thousands of their own constituents. Not all Medi-Cal programs that provide assistance to Medicare beneficiaries, children, and their caretakers are intertwined with the ACA. However, we all know that an accident or illness that befalls a household’s primary wage earner can lead to cascading effects for the whole family. Medi-Cal helps people bounce back after an accident or illness to support the whole family.
Regardless of the error, Medi-Cal updates the Covered California income section denying the non-Medicare spouse their private health insurance with the subsidy. The spouse is determined Medi-Cal eligible and their health plan is terminated.
When there is an error in a county Medi-Cal determination, it is nice if the beneficiary has an actual person to talk to. These people are known as case eligibility workers that work with most aspects of the eligibility determination process. Case eligibility workers seem to be going the way of most customer service departments for any business where access is governed by automated phone menus and chatbots.
While the network of health care providers is small with Medi-Cal programs, if you qualify for the 250% Working Disabled Program, you may be able to save quite a bit of money. To see you if you might qualify, contact your county’s social service department for Medi-Cal eligibility unit.
Not all the below options may be available to you because some are contingent on your age, employment, or income. Those health insurance alternatives available to you are worth investigating and considering if they meet your budget or adequately address health care challenges you may be facing.
