Kevin Knauss: Health, History, Travel, Insurance
Posts related to California's Medi-Cal program, specifically MAGI based, income eligibility, enrollment, costs, children, Covered California.
Some people only learn they have been flipped into Medi-Cal when they are at their doctor’s office and the receptionist tells them their health insurance has been cancelled. What follows for many people is a nightmare scenario of trying to learn why their Covered California plan was terminated, who terminated it, why they are in Medi-Cal, and how to get of the Medi-Cal system.
The Medi-Cal annual redetermination paperwork can be confusing and complicated. It can be hard to reach a county Medi-Cal case worker to answer questions. The Department of Health Care Services maintains a webpage of local health enrollment navigators by county.
The purpose of this All-County Welfare Directors Letter (ACWDL) is to provide counties with guidance regarding the elimination of assets for Non-Modified Adjusted Gross Income (Non-MAGI) Medi-Cal programs and the elimination of the requirement to compute and report potential overpayments based on excess property.
State and federal law require Medi-Cal to seek the reimbursement for health care services from any settlement that results from a personal injury or accident paid by a third-party such as an insurance company that covered the responsible party for liability.
If there is no existing enrollment of any family member into a Covered California health plan, the default plan selection in most cases will be the lowest cost Silver plan. For many people with low incomes, there may be no monthly premium for the lowest cost Silver plan. If you don’t like the plan selection, you can change it.
Each county handles Medi-Cal eligibility and enrollment. The California Department of Health Care Services manages the Medi-Cal programs. You need to be in communication with your county Medi-Cal office to update information in the Medi-Cal system. To find your county office address, phone number, and website visit https://www.dhcs.ca.gov/services/medi-cal/Pages/CountyOffices.aspx
With a few clicks on a computer keyboard, a county Medi-Cal worker ripped Phoebe’s health insurance away leaving her completely uninsured. It didn’t even show that she was pending Medi-Cal eligible. She had become uninsured.
In order to avoid some people bouncing back and forth between Medi-Cal and private health insurance, the Department of Health Care Services applied for a waiver to review the assets of the non-MAGI Medi-Cal beneficiaries through the end of 2023. This waiver was granted by the federal Centers for Medicare and Medicaid Services (CMS.)
The income columns that have been updated to reflect the higher federal poverty levels are 138%, 213%, 266%, and 322%. All those income columns, based on household size, correspond to Medi-Cal eligibility for adults, Medi-Cal for Pregnant Women, Medi-Cal for Children, and Medi-Cal Assess Program and CCHIP for children in counties in San Francisco, San Mateo, and Santa Clara counties. The other income columns that are not tied to Medi-Cal eligibility remain unchanged from the 2023 open enrollment period.
In 2022, a single adult earning $1,564 or less per month (138% FPL) was eligible for Modified Adjusted Gross Income (MAGI) Medi-Cal. The 2023 FPL income levels increases approximately 6.70 percent. This means that a single adult can qualify for MAGI Medi-Cal in 2023 with a monthly income of $1,677. For 2 adults, the household income can go as high as $2,269 per month and still maintain Medi-Cal eligibility.
