Kevin Knauss: Health, History, Travel, Insurance
Posts related to how California MAGI Medi-Cal works, especially with Covered California, enrollment, termination, household income.
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.
Medi-Cal breaks up the income into unearned income, earned income, in kind income, and exempt income. Finally, there are certain expenses that will reduce the final countable income for eligibility in the Medicare Savings Program.
I have created this income table that has the monthly income numbers for Medi-Cal eligibility next to the 2024 annual income amounts for the Covered California subsidies.The Medi-Cal income columns of the Covered California income table are 138% FPL for adults, 213% FPL for pregnant women, 266% FPL for children 18 years and younger, and 322% FPL for children in certain counties of California.
The California Department of Health Care Services will now participate in a Part A Buy-In program with Centers for Medicare and Medicaid Services (CMS) and cover the premiums for Part A. Medicare beneficiaries eligible to have their Part A premiums covered are:
A single adult can now have a monthly income of $1,732 per month and retain their Modified Adjusted Gross Income (MAGI) Medi-Cal. The higher monthly income, an increase of $55 over 2023, is based on 138 percent of the federal poverty level.
