There is a situation where Covered California will adjust your income. It happens if you fail to submit the income verification documents. In this case, because you have not verified your stated income, Covered California drops the income to $0 and you then become Medi-Cal eligible. Once you are determined Medi-Cal eligible, ONLY your county Medi-Cal office can adjust your income upwards to make you eligible for a private plan with the subsidies.
California MAGI Medi-Cal
Posts related to how California MAGI Medi-Cal works, especially with Covered California, enrollment, termination, household income.
Do You Report The Extra $300 Lost Wages Assistance to Medi-Cal or Covered California?
California policy states that Disaster and Emergency assistance payments received from federal, state, or local government agencies is exempt from both Modified Adjusted Gross Income (MAGI) and non-MAGI Medi-Cal programs. Consequently, county Welfare Directors have been directed to disregard the LWA when making income eligibility determinations. However, for Covered California, the LWA money is counted as taxable income for eligibility and calculation of the monthly Advance Premium Tax Credit subsidy (federal) and the California Premium subsidy.
The Basics of MAGI Medi-Cal Through Covered California
Covered California doesn’t administer or enroll you into a MAGI Medi-Cal health plan. Through the Covered California income section where you enter you monthly income, the Covered California application system determines if you or your dependents are eligible for MAGI Medi-Cal. If your income indicates you are eligible for MAGI Medi-Cal in the Covered California system, that information is pushed over to the Department of Health Care Services and your county social services office.
Medi-Cal Covered California Income Snag
Covered California screens for Medi-Cal eligibility based on your monthly income, not annual income. Therefore, it is imperative, that when you are reporting a change to your income that the monthly income be accurate relative to published 138% of federal poverty level for adults and 266% for children.
Coronavirus Aid Payments As Income for Medi-Cal and Covered California
Covered California has released a document explaining how the Coronavirus aid payments count as income for individuals and families. What could be a real issue for many mixed households (adults in Covered California and children on MAGI Medi-Cal) is that some of the extra unemployment benefits will be counted differently for the purposes of household income between the two agencies.
Medi-Cal Relaxes Verifications For Eligibility During Covid-19 Pandemic
To allow for counties to prioritize processing of access to care issues, and concentrate staffing resources where needed during this public health crisis, the county shall stop processing annual renewals immediately and may exceed the timeliness standard for all administrative processing of Medi-Cal or Children’s Health Insurance Program (CHIP) redeterminations. The delay shall be effective for 90 days from the date of this MEDIL.
Updated Countable Sources of Income Covered California 2020
Let me emphasize that you are ESTIMATING your income for the year. Your past income and tax return can be used as a guide, but may not be an accurate predictor of your future MAGI. For example, if your spouse is set to collect Social Security retirement benefits in 2020, that income needs to be added to the MAGI.
Revised 2020 Covered California Income Eligibility Chart
There really is no mystery as to why the Covered California income chart doesn’t match the Medi-Cal federal poverty level income table. Covered California is working with two different programs. They must screen for MAGI Medi-Cal eligibility based on current monthly income and the latest federal poverty levels, and, they must also determine the Advance Premium Tax Credit subsidies following IRS guidelines that use the previous year’s federal poverty levels. And if you follow all of that, you are smarter than me!
Do I Have To Repay Medi-Cal?
If your income increases, many people incorrectly assume they are no longer eligible for MAGI Medi-Cal. That is not the case. Medi-Cal is based on your monthly income, not necessarily your annual income. Just because you had an unexpected bump in your hours for one month, does not mean you are no longer eligible. Just report the change to Medi-Cal and let them make the determination. The same applies if you receive a one-time lump sum income amount. These types of events are not necessary counted against you.
Are Health Insurance Premium Payments Delayed With Coronavirus Emergency?
There are a couple of different reasons why health insurance companies may be reluctant to extend a grace period beyond the current 30-day date range. The first reason is California’s expanded Medi-Cal option. If an individual or family has a sudden decrease of income – below 138 percent of the federal poverty level for adults – and they do not have employer sponsored health insurance, they can immediately apply for Medi-Cal and get coverage at no cost.