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Qualifying for Medi-Cal Health Insurance

“Medicaid” is Federal health insurance program for low income individual and families. In California, it’s called Medi-Cal.

Medi-Cal used to be only available for those who are age 65 or older, and either blind or disabled. After Affordable Care Act (a.k.a Obamacare) came into force in 2014, it is available for people who are under age 65 and meet the low income requirement. The adults are eligible if their income level is 138% of federal poverty level (FPL). If the family’s income is 226% of FPL, the kids are eligible for Medi-Cal. Here is a chart of income level that is used to determine your eligibility.

For Californians who are age 65 or older, also qualified for Medicare, Medi-Cal eligibility requirement is different. The old rules still in effect, i.e. both income, and assets & savings limit have to be met. The current Medi-Cal income limit is $1,242 per month for an individual and $1,682 for a couple.

As for the asset limit, individuals may own assets, such as bank account no more than $2,000; married couples may own $3,000 worth. A primary home, a vehicle, and life insurance policies and the balance of pension funds, IRAs, and certain annuities are exempt.

A caveat worth noting is that according to California’s “Estate Recovery Law“, the State may send a bill to the Medi-Cal member’s descendant to ask for recovery of all the payment that Medi-Cal made on behalf of the deceased Medi-Cal member. This is only if the deceased still owns assets including the house at the time of the death. There are ways to avoid it. Please contact us for consultation. This only applies to those who are age 65 or older. The Medi-Cal recipients in Exchange are “estate recovery free.”

Medi-Cal benefits covers a wide range of medical services, and hospitalization. It even has dental coverage called Denti-Cal, vision, and long term care and supports. The members normal do not pay anything or just pay a minimum shared cost.

DISCLAIMER: Insurance matters discussed are always changing, so accuracy or usefulness of facts may be time-sensitive. Article content is used solely for the purpose of informing readers, and is not intended for any commercial use. Any views or opinions that are expressed in this article are those of the author and do not necessarily reflect the position of any entities involved or mentioned.