Do you have to repay Medi-Cal after your income increases?
You will not have to repay the premium assistance you receive if your income is verified as eligible at one point and later you become Medi-Cal eligible, as long as you report the income change within 30 days.
If you're receiving free Medi-Cal and your income goes up because you are working, you may be eligible to switch to the WDP program. Medi-Cal workers are required to automatically check to see if you are eligible for this program when your income disqualifies you from your eligibility category.
The Medi-Cal Estate Recovery program must seek repayment from the estates of certain Medi-Cal members after they die. Repayment only applies to benefits received by these members on or after their 55th birthday and who own assets at the time of death.
If you do not report changes to your personal information right away, and then receive Medi-Cal benefits that you do not qualify for, you may have to repay DHCS.
If your income is too high for Medi-Cal, you may qualify to purchase health insurance through Covered California. Covered California offers “premium assistance.” It helps lower the cost of health care for individuals and families who enroll in a Covered California health plan and meet income rules.
Most single individuals will qualify for Medi-Cal if there income is under $1,676 per month. Most couples will qualify if their income is under $2,267 per month. If you have disabilities, your income can be slightly higher. You can qualify for Medi-Cal even if you have assets.
If you get Medi-Cal coverage and then get a job, you have a couple of options for keeping your Medi-Cal benefits. If you got Supplemental Security Income (SSI) cash benefits before you got your job, Social Security's 1619(b) program lets you earn up to $58,638 annually and still keep Medi-Cal coverage at no cost.
Need-based benefits usually require repayment
Every cent paid out on behalf of a Medi-Cal recipient is subject to collection efforts. It is common for Medi-Cal to bring a claim against someone's estate after they die in pursuit of the full value of all benefits that they received.
The current asset limit is $130,000 for one person. Each additional household member adds $65,000 to the asset limit. Up to 10 members can be in a household. Medi-Cal will also consider income information (including income from property).
The best way to avoid a recovery claim is to have nothing in the Medi–Cal beneficiary's name at the time of death. The state cannot collect from a life insurance policy or a retirement account if you have named a beneficiary of the policy or account.
Does Medi-Cal check bank accounts?
Starting on January 1, 2024, Medi-Cal applications will no longer ask for asset information.
All California residents under the age of 26 who meet the eligibility requirements can qualify to receive Medi-Cal, regardless of U.S. citizenship or immigration status.
Drawbacks of Medi-Cal Trusts
You don't have the same access during your life. You may actually need these resources at some point in time. In addition to this, you may never need Medi-Cal because you may never become incapacitated.
Medi-Cal members must renew their coverage each year to keep their health care benefits. For most members, coverage is renewed automatically. Sometimes the county will send you a renewal form that you must review and return, along with any additional required information.
For many individuals who enroll in Medi-Cal, there is no premium, no co-payment, and no out of pocket cost. Effective July 1, 2022, all monthly premiums were reduced to $0.00. In general, individuals in Medi-Cal will get the same health benefits available through Covered California at a lower cost.
Medicaid income eligibility in California is based on household size. To qualify for free Medi-Cal coverage, you need to earn less than 138% of the poverty level, based on the number of people who live in your home. The income limits based on household size are: One person: $17,609.
First, if you own a home, you can still qualify for Medi-Cal. California has one of the best health services in this regard because California does not ask that you sell your home and pay for your medical needs, but rather it will front all the medical bills for you while you are alive.
Your Medi-Cal coverage will end if you don't turn in your renewal form or you are missing proof of things like income that the county asked you to send. Your local Medi-Cal office will mail you a letter (Notice of Action) to let you know if you didn't turn in your renewal form or are missing information.
The Medi-Cal program determines eligibility for benefits on a “means” tested basis. If a Medi-Cal applicant's property/assets are over the Medi-Cal property limit, the applicant will not be eligible for Medi-Cal unless they lower their property/assets according to the program rules.
How do I know when my Medi-Cal expires?
If DPSS has the information they need, they will send you a notice to tell you whether or not you still qualify for Medi-Cal coverage. If you do still qualify, the letter will indicate that your Medi-Cal is renewed for one year. If you do not still qualify, the letter will indicate when the your Medi-Cal coverage ends.
Income can be verified by providing various types of documents such as the acceptable list below. One of the most common proofs is a pay stub. If you submit a pay stub, make sure that it is current and within the last 45 days; otherwise, Covered California may not accept it.
As a recipient of government benefits, you may not have more than $2,000 in assets before your eligibility for government benefits will be affected.
- Principal Residence. Property used as a home is exempt (not counted in determining eligibility for Medi-Cal). ...
- Other Real Property. ...
- Real Property Used in a Business or Trade.
