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Horizon Elder Law & Estate Planning Blog

Wednesday, October 11, 2017

How Do I Qualify for Medi-Cal?

Every state creates and operates its own Medicaid program using state and federal funds. Medi-Cal is the California Medicaid program. If you live in California and you need health care, you may want to explore your options for Medi-Cal planning with an experienced elder law attorney.

Residency Requirements for Medi-Cal

Medi-Cal provides free or low-cost health care coverage for low-income adults, families with children, seniors, and disabled persons. Women who are pregnant, foster children and former foster children (up to age 26) may also be eligible. To qualify, you must be a U. S. citizen or U. S. national, permanent resident, or legal alien and be a resident of California. You are allowed to apply if your family includes immigrants. Even if your immigration status makes you ineligible, your children might be eligible for Medi-Cal.

You will have to submit acceptable documents that prove your identity and Social Security number. You must show that you are not incarcerated, or that you are released or on parole. Medi-Cal requires you to prove your status as a U. S. citizen or national, or to show your immigration status or lawful presence.

There are different documentation requirements for:

  • Lawful Permanent Residents (LPR/Green Card Holders)
  • Asylees
  • Refugees
  • Conditional Entrants (CE) granted before 1980
  • Individuals granted withholding of deportation or removal
  • Individuals paroled into the U.S.
  • Cuban or Haitian Entrants
  • Qualified domestic Violence Survivors
  • Victims of trafficking and his/her spouse, child, sibling or parent
  • Members of federally recognized Indian tribes or American Indians born in Canada
  • Other non-immigrant status (letter visas), which include student or worker visas
  • Twelve additional unique situations

Medi-Cal Income Requirements

You must also meet the Medi-Cal requirement of low income. The maximum amount of income you can have to be eligible will depend on the number of people in your household. Currently, the income limits are:

Household size                 Income Limit

1 person                                              $15,800

2 people                                              $21,307

3                                                             $26,813

4                                                              $32,319

5                                                              $37,825

6                                                              $43,331

7                                                              $48,851

8                                                              $54,384


If there are more than eight people in your household, add $5,533 for each additional person. These income limits change periodically, so be sure to check the current limits.                                           

How Much Your Premiums Will Cost

Many Californians get health care insurance through Covered California at little or no cost. The factors that determine the amount of your premiums are:

  • Your age
  • Your ZIP code
  • Your household size
  • Your household income
  • The health plan and benefit level you select

Application Requirements

You can apply through the Covered California online application portal, or in person at your local county social services office. Although the open enrollment period is from November 1 through January 31 each year, you are allowed to apply at any time during the year if you have a qualifying life event.

Unlike Covered California health insurance plans, you can apply for Medi-Cal at any time during the year. You use the same application for Medi-Cal and Covered California. They will automatically check your application to see what financial help you and your family can receive.

The California Department of Health Services can help you locate your local agency office. You can call them at 916-445-4171 (916-445-0553 for TTY users).

The eligibility rules change frequently, so you should talk with a Medi-Cal planning lawyer in your area. For competent counsel, talk to the professional elder law attorneys at Horizonlaw today by requesting a consultation.


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