There are many different Medi-Cal programs, and each has its own rules for eligibility. In general, a VA pension counts as unearned income. Some Medi-Cal programs are not income-based, so a person with a higher income could qualify for those programs if they meet the requirements. A California Medi-Cal planning attorney can answer your questions, including how your VA pension is counted for Medi-Cal purposes.
Categories of Medi-Cal
Medi-Cal has two primary categories of benefits programs, income-based Medi-Cal and Medi-Cal for people with disabilities. Each category has different requirements for eligibility. Also, different programs within the same category can have different qualification requirements. For example:
Income-Based Medi-Cal
Medi-Cal is for U.S. citizens and qualifying immigrants who do not qualify for Medicare and are either:
- Between the ages of 19 and 64 with a total family income no greater than 138 percent of the Federal Poverty Level (FPL). The Federal Poverty Level for 2020 is $12,760 a year for one person and $17,240 for two people. You add $4,480 for each person beyond two people. One hundred thirty-eight percent of the FPL is $17,609 for an individual and $36,156 for a family of four people.
- Your family’s total income is no greater than 266 percent of the FPL, and you are under the age of 18 years.
- Your total family income is no more than 213 percent of the FPL, and you are pregnant.
California uses the concept of Modified Adjusted Gross Income (MAGI) to determine whether an applicant is eligible for income-based Medi-Cal benefits. When you apply for an income-based Medi-Cal program, most of your earned (like wages) and unearned income (like interest and dividends) will count toward your income. For purposes of income-based programs, Medi-Cal does not count veterans’ disability benefits or Supplemental Security Income (SSI) benefits.
You do not have to be disabled to qualify for an income-based Medi-Cal program. These programs do not limit the number of financial resources (assets) you can own.
Medi-Cal for People with Disabilities
California has four Medi-Cal benefits programs for people with disabilities. They include:
- Aged & Disabled Federal Poverty Level Medi-Cal (A&D FPL). This program only requires you to be aged (65 or older) or disabled – not both. The name can cause confusion and lead people to think you must be both older and disabled, but that is not the case. Your medical condition must meet the Social Security Administration (SSA) definition of a disability. Your monthly income cannot exceed $1,294 for an individual, $1,747 for a couple. You can only own up to $2,000 in countable assets for an individual, $3,000 for a couple.
- SSI-Linked and SSI 1619(b)-Linked Medi-Cal. If you already collect SSI benefits, you automatically qualify for SSI-Linked Medi-Cal. You do not have to fill out another application. SSI Rule 1619(b) lets you continue getting SSI benefits if you go back to work and satisfy the Rule 1619(b) requirements.
- Medi-Cal’s Working Disabled Program. You might be able to get Medi-Cal benefits by paying an inexpensive monthly premium if you are disabled and work, earning too much money to qualify for other types of Medi-Cal.
- Aged, Blind, & Disabled Medically Needy Medi-Cal (ABD-MN). This program lets qualifying people access Medi-Cal benefits after you pay a share of the cost of your medical care.
Each of these programs has its own rules about what counts as income for purposes of eligibility. A
California Medi-Cal planning attorney can provide additional guidance about how your VA pension affects your eligibility for Medi-Cal benefits. Contact us today.