How do you qualify for California Medi-Cal and what is the maximum income to qualify for Medi-Cal 2023? Is there an asset limit for Medi-Cal eligibility? If you have these questions and others about California Medicaid, we can help. In this post, we will explain in detail the California Medi-Cal Eligibility requirements and everything you need to know to apply for Medi-Cal benefits.
This includes the new asset limits for Medi-Cal, which now increases the pool of applicants eligible for Medi-Cal long-term care assistance.
Table of Contents:
- What is Medi-Cal?
- California Medi-Cal Eligibility
- Maximum Medi-Cal Income Limits for 2023
- Medi-Cal Asset Limits in 2023
- California Medi-Cal Eligibility Verification
- How to Apply for Medi-Cal
- What does Medi-Cal Cover?
What is Medi-Cal?
Medi-Cal is California’s Medicaid public health insurance program.
The program provides medical, dental, and vision insurance to low-income families in California.
Medi-Cal has always covered low-income children, pregnant women, and families.
On Jan. 1, 2014, California expanded Medi-Cal eligibility to include low-income adults with incomes below 138% of the federal poverty level (FPL).
California Medi-Cal Eligibility
There are three ways you can qualify for Medi-Cal:
First, you can qualify if you meet the income limits.
To see if you qualify based on income, look at the chart below. Income numbers are based on your monthly or yearly earnings.
Second, you can also get Medi-Cal if you are:
- 65 or older
- Under 21
- In a skilled nursing or intermediate care home
- On refugee status for a limited time, depending on how long you have been in the United States
- A parent or caretaker relative of an age-eligible child
Additionally, there are special Medi-Cal programs for individuals who:
- Have been screened for breast and/or cervical cancer (Breast and Cervical Cancer Treatment Program)
- Have tuberculosis (for citizens and documented non-citizens only)
- Receives Medicare (for payment of the Medicare premium)
- Are minors in need of confidential treatment for drug and/or alcohol abuse, sexually transmitted diseases, sexual abuse, pregnancy, family planning, or mental illness
- Have had an organ transplant in the previous two years and need anti-rejection medication
Third, if you are enrolled in one of the following programs, you can also get Medi-Cal:
- CalWorks (AFDC)
- Refugee Assistance
- Foster Care or Adoption Assistance Program
Maximum Medi-Cal Income Limits for 2023
Medi-Cal income limits are calculated as a percentage of the Federal Poverty Line (FPL).
To qualify for Medi-Cal based on income, you cannot make more than the income guidelines below.
- Children up to age 1 with family income up to 266 percent of FPL
- Any child age 1-5 with a family income up to 266 percent of FPL
- Children ages 6- 18 with family income up to 266 percent of FPL
- CHIP for children with family income up to 266%-322% percent of FPL
- Pregnant women with family income up to 213 percent of FPL
- Parents of minor children with family income up to 114 percent of FPL
- Individuals who are elderly, blind, and disabled with family income up to 100% of the FPL
- Adults without dependents under Medicaid expansion with income up to 138% of the FPL
As shown above, Adults (ages 21-64) whose income is at or below 138% of the Federal Poverty Level may qualify for Medi-Cal under the Affordable Care Act Medicaid expansion.
Below are the 2023 California Medi-Cal income limits for adults based on household size.
In 2023, a single adult earning $1,677 or less per month (138% FPL) is eligible for Medi-Cal.
That’s approximately a 6.70 percent increase from the 2022 income limit.
For 2 adults, the household income limit is $2,269 per month for Medi-Cal eligibility.
|California Medi-Cal Income Limits for 2023 – 138% of FPL|
|Family Size||Monthly Income Limit||Annual Income Limit|
For income limits for other Medi-Cal eligible groups in California, see our Medi-Cal income limit guide.
Medi-Cal Asset Limits in 2023
Starting in 2022, California is removing Asset Test for Medicaid Eligibility.
The state is making big changes to how it determines Medicaid eligibility for long-term care by eliminating the requirement that applicants have limited assets.
While the rules apply only to California right now, other states may follow suit.
Most states cap assets at $2,000 for Medicaid eligibility for long-term care.
This means that if your assets (with the exception of your home and one vehicle) exceed this amount, you would not qualify for Medicaid assistance.
The program’s strict asset rules compel many applicants to “spend down” their assets before they can qualify for coverage.
This year, California will become the first state to phase out the asset test altogether.
The next state budget bill begins this process by increasing the asset limits over a two-and-a-half-year period before removing them entirely.
That way, Medi-Cal eligibility will be determined solely by income.
As of July 1, 2022, the asset limit for an unmarried applicant for Medi-Cal will be raised from $2,000 to $130,000 and from $137,400 to $267,000 for a married applicant.
These changes will significantly increase the pool of Medi-Cal recipients and, for many, may reduce the need to spend down or gift assets to qualify for benefits.
The asset test will be fully eliminated by July 1, 2024.
The new limits will be as follows:
Household Asset Limits for Non-MAGI Programs as of July 1, 2022
|Household size||Asset limits|
California Medi-Cal Eligibility Verification
In order to qualify for Medi-Cal, you also have to meet the following requirements:
1. Citizenship/Immigration Requirements
To receive full-scope Medi-Cal benefits, citizens/immigrants, age 26 and older, may be asked to
provide an original or certified copy of the following:
- Birth certificate
- Other proof of citizenship/immigration paperwork
Those who are unable to provide proof may be eligible for restricted Medi-Cal to cover:
- Emergency services
2. California Residency
Proof of California residency may be required to receive benefits under some Medi-Cal programs, options include:
- Valid California Driver’s License
- Utility bill
- Rent receipt
- Mortgage statement
- Paystub from California employer
3. Proof of Household income
The most common documentation for proof of income includes:
- Most recently filed Federal Income Tax Form 1040, with any appropriate Schedules.
- Wage/Income Tax Statement (such as a W2, 1099MISC, 1099G, 1099R, 1099SSA, 1099DIV, 1099SS, 1099INT, or 1099NEC, or
other form displaying your income and taxes).
- Employer statement.
- Foreign Income (Pay stub, other documents. Use dollar conversion based on the date of the document).
- Self-Employment Income (Self-employment Profit and Loss Statement or Ledger documentation and Federal Tax Form 1040 with any appropriate Schedules).
How to Apply for Medi-Cal
There are four ways to apply for Medi-Cal in California:
Option 1 – In Person
Apply for Medi-Cal at your Local County Services Office, where you can get personal help completing your application.
Option 2 – By Mail
Download a Medi-Cal application, available in English and other languages, through the Single Streamlined Application, which you can find here.
Send the completed and signed application to the address provided on the form.
Option 3 – By Phone
You can also apply for Medi-Cal over the phone, by calling your Local County Services Office.
Option 4 – Online
The fastest way to apply for Medi-Cal is online. Here, you have two options:
You can apply for Medi-Cal online through Benefitscal.com.
In addition, you can sign up for Medi-Cal online through Covered California.
CoveredCA.com is a joint partnership between Covered California and the Department of Health Care Services.
What does Medi-Cal Cover?
Medi-Cal provides comprehensive health benefits, including:
- Outpatient (Ambulatory) services
- Emergency services
- Maternity and newborn care
- Mental Health and Substance Use Disorder Services, including Behavioral Health Treatment
- Prescription medication
- Programs such as physical and occupational therapy and related devices
- Laboratory services
- Preventive and wellness services
- Chronic disease management
- Dental care
- Children’s (Pediatric) services, including oral and vision care
- IHSS Program
California Medi-Cal Eligibility Summary
We hope this post on California Medi-Cal Eligibility was helpful.
If you have further questions about Medi-Cal, please let us know in the comments section below.
Be sure to check out our other articles about Medicaid, including: