MAGI
I am applying for MAGI with my 18 year old child and have income of $1903.
Who is aid code M1 for?
HH of 1 = $2000
HH of 2 = $3000
What are Non-MAGI property limits?
A marketplace accessed on the internet for people and small businesses to find out if they are eligible for financial help in getting health insurance, including Medi-Cal.
What is Covered California?
Give zero share of cost Medi-cal to those individuals who have been discontinued from SSI/SSP due to Social Security COLA or annual increase.
What is the Pickle Program?
provides zero Share of Cost (SOC) Medi-Cal benefits to eligible aged and disabled persons.
What is the Aged and Disabled Federal Poverty Level Program?
It is the primary method of determining eligibility that most of our casework start with?
What is MAGI?
Aged
Blind
Disabled
In need of long term car or HCBS
A parent and/or caretaker living with children and who has care and control of the children.
What is a Non-MAGI coverage group?
Determines eligibility using the Business Rules Engine for Health Care Programs including Medi-Cal under the Patient Protection and Affordable Care Act
What is CalHeers?
Screening
Disregard
Needs test/Financial Eligibility
What is the Pickle Process?
has not been determined disabled, or
has a SSI/SSP or DDSD determination of “blindness” that does not indicate “disability”.
When is a referral to DDSD required?
Is limited to applicants and beneficiaries who have income up to 138% of the FPL.
What is Eligibility for MAGI?
Property verification and asset test.
What is required for a Non-MAGI eligibility determination?
October 15 - January 31?
When is Covered California open enrollment?
identifies those persons who currently receive SSA benefits, were terminated from SSI/SSP in the past three years (for any reason other than COLA), and previously found ineligible for the Pickle Program
What is Pickle Tickler Report?
$230
$310
What is income disregard?
Infants and Children under 19
Parents/Caretaker Relatives
Pregnant Woman
Adults age 19 - 64
Targeted Low Income Children Program (TLICP)
Tuberculosis Program
What is the MAGI coverage group?
Meet the non-MAGI coverage group criteria
Have income within the applicable FPL limit for their family size
Request to be screened under a non-MAGI basis
What is the Hierarchy for Non-MAGI?
We do not ask about income or health because we do not check out data sources for reasonable compatibility for that data.
What is not needed for Covered California for unsubsidized Covered California Plan?
identifies those persons terminated from SSI/SSP in January of this year, due to COLA, and recipients of IHSS, who require a Pickle Program eligibility determination.
What is 503 Leads File Report?
Medi-Cal regulations presume that any property owned by someone in a nursing home, that has been transferred, was transferred in in order to qualify for Medi-Cal.
What is MEM 50408 & 50409?
Medicare premium payment program
Minor Consent
Most LTC applicants
DDS HCBS In-Home Operations Waiver
Former Foster care Children
When is a MAGI determination not required?
Non-disabled individual who is under the age of 21
Disabled individual under the age of 18
Disabled individual 18 to 21 years of age, living in the home of a parent and attending school, college, university, vocational or technical school.
What is a child for Non-MAGI?
Individual with Financial Assistance
Individual without Financial Assistance
SHOP employee
SHOP Employee with Financial Assistance
What are the 4 Covered California application types?
Was filed expressly prohibiting the Department of Health Services from limiting Pickle eligibility to only those persons discontinued from SSI/SSP due to a COLA increase in his/her Social Security (RSDI) benefits.
What is Lynch vs. Rank?
principal residence to spouse, children, or siblings (Conditions apply)
exempt property to spouse
non-exempt property to spouse or disabled children
What is Exempt transfer?