Application Processing
This type of application comes into the county through CalHEERS.
What is a MAGI Referral?
This is the form used to request written verifications for Medi‑Cal only.
What is a CSF 103?
Do not use gross income whenever this appears on the customer’s income verification.
What is taxable income?
Cash on hand, checking accounts, & savings accounts are added in CalSAWS as this type of property.
What are liquid assets?
SSI/SSP, Pickle, and Former Foster Youth are part of this level of the Medi‑Cal Hierarchy.
What is Mega Mandatory?
This person may help a customer complete their application, answer questions on their behalf, and the county must send all required notices to them.
What is an Authorized Representative?
An explanation collected verbally or in writing in lieu of admin verification when e-verification of income fails.
What is a Reasonable Explanation?
This is needed to determine MAGI countable income and is based on what the customer “expects” to do.
What is tax household?
This is the property limit for one person and for each additional member of the Medi-Cal Family Budget Unit (MFBU).
What is $130,000 and $65,000? Note: Eff. 07/01/2027: $21,000 for 1 person, $31,000 for couples and $1,550 for each additional member.
This chart lists monthly and annual FPLs and groups aid codes by FPL percentage.
What is DPSS 1442 - Medi-Cal Reference Chart?
This step must be taken when MAGI cannot be requested, ex‑parte review fails, and before sending a written request.
What is a telephone contact?
Additional time allotted when verifications such as citizenship and proof of Medicare coverage is requested.
What is a Reasonable Opportunity Period (ROP?)
Give at least 4 examples of exempt income for MAGI
SDI, Child support received, Veterans benefits, military allowances, workers' compensation, gift/inheritances, loans, FC, AAP, educational income, tax returns, awards/settlements, public assistance (CW, GA, CF, SSI/SSP)
This report is required at each MC application, RE, and CIC for ABD, LTC, and their responsible relatives.
What is an AVP report?
This provides subsidized healthcare for customers ineligible to MAGI and Non-MAGI.
What is Advance Premium Tax Credit (APTC)?
The county provides this when new verification is needed, even if previous requests were already sent.
What are additional contacts?
When all verification sources fail, the county accepts this instead.
What is a self-attestation?
This rule applies when income starts after January 1, the start date is verified, and the customer is ineligible under regular MAGI methodology.
What is the Bounce Back Rule?
At RE, property information on either of these forms is accepted and the MC 604 IPS is not required.
MC 210 RV Non-MAGI RE packet, MC 217 Mixed HH RE Packet.
A person who is disabled, gets SSA Disability, has no Medicare, and is under 138% FPL belongs here in the hierarchy.
What is MAGI?
This term describes evaluating each household member’s Medi‑Cal eligibility separately (tip: not everyone may qualify).
What is Individual Level of Eligibility?
Medi‑Cal benefits must not be delayed when the only missing verification is any of these items (name at least three).
Retro, MC 05/veteran’s, OHC, CW 2.1s, Medicare, SSN, citizenship/immigration status
Provides detailed information regarding the treatment of income for Non-MAGI.
What is MEM Sections 50501-50571 or MEPM Article 10?
Property attestations must be compared against an AVP report either prior to or after approval of eligibility to determine ________ ________.
What is reasonable compatibility?
This program increases the FPL for disabled non-MAGI applicants and beneficiaries with earned income.
What is the 250% Working Disabled Program?