Application Process & Conditions of Eligibility
This is the maximum number of days allowed to approve or deny a Medi-Cal application.
What is 45 days?
Child support payments received are considered this type of income when determining MAGI Medi-Cal eligibility.
What is excluded income?
This individual either does not file taxes or is a tax dependent who meets an exception under MAGI rules.
What is Non-Filer?
Olivia (51) lives with her 14-year-old daughter. She’s not pregnant or disabled. She qualifies under this coverage group.
What is the Parent/Caretaker group?
If verifications are not provided by the due date of the second VCL, this action may be taken.
What is deny for failure to provide (FTP)?
These are the three key times when income must be verified for eligibility purposes.
What are applications, redetermination (RE), and anytime a change is reported?
This group of people must be included in a MAGI household if the taxpayer claims them on their tax return.
Who are tax dependents?"
George (68) lives with and cares for his grandchild (12). He is not disabled. He qualifies under this coverage group.
What is the Parent/Caretake group?
This type of urgent situation includes pregnancy, hospital or nursing home care, doctor or medical appointments, and prescription refills.
What is an immediate medical need?
Mila receives $600/month in unemployment benefits. Is this income counted for MAGI Medi-Cal?
What is yes?
John is divorced and does not claim his son on his taxes. His ex-wife claims the son as a dependent. Who is included in John's MAGI household?
Who is John only?
Sandy (27) is pregnant in her 3rd trimester with no other children. She qualifies under this coverage group.
What is the pregnant women coverage group?
Medi-Cal applicants must meet this requirement, which can be verified by verbal attestation or a California address on the application.
What is California residency?
Mateo receives $900/month from Social Security retirement. Is this income countable under MAGI?
What is yes?
Sally files as Head of Household and claims her grandmother as a tax dependent. Who is included in Grandma’s MAGI household?
Who is Grandma only?
Robert (35) is the father of a 12-year-old child but does not live with him and pays child support. He qualifies under this coverage group.
What is the New Adult group?
A customer does not respond to the first CW 2200 sent on 07/02/2025. A second CW 2200 is sent on 07/13/2025. What is the due date for the second request?
What is July 23, 2025?"
Maya earns $800/month and gets $250/month Social Security and $150/month child support. What is her countable income for MAGI?
What is $1,050?"
Addison and Zed are married and file taxes jointly. They have two children whom they claim as tax dependents. Who is included in Addison's MAGI household?
Who are Addison, Zed and their two children?
Rubi (16), who is pregnant in her 3rd trimester with no other children. She qualifies under this coverage group.
What is the infant/children coverage group?