Published on: 3/20/2019 12:43 PM
Modified Adjusted Gross Income (MAGI) Medi-Cal eligibility depends on the following criteria:
California residency is a requirement for the Medi-Cal program. Residency requirements are met when the applicant:
- Is physically present and is living in California with the intent to remain permanently, or for an indefinite period
- Provides acceptable verification of California residency
MAGI Medi-Cal utilizes the adjusted income reported to the IRS on the 1040 to determine eligibility. Income is limited to 138% of the Federal Poverty Level (FPL) for adults and 266% for children. Generally, the income is based on the tax filing household.
Children with parents whose income is between 160% and 266% will have a $13 monthly premium for MAGI. Although the premium is per child, the most any family will have to pay is $39.
Monthly Income Limits for MAGI Medi-Cal*:
||Children- No Premium
MAGI Medi-Cal benefits are split into two categories of eligibility: Full Scope and Restricted.
Who is Eligible?
- U.S. Citizens
- Eligible Immigrants
- Undocumented Children
|What is Covered?
- Doctor visits
- Hospital care
- Emergency room
- Mental health
- Family planning
- X-Rays and mammograms
- Renal Dialysis
- Emergency care
- Pregnancy and postpartum
- Renal dialysis
Tax Household Size
Medi-Cal household size is based on tax household size.
Example: A husband and wife file taxes Married Jointly and claim their two mutual children as dependents. The MAGI household size is 4 for all individuals.
Medi-Cal Household size may not be the same for all individuals..
Example: An unmarried couple with two mutual children where dad files taxes Head of Household and claims the children, and mom files Single. The MAGI household size is 3 for dad and the two kids and 1 for mom.
*These monthly income limits are generic and do not reflect individual eligibility amounts. Your County Eligibility Worker will evaluate your income for program eligibility.