Medi-Cal Eligibility in California: Who Qualifies?

Medicaid is a federal program implemented in each state to provide health care to those who cannot afford it. In California, the Medicaid program is referred to as "Medi-Cal." The program is administered by the Department of Health Services (DHS).

Eligibility Categories

• The Medi-Cal program offers insurance to a variety of eligibility groups, including pregnant women, children, adults under 21, parents or caretakers of children, and medically-needy elderly, disabled or blind people. Medi-Cal also covers long-term care, such as nursing home expenses. You must be a U.S. citizen or legal immigrant to qualify.

Resources

• Medi-Cal restricts the amount of "countable" resources for certain eligibility groups. There is no asset limit for children up to age 18 or pregnant women. The asset limit for a household of one or two is $3,000. Households of three are limited to $3,150. SSI recipients cannot exceed $2,000 for a single person or $3,000 for a couple.

Income

• Medi-Cal considers an applicant's income in comparison to the federal poverty level (FPL). In 2011, the poverty level was $10,830 for a single person. Pregnant women and infants can earn 200% of FPL or less. Individuals 18-21 can't earn more than100 percent of the FPL. Elderly or disabled SSI/SSP recipients are automatically eligible for Medi-Cal.

Deductions

• Certain deductions are allowed to reduce the income basis for applicants. If household members are employed, there is a $90 work-related expense deduction. The deduction applies to each working household member. If you pay for day care, deduct $200 for infants and children up to age 2. For disabled dependents, there is a $175 deduction.