See Medi-Cal brochures for more information on eligibility criteria and requirements. The main additional ways to qualify are: These ways to qualify are explained here. See how the Working Disabled Program can help. Blue Shield of California Promise Health Plan has neither reviewed nor endorsed this information. If you are pregnant, Medi-Cal may provide you with free or low-cost health care coverage during your pregnancy. IHSS helps pay for personal assistance services so that people with disabilities can live in the community. We know our members come from all over the world, and all walks of life. Medi-Cal provides important health benefits to adults and children. Can I get a doctor referral or a list of providers? We are contracted with L.A. Care Health Plan and the Department of Health Care Services. Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association. Learn more about essential health benefits. On Jan. 1, 2014, California expanded Medi-Cal eligibility to include low-income adults. We can help! You can think of Medi-Cal as a single program that you can qualify for in a number of ways. You only have to pay a share of cost in months when you have medical expenses. The following programs are available: (1) Tuberculosis; (2) Special Treatment Programs for Dialysis or Total Parenteral Hyperalimentation (TPN); (3) Breast and Cervical Cancer Treatment Program (BCCTP). Medi-Cal is the name for the Federal Medicaid Program in California. It is mandatory to procure user consent prior to running these cookies on your website. If you are entitled to or receiving Medicare, you may be eligible to payment of your Medicare Part A and/or Part B premiums, deductibles, and co-insurance fees by applying for the Medicare Savings Programs, even if you are not receiving Medi-Cal. These cookies do not store any personal information. Different programs sometimes use slightly different numbers for the. Medi-Cal with Blue Shield Promise Health Plan is free for residents who meet eligibility requirements. Who can apply for Medi-Cal and join BlueShield Promise Medi-Cal? Be either aged (65+), or disabled (meet Social Securitys. Enrollment in Blue Shield of California Promise Health Plan depends on contract renewal. For information about Medi-Cal, see the official Medi-Cal site. If you live with others, you should use DB101's Benefits and Work Estimator. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. The Medi-Cal regulations do not define what working means for this program, and you can qualify if you are working part time. The nine categories are: The main text is supported by a glossary, an index, and an Aid Code Quick Reference sheet. Like SSI, this program does not count all of your assets. Some immigrants don't qualify for Medi-Cal's Working Disabled Program, but do qualify for government help paying for a private insurance plan. The Minor Consent program provides eligible minors temporary confidential Medi-Cal benefits without parental consent for certain services. To learn about other eligibility categories, you can visit a benefits planner or talk to a Medi-Cal eligibility worker at your local county social services agency. Have assets worth less than $130,000 for an individual ($195,000 for a couple). You will have to pay the first $1,063 in medical expenses during the month before Medi-Cal will start covering you. Have countable income less than 250% of the federal poverty level (in 2022, this equates to $2,853/mo. Compare the results to the WDP income limit ($2,831 per month for individuals) to see if you're eligible. If you are living in a board and care facility, subtract $315. The easiest and quickest way to apply for CalWORKs, CalFresh and/or Medi-Cal is online at www.benefitscal.com. Even though his income is now higher than the usual income limits for Medi-Cal, he is still eligible for Medi-Cal through 1619(b) because his annual income is less than $54,082. The orientation chapter discusses Medi-Cal eligibility, immigration and disability issues, financial requirements, application process and redetermination procedures, and coverage and benefits. Take the number of people in your household who are. You must prove your disabling physical and/or mental problem(s) with medical records, tests, and other medical findings. Note: The California Health Care Foundation focuses on policy research, and we are unable to assist with individual Medi-Cal cases. On July 1, 2022, Medi-Cal asset limits increased to $130,000 for individuals, $195,000 for couples. Page last updated: 05/27/2022 Blue Shield of California Promise Health Plan cumple con las leyes estatales y las leyes federales de derechos civiles vigentes, y no discrimina por motivos de raza, color, pas de origen, ascedencial, religin, sexo, estado civil, genero, identidad de genero, orientacin sexual, edad ni discapacidad. Like SSI, this program does not count all of your assets. If it is higher than $1,563 for individuals, you may qualify for Medi-Cal's Working Disabled Program or ABD-MN Medi-Cal instead. Fill out the application as completely as possible to avoid delay in processing your application. Blue Shield of California Promise Health Plan is a Medicare Advantage HMO plan with a Federal Government contract in California. This includes adults, children, families with children, seniors, and persons with disabilities. If you are enrolled in the program, you can save earnings in a separate bank account and this money will not count against the programs resource limit. 138% of FPL for adults 19-64 years old. I lost my Medi-Cal card, where can I get another card? Staff verifies the application submitted is complete and schedules the customer for an interview to obtain appropriate non-financial/financial information and verifications to determine program eligibility. For information on Blue Shield Promise Cal MediConnect Plan and other Cal MediConnect options for your health care, call the Department of Health Care Services at 1-800-430-4263 (TTY: 1-800-735-2922), or visit https://www.healthcareoptions.dhcs.ca.gov/. We Provide Free Translation and Interpreter Services, including ASL. Depending on income and family size, you and your family may be eligible to free or low-cost Medi-Cal. If your resources are too high for Medi-Cal's Working Disabled Program and your income is too high for other forms of Medi-Cal, you may be able to get government help paying for an individual plan on Covered California instead. Medi-Cal's Working Disabled Program is described, Compare with private plans on Covered California, Income-based Medi-Cal, children (266% FPG), Subsidized private plans, reduced fees (250% FPG), Subsidized private plans (no income limit), Your Impairment Related Work Expenses (IRWEs), Gross Income Less than SGA ($1,350 for individual, $2,260 if blind). This book provides important information crucial to understanding the Medi-Cal program. It may also cover services for any other medical condition that is medically necessary for the woman. There may be situations where an individual plan on Covered California has a lower premium than your Medi-Cal's Working Disabled Program if you qualify to get government help with your premium. For more information Medi-Cal's Working Disabled Program, contact your local county social services agency. For detailed information about benefits, review the Blue Shield Promise Medi-Cal Evidence of Coverage (EOC), also known as the Member Handbook. Countable income less than the, for couples; money in retirement accounts is not considered as an asset, Learn more about what types of income affect income-based Medi-Cal eligibility, Some types of income do not count against these limits, including SSI benefits, Aged & Disabled Federal Poverty Level Medi-Cal, Aged, Blind, & Disabled Medically Needy Medi-Cal, Buying Health Coverage on Covered California article, Medi-Cal for the Working Disabled Estimator, SSI/SSP benefit amount for your living situation, Work Incentives Planning and Assistance (WIPA) counselor, county In-Home Supportive Services (IHSS) office, Health Insurance Counseling & Advocacy Program (HICAP), Department of Rehabilitation (DOR) office, America's Job Center of California (AJCC), You are 19-64 years old and your familys income is at or below 138% of the. Be working and earning income (this can be part-time work). Are you sure you want to lock your account? California Physicians Service DBA Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association. If you are single, you can figure out your share of cost by following the first step for calculating A&D FPL eligibility. What if Im denied for Medi-Cal, what other health coverage options do I have? These cookies will be stored in your browser only with your consent. If youre living outside of these counties, check out the Department of Health Care Services website for coverage in your area. If your family's income is at or below the limit for a program, you may qualify if you meet other program rules. Necessary cookies are absolutely essential for the website to function properly. Health Care Options: 1-844-580-7272, Monday through Friday from 8 a.m. - 6 p.m. TTY users should call 1-800-430-7077. You will receive notice when necessary. If it is less than $1,563 for individuals or $2,106 for a couple, then you qualify for free, full scope Medi-Cal based on A&D FPL rules. After working for a year, Joe got a raise and went over the 1619(b) limit, so he switched to Medi-Cal's Working Disabled Program and paid a small monthly premium so he could keeping getting his Medi-Cal coverage. The guide also provides information on non-Medi-Cal programs. Medi-Cal offers free or low-cost health coverage for California residents who meet eligibility requirements. If ineligible to a County based Medi-Cal program, the customers application will be referred to Covered CA to determine eligibility to other non-County based health coverage. Countable income less than the SSI/SSP benefit amount for your living situation, Up to $130,000 for individual, $195,000 for couples, Countable Income less than 250% of the Federal Poverty Level ($2,831 per month for individuals, $3,815 for couples), SSI's countable income calculation, but any disability income is not considered income, Up to $130,000 for Individual, $195,000 for couples; money in retirement accounts is not considered as an asset, No income limit, but your countable income determines your share of cost, SSI's countable income calculation - MNA for number of people in household, including the applicant health, vision, and dental insurance premiums, Up to $130,000 for individuals, $195,000 for couples, with an additional $65,000 per additional family member. You can apply for Medi-Cal regardless of sex, race, religion, color, national origin, sexual orientation, marital status, age, disability, or veteran status. Note: If you ever need to qualify for a different Medi-Cal program that has a resource limit, the earnings you saved in this account while on WDP will not be counted as resources. And it doesn't change income-based Medi-Cal, which doesn't have an asset limit. The Medicare Savings Programs are: Specified Low Income Medicare Beneficiary (SLMB). If you are working, disabled, and your income is too high to qualify for free Medi-Cal, Medi-Cal's Working Disabled Program may allow you to get Medi-Cal by paying a small monthly premium. Big changes for disability-based Medi-Cal categories with asset limits: This applies to Medi-Cal through A&D FPL, the Working Disabled Program, and ABDMN, as well as Medicare Savings Programs (MSPs). Eligibility requirements include property and income limits which may change annually. If you get a number that is 0 or less, then you have no share of cost. Copyright 2022World Institute on Disability, Technology 2002-2022Eightfold Way Consultants. A share of cost is usually more expensive than paying a premium, Your ABD-MN Medi-Cal share of cost could be very high. Modernizing Payment to Community Health Centers, The Guide to Medi-Cal Programs, Third Edition (, Transitional or continuing Medi-Cal coverage. For Assistance, Call 1-866-613-3777. We can help! People with disabilities have more ways they can qualify for Medi-Cal if they don't meet the standard eligibility rules described above. However, you would to pay a share of cost. All earned and unearned income is counted based on IRS rules for adjusted gross income. Apple and the Apple logo are trademarks of Apple Inc. App Store is a service mark of Apple Inc. Google Play and the Google Play logo are trademarks of Google LLC. 2002-2022. This is called Medi-Cal for Pregnant Women and it covers pregnancy-related services, including prenatal care, labor, delivery, postpartum care, and family planning services. 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