Aged and Disabled Federal Poverty Level Medi-Cal provides free, full scope Medi-Cal services for disabled or aged individuals who meet the income and asset requirements of the program. Blind people are also eligible, but must be determined disabled.
Yes. You are allowed to have assets up to $2,000 in value ($3,000 for a couple). Some of your assets, like your home and car, are not counted for this program. Click here for a list of additional exemptions.
Assets may include:
checking and savings accounts;
the value of stocks, bonds, and trust deeds;
additional cars or recreational vehicles; and
promissory notes and loans that are payable to you.
Yes. This Medi-Cal eligibility category has been referred to as “Aged, Blind and Disabled Medi-Cal” and was once called “133% Medi-Cal” when it began in January 2001.
No. There are different ways you can qualify for Medi-Cal. Each Medi-Cal eligibility category has unique requirements. Besides the Aged and Disabled FPL program, DB101 has detailed information on the following Medi-Cal programs:
To qualify for the Aged and Disabled Federal Poverty Level Medi-Cal, an individual's monthly total countable income (minus a Maintenance Needs Allowance and any health, vision, and dental insurance premiums) must be less than $1,133 through 3/31/2010 ($1,579 for a couple through 3/31/2010).
You will be covered for drugs that are on Medi-Cal's approved list of prescription drugs. If you have both Medi-Cal and Medicare, the list of drugs that are covered depends on which plan you are enrolled in under Medicare Part D.
To apply for Aged and Disabled Federal Poverty Level Medi-Cal, go to your county Medi-Cal office and submit an application. Medi-Cal provides applications in eleven languages. You can download an application online, but you must still submit it in person or by U.S. mail.
On average, processing of an application takes between 30 to 90 days. The eligibility worker may enroll you in the program without conducting a medical determination of disability. For example, Social Security Disability Insurance (SSDI) beneficiaries have already met the disability rules for this program and do not need a disability determination.
Yes. Your enrollment in private health coverage will not jeopardize your participation in Aged and Disabled Federal Poverty Level Medi-Cal. Obtaining private health coverage may allow you to access providers or services you may not have had available to you on Medi-Cal alone. If you have private health coverage and are eligible for Medi-Cal, you may qualify for the Medi-Cal/HIPP program, which can pay for your insurance premiums.
When using private health coverage and Medi-Cal simultaneously, the private health coverage is billed first. After the private health carrier pays or denies a claim, Medi-Cal is then billed and will pay for services it covers.
As long as you continue to meet disability and financial requirements, you will continue to be eligible for Aged and Disabled Federal Poverty Level Medi-Cal. This program verifies assets, income and earnings annually. If you get a job or your circumstances change, you may want to consider accessing Medi-Cal through another eligibility category (see FAQ 6).
Yes. If you are married and both you and your spouse are eligible for Aged and Disabled Federal Poverty Level (A & D FPL) Medi-Cal, then the income level for two people ($1,579 through 3/31/2010) is used. If your spouse is not eligible for A & D FPL Medi-Cal, then Medi-Cal uses deeming rules to determine if you are eligible for the program.
Contact your local county Medi-Cal office for more information about how deeming rules work and how they can affect your eligibility for this program.
Yes. You can work and continue to be eligible for Aged and Disabled Federal Poverty Level Medi-Cal if your monthly total countable income (minus a Maintenance Need Allowance and health, vision, and dental insurance premiums) remains below $1,133 for an individual through 3/31/2010, or $1,579 for a couple (through 3/31/2010).
When determining eligibility in the program, Medi-Cal does not consider the entire amount of your earnings. Instead, they use a countable income calculation. See the program description or glossary entry for more information.
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