Transitioning from MAGI Medi-Cal to Medicare

As of 8/1/16, CalHEERS has been able to verify Part A entitlement through the Federal Data Hub.  Medicare entitlement precludes MAGI New Adult group eligibility, though it does not preclude eligibility through the MAGI Parent/Caretaker Relative or pregnancy coverage groups when eligible.

New Medi-Cal applicants who are eligible for Medicare will be evaluated for Non-MAGI Medi-Cal programs.  For New Adult MAGI beneficiaries who are become eligible for Medicare, the county shall evaluate for other MAGI programs.  Beneficiaries shall be placed on a Soft Pause until a Non-MAGI Medi-Cal eligibility determination can be made.

DHCS ACWDL 17-08 (February 24, 2017).