Denials and Terminations of Caretaker Adult MAGI Medi-Cal Cases when Child Lacks Coverage

Under current State and Federal regulations, a parent or caretaker relative with a dependent child under 19 living in the home does not qualify for MAGI Medi-Cal if the child does not have minimum essential coverage (MEC).

Applicants and beneficiaries can self-attest that a dependent child has MEC at the time of application, renewal, or change in circumstance unless the county has information that states otherwise.  If a County worker learns that a dependent child does not have MEC, the worker should do an ex parte review to confirm MEC status.

As with any other discontinuance or denial, the County must send a NOA with proper language.  DHCS has provided sample language for such notices.

DHCS ACWDL 18-01 (January 8, 2018).