For Non-MAGI Medi-Cal determinations, DHCS has provided supplemental forms and a flow chart to help evaluate cases for proper eligibility.  Non-MAGI evaluations are required when an applicant requests such a determination, when MAGI does not apply, or when there is potential non-MAGI eligibility for those not income-eligible for MAGI.

If an ex parte review reveals the need for additional information, county eligibility workers need to send applicable supplemental forms to get that information.  Workers must attempt to contact the applicant at least twice.

DHCS ACWDL 17-26 (July 20, 2017).

The online application for Medi-Cal and other health insurance programs has been redesigned to group questions in a more logical fashion, using prior responses to display future questions on an as-needed basis for program eligibility determinations.

Additionally, the application has changed to conform with newer statutory and regulatory requirements.  Applicants are to be treated in a manner consistent with their gender identity.  They will be able to designate a choice without need for verification from the county.  Individuals can also be deemed pregnant regardless of gender identity.  Additionally, DHCS must collect voluntary information about sexual orientation and gender identity.  The application also removes requirements to collect Social Security numbers from non-applicants.

The updated online application adds questions about Indian Health Service access, military service, and personal injury lawsuits.  It also adds Medi-Cal notice information about non-discrimination, 10-day reporting requirements, and estate recovery to the signature page.

DHCS MEDIL I 17-08 (June 29, 2017).

The Medi-Cal Access Program (MCAP) provides full-scope Medi-Cal services for pregnant women between 213% and 322% of the federal poverty level.  Prior to October 1, 2016, MCAP-eligible pregnant women received services through managed care plans and were assigned aid code 0D.  Between October 2, 2016, and June 30, 2017, MCAP-eligible pregnant women have been assigned aid code 0G and receive services through Medi-Cal Fee-for-Service.  Starting July 1, 2017, MCAP-eligible pregnant women will be enrolled into managed care plans under aid code 0E.

All MCAP-eligible pregnant women receive full-scope services until the end of their post-partum eligibility period (the end of the month of the 60th day after the end of the pregnancy).

DHCS MEDIL I 17-07 (June 9, 2017).

Participants in the HCBS-DD (Developmentally Disabled) Waiver can be eligible under any of the MAGI eligibility programs, including the Targeted Low-Income Children’s Program (TLICP) without a change to their aid codes.

The HCBS-DD Waiver allows Regional Center patients who would either be assigned a share of cost or be ineligible for Medi-Cal due to deemed income or assets of parents, spouses or others to qualify on their own income and assets.

DHCS ACWDL 17-15 (May 18, 2017).

Unmarried pregnant women under the age of 21 and not otherwise eligible for Medi-Cal can be eligible for full-scope or pregnancy-related Medi-Cal.  Such potential beneficiaries must either be living with parents and not filing a tax return for the year, or will be claimed as a tax dependent by parents for the tax year.  For this group, DHCS will disregard all household income.  Beneficiaries will be assigned to aid codes M7 or M8, depending on immigration status.

This program is effective August 1, 2016.

DHCS ACWDL 17-06 (March 1, 2017).