Would you like to take a short survey telling us about your experience with DB101? If you are aged or disabled, and are not eligible for SSI, you may be able to get Medi-Cal through the Aged & Disabled Federal Poverty Level (A&D FPL) program.

The guide also provides information on non-Medi-Cal programs. If you cannot qualify for free Medi-Cal or Medi-Cal's Working Disabled Program (described below), you may be able to get Medi-Cal through the Aged, Blind, & Disabled - Medically Needy (ABDMN) program. Medicare is public health coverage for people with disabilities and seniors. Interested in joining? The complete guide is available as a PDF under Document Downloads. Medi-Cal offers free or low-cost health coverage for California residents who meet eligibility requirements. If you are single and live on your own, you can use the tool below to help figure out your countable income. For Assistance, Call 1-866-613-3777. On Jan. 1, 2014, California expanded Medi-Cal eligibility to include low-income adults. Depending on income and family size, you and your family may be eligible to free or low-cost Medi-Cal. Most applicants who apply through Covered California and enroll in Medi-Cal will receive care through managed health plans. Take the number of people in your household who are. In San Bernardino County you will be required to select a managed care provider such as Molina or the Inland Empire Health Plan as your primary care provider., You may have a share of cost, similar to a Co-Payment, for medical/dental treatment based on your income and family size. Closed Captioning (subtitles)in multiple languages, can be enabled by using the CC icon. Select your preferred language using the GEAR icon. But opting out of some of these cookies may affect your browsing experience. Blue Shield of California Promise Health Plan has neither reviewed nor endorsed this information. You will receive notice when necessary. The Former Foster Youth program provides Medi-Cal coverage up to age 26 for youth who were in Foster Care on their 18th birthday. This includes adults, children, families with children, seniors, and persons with disabilities. These cookies do not store any personal information. 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. 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. Blue Shield of California Promise Health Plan offers a large selection of Medi-Cal doctors. 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. You qualify for ABD-MN Medi-Cal. Medi-Cal with Blue Shield Promise Health Plan is free for residents who meet eligibility requirements. Note: This doesn't change SSI-linked Medi-Cal or Medi-Cal through SSI 1619(b), as they still have SSI's $2,000 asset limit. The orientation chapter discusses Medi-Cal eligibility, immigration and disability issues, financial requirements, application process and redetermination procedures, and coverage and benefits. To learn more about dental coverage please visit Denti-Cals website or call them at (800) 322-6384 (TTY: 711). So, we give all providers training and support to make sure our members get the best service. Be working and earning income. You can apply for Medi-Cal regardless of sex, race, religion, color, national origin, sexual orientation, marital status, age, disability, or veteran status. When your provider uses your Benefits Identification Card (BIC) to verify your Medi-Cal eligibility, your provider will know if Medi-Cal will pay for a medical/dental treatment or if you need to make a Co-Payment for any treatment. Note: The California Health Care Foundation focuses on policy research, and we are unable to assist with individual Medi-Cal cases. However, you would to pay a share of cost. 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. If you are single, you can figure out your share of cost by following the first step for calculating A&D FPL eligibility. Dental benefits are available to Medi-Cal members who qualify through Denti-Cal program provided by the Department of Health Care Services(DHCS). Subtract any health insurance premiums that you pay. , If you did not receive your card, lost your card, your card was stolen, or the card you received in the mail has the wrong information on it, you may call and ask for a Benefit Identification Card (BIC) by contacting the Customer Service Center at 1-877-410-8829., Medical, Dental, and Vision services and some prescriptions., If you are pregnant and cannot afford to pay for health care and some dental care, Medi-Cal can help pay for medical expenses for you and your unborn.

Enrollment in Blue Shield of California Promise Health Plan depends on contract renewal. People with disabilities have more ways they can qualify for Medi-Cal if they don't meet the standard eligibility rules described above. On January 1, 2024, these asset limits will be removed completely. Blue Shield of California Promise Health Plan, 601 Potrero Grande Drive, Monterey Park, CA 91755. What if Im denied for Medi-Cal, what other health coverage options do I have? The Medi-Cal program descriptions are organized into nine broad categories. Medi-Cal is a major government-funded health program that helps people with low income. Can I get a doctor referral or a list of providers? Like SSI, this program does not count all of your assets. Call us toll-free at (866) 820-6009 (TTY 711), Monday through Friday, 8 a.m. 6 p.m. You can also read Blue Shield Promise Health Plans step-by-step Medi-Cal enrollment guide. If you get Supplemental Security Income (SSI), a benefit for people with low income who are aged, blind, or disabled, you get Medi-Cal automatically. Blue Shield of California Promise Health Plan Have assets worth less than $130,000 for an individual ($195,000 for a couple). See how the Working Disabled Program can help.

for couples; these figures include the $20 disregard). Medi-Cal provides comprehensive health coverage for children and families. Many times you can get Medi-Cal at no cost to you, even if you have income. For information go to www.coveredca.com or call 888-975-1142. If you've been denied Medi-Cal or an MSP because you had too much in assets, try applying again. Depending on your situation, individual health plans on Covered California might make more sense than Medi-Cal's Working Disabled Program or ABDMN Medi-Cal (described above). Log in, Aged & Disabled Federal Poverty Level (A&D FPL) Program, Medi-Cal Programs Qualification at a Glance chart, California State Disability Insurance (CSDI), learn about how AB 1269 made the California Working Disabled program event better, local Social Security Administration office, contact your Department of Public Social Services (DPSS) county office, 250% California Working Disabled (CWD) Program, Life-insurance policy with a face value of $1,500 per person, Prepaid burial plan (unlimited if irrevocable or up to $1,500 if revocable) and burial plot, Be aged (65+) or disabled (meet Social Securitys, Have less than $130,000 in assets for an individual and $195,000 for a couple. Medi_22_079_LS_052422. Staff approves or denies the County based Medi-Cal program within prescribed timeframes. 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. 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 less than $130,000 for an individual and $195,000 for a couple. Copyright 2022World Institute on Disability, Technology 2002-2022Eightfold Way Consultants. In most cases, it would be cheaper for you to pay a monthly premium for Medi-Cal's Working Disabled Program or even for you to get an individual plan with government subsidies on Covered California. It is mandatory to procure user consent prior to running these cookies on your website. 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). If you lock your account, you won't be able to log in again. income. Blue Shield of California Promise Health Plan is a managed care organization, wholly owned by Blue Shield of California, offering Medi-Cal and Cal MediConnect Plans. If you live with others, you should use DB101's Benefits and Work Estimator instead, since the calculation requires more information about their income. If you are living in a board and care facility, subtract $315. We know our members come from all over the world, and all walks of life. See Medi-Cal brochures for more information on eligibility criteria and requirements. These cookies will be stored in your browser only with your consent. Covered California is the health insurance market place which serves as a one-stop shop where individuals and families obtain information about health care options. The provider network may change at any time.

If you were in Foster Care on your 18th birthday, you are eligible to Full-Scope Medi-Cal benefits up to age 26. Blue Shield of California Promise Health Plan is a Medicare Advantage HMO plan with a Federal Government contract in California. We can help! You must prove your disabling physical and/or mental problem(s) with medical records, tests, and other medical findings. California Physicians Service DBA Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association. 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. Learn more about what types of income affect income-based Medi-Cal eligibility. 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. Medi-Cal provides important health benefits to adults and children. 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. This website uses cookies to improve your experience while you navigate through the website. It can range from $20 to $250 for an individual, or $30 to $375 for couples. After Step 1, take your countable income and subtract the MNL for your family size including yourself and also subtract any health, dental, or vision insurance premiums you pay each month. 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. 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. Here are a few examples: See DB101s article about Buying Coverage on Covered California to learn more. Note: If you dont qualify for Medi-Cal through 1619(b) because your income is too high, you may qualify for Medi-Cal's Working Disabled Program. We also use third-party cookies that help us analyze and understand how you use this website. Learn more about essential health benefits.

Income-based Medi-Cal counts most types of earned and unearned income you have. If you need health benefits, you can apply for Medi-Cal anytime throughout the year online or through Covered California. Worried about losing Medi-Cal? These include Medicare, health, vision, and dental insurance premiums. Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association. , Clinical policies, procedures and guidelines, Policies, guidelines, standards and forms, Department of Health Care Services website, Blue Shield Promise Medi-Cal Evidence of Coverage (EOC), About Blue Shield of California Promise Health Plan, https://www.healthcareoptions.dhcs.ca.gov/, Primary care doctor, wellness and specialist visits, Family planning, maternity and newborn care, Individual, Family, and group Mental Health services for mild/moderate conditions, Behavioral Health treatment for youth under 21, Substance misuse screening and counseling, Care management for higher levels of mental health care, Medical supplies and durable medical equipment, People who live in our service area (Los Angeles and San Diego Counties), People who meet income guidelines and/or other program requirements. Have less than $1,584 in countable monthly income for an individual ($2,126 for a couple). Customer picks a Covered CA plan, if ineligible to Medi-Cal. All earned and unearned income is counted based on IRS rules for adjusted gross income. Blue Shield of California Promise Health Plan currently serves Medi-Cal members in Los Angeles and San Diego Counties. Note: The guide is intended to provide a better understanding of this complex program; however, it is important to note that this is not an eligibility manual. We Provide Free Translation and Interpreter Services, including ASL. You will have to pay the first $1,063 in medical expenses during the month before Medi-Cal will start covering you.

There is no limit to how much of your earnings you can save this way and still remain eligible for Medi-Cal. You also have the option to opt-out of these cookies.

Read DB101s SSI article for more information about whether you qualify for SSI. If you have limited income and resources, the Medi-Cal Program provides comprehensive health coverage to you and your family for free or low-cost. This category only includes cookies that ensures basic functionalities and security features of the website. Can I get help from Medi-Cal with Medicare costs? Click below for an informational PDF. Note: If you got SSDI before you reached retirement age and now your SSDI benefits have been converted to Social Security retirement benefits, they will not be counted as income either. A share of cost is usually more expensive than paying a premium, Your ABD-MN Medi-Cal share of cost could be very high. 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. DPSS provides health care assistance to Seniors as well as children and adults with disabilities. To get Medi-Cal as a disabled person, you must have severe physical and/or mental problem(s) which will: Stop you from working during those 12 months, OR. If your SSI benefits go to zero because you go back to work, an SSI rule called 1619(b) lets you to keep your Medi-Cal coverage if you: For additional information, read the DB101 SSI article, check out Social Securitys webpage on 1619(b), or talk to a benefits planner. Be working and earning income (this can be part-time work). The medical problem must be the main reason why you do not work. 266% of FPL for children 18 and under. The Medicare Savings Programs are: Specified Low Income Medicare Beneficiary (SLMB). It is for people who meet the income requirements and live in the state. The Affordable Care Act makes sure that all Medi-Cal health plans offer the essential health benefits. If you reside in a nursing home (also known as long-term care facility) or need nursing home care, Medi-Cal could pay for all or part of the care and services you receive. You only have to pay a share of cost in months when you have medical expenses. The resulting figure is your share of cost each month. These figures include the $20 disregard. 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. Spend some time looking at your results. The premium you pay for WDP coverage depends on your countable income and family situation. We can help! When you complete a Covered California application, your eligibility for Medi-Cal will automatically be determined.

Are you sure you want to lock your account? 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. If you are pregnant, Medi-Cal may provide you with free or low-cost health care coverage during your pregnancy. Have countable income less than 250% of the Federal Poverty Level ($2,831 per month for individuals and $3,815 for couples). For information about Medi-Cal, see the official Medi-Cal site. The Minor Consent program provides eligible minors temporary confidential Medi-Cal benefits without parental consent for certain services. Blue Shield of California Promise Health Plan complies with applicable state laws and federal civil rights laws, and does not discriminate on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, or disability. For example, if you have a disability, you may qualify for Medi-Cal even if you have higher income or are on Medicare. This book provides important information crucial to understanding the Medi-Cal program. Were eligible for SSI benefits for at least 1 month, Still meet all the other SSI requirements, such as being disabled and having, Meet the medical requirements of Social Securitys. Note: If you are blind, subtract any money you use for Blind Work Expenses (BWEs) from this amount. 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. Different programs sometimes use slightly different numbers for the. The Adults without Children Medi-Cal program provides no cost Medi-Cal benefits to adults between the ages of 19 to 64 without children. Who can apply for Medi-Cal and join BlueShield Promise Medi-Cal? If your family's income is at or below the limit for a program, you may qualify if you meet other program rules. No income is disregarded. You or your supervisor must tell us if you should no longer have this role. Necessary cookies are absolutely essential for the website to function properly. You are a child 18 or younger and your familys income is at or below 266% of FPL ($73,815 per year for a family of four). By clicking Accept on the right side of this banner, you consent to the use of ALL cookies. We cannot refer you to individual providers. Have less than $1,563 in countable monthly income for an individual ($2,106 for a couple). 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. 138% of FPL for adults 19-64 years old. You can use pay-stubs or other written verification from an employer to prove that youre working. IHSS helps pay for personal assistance services so that people with disabilities can live in the community. Page last updated: 05/27/2022 The number you get is the amount of monthly income that is counted for the A & D FPL program. I lost my Medi-Cal card, where can I get another card? With a DB101 account, you can easily save and find your favorite DB101 pages, mini-tools, and estimator sessions. And it doesn't change income-based Medi-Cal, which doesn't have an asset limit. 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). You live alone and have $1,663 per month in countable income and have no other insurance. In addition to everyday health care, there are special health problems that require specialized services. Medi-Cal has always covered low-income children, pregnant women and families. The Medi-Cal regulations do not define what working means for this program, and you can qualify if you are working part time. Your countable income is too high for free Medi-Cal and you don't work, so you can't get Medi-Cal's Working Disabled Program. On July 1, 2022, Medi-Cal asset limits increased to $130,000 for individuals, $195,000 for couples. You may apply for Medi-Cal online via BenefitsCal, in person at your local offices, via mail, over the phone, or by fax. Fill out the application as completely as possible to avoid delay in processing your application. You must: If you are single and live on your own, follow these steps to figure out if your countable income makes you eligible for A&D FPL Medi-Cal. Like SSI, this program does not count all of your assets. The easiest and quickest way to apply for CalWORKs, CalFresh and/or Medi-Cal is online at www.benefitscal.com.

Then go back to your Vault to learn more. If youre living outside of these counties, check out the Department of Health Care Services website for coverage in your area. 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.

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.

Sitemap 25