Medi-Cal provides health insurance to uninsured and underinsured individuals who meet certain eligibility requirements. Medi-Cal categories include families with dependent children, pregnant women, children up to age 19, persons age 19 to 64, seniors age 65 and older, or individuals determined blind or permanently disabled. In addition, individuals with specific health care needs may also qualify for Medi-Cal (e.g., people in need of dialysis, tuberculosis services, Total Parenteral [intravenous] Nutrition [TPN] Services, Breast and Cervical Cancer treatment, Minor Consent services, and nursing home care). The financial requirements vary for each of these programs.
Health Care Reform
Effective January 1, 2014, Health Care Reform (HCR) was implemented and expanded Medi-Cal coverage to single childless adults between the ages of 19 to 64 who are not blind or disabled and whose income does not exceed certain income limits.
As a result of the implementation of HCR, the Medi-Cal program has been separated into Modified Adjusted Gross Income (MAGI) Medi-Cal and Non-MAGI Medi-Cal.
Non-MAGI Medi-Cal refers to eligibility programs that existed prior to the implementation of HCR, and continue to provide medical benefits under pre-HCR regulations. Property and resources are counted for Non-MAGI Medi-Cal.
MAGI Medi-Cal includes the following new categories: childless adults between the ages of 19 and 64 who are not blind or disabled; pregnant women; parents/caretaker relatives; and children up to age 19. Eligibility for these individuals is based on reported income. Property and resources are not counted for MAGI Medi-Cal.