Medi-Cal
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2016 Cutoff and Processing schedule for Medi-Cal managed care enrollment
DHCS issued to Medi-Cal managed care plans the schedule for processing and cutoff for enrollment into and out of health plans. The letter includes the file posting schedule for months of eligibility through January 2017. APL 16-002 (1/19/16).
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Medi-Cal income exemptions for American Indian/Alaska Native sources
When an individual claims to be American Indian or Alaskan Native on the single streamlined application for health coverage, income exceptions apply to MAGI Medi-Cal but not APTC eligibility. This letter discusses the specific income exclusions. ACWDL 16-02…
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Medi-Cal Eligibility information for unaccompanied refugee children
Youth in the Unaccompanied Refugee Minors program are eligible for Medi-Cal as foster youth and former foster youth. Counties are directed to following the foster youth/former foster youth eligibility instructions in ACWDL 14-41. ACWDL 16-01 (1/13/16).
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No increases in 2016 Spousal Impoverishment Caps
DHCS is not raising the community spouse resource allowance or the maximum spousal income allocation under the Medicare Catastrophic Coverage Act. These limits will remain at $119,200 and $2981, respectively. ACWDL 15-38 (12/18/15).
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Medi-Cal 1095-B forms issued
Beginning January 4, 2016, DHCS started to issue 1095-B forms to Medi-Cal beneficiaries as proof of minimum essential coverage for 2015 tax returns. Mailings were sent on a rolling basis on county and zip code. The MEDIL includes…
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Medi-Cal managed care coverage of BHT for children with autism
DHCS has provided new guidance on how Medi-Cal managed care plans cover BHT services to beneficiaries under 21 through EPSDT. Beginning 2/1/16, BHT services for those who received them at regional centers prior to 9/15/14 will transition to…
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Updated family member base allocation amount for 2015-2016
DHCS issued a letter updating the family member base allowance amount from $1967 to $1991, effective July 1, 2015. This allowance is used to determine how much a long-term care beneficiary may allocate to family members living with…
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Fixes for Former Foster Youth who enrolled in Covered California
Former foster youth (FFY) up to the age of 26 may be eligible for Medi-Cal under the Affordable Care Act, though CalHEERS has only recently implemented the proper software. DHCS issued a letter to clarify how to fix…
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How to treat disaster-related payments for Medi-Cal eligibility
DHCS issued guidance to the counties on how to treat certain disaster assistance payments for MAGI and Non-MAGI Medi-Cal programs. Existing rules remain applicable for non-MAGI cases (see ACWDL 92-08, MEPM Article 9M, 22 CCR §§ 50481, 50535.5). …
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Full-scope Medi-Cal expanded options for pregnant women
As of August 1, 2015, the full-scope income limit for pregnant women increased from 60% FPL to 138% FPL, to be automatically applied through both CalHEERS and SAWS applications. For new applicants, eligible pregnant women up to 138%…