Covered CA & Medi Cal MAGI  Income Chart  
FPL Federal #PovertyLevel – Program, Eligibility & Subsidy Chart 

#FAQ ‘s, Explanations & More Details 

Footnotes

1   What is my Medi Cal or Covered CA  Household Size– Definition

Try this Flow Chart for a simpler explanation

How many dependents are on your Tax Return?  Section 151

Household Income includes all dependents on your return

2   What is MAGI Modified Adjusted Gross Income – Line 11 AGI + Social Security, Tax Exempt Interest & Foreign Income

Tax Return Reconciliation of Subsidy is on  8962 at the end of the year

• 4   MAGI based Medi-Cal    One can get FREE Medi-Cal base on  MAGI Income Line 37 of your 1040  – If your income falls  below 138% of the CA Poverty Line on the chart above.  There is no longer an asset  test, nor  estate recovery.
  • Medi-Cal versus Covered California Income, Who Decides?  Kevin Knauss
  • Why Your Covered California Health Insurance Subsidy Dramatically Drops with an Income Increase  InsureMeKevin.com 
  • Getting out of Medi Cal when your income increases?  
  • If you’re on SSI you should automatically get Medi Cal
  • Learn more about Share of Cost Medi Cal and not having to pay extra for IHSS  In Home Supportive Services
  • If your income is below 138% and you don’t like Medi Cal, you can buy Covered CA or direct, but without subsidies Learn More 

5   MAGI Medi-Cal for Pregnant Women

6   Medi-Cal Access Program   If you’re pregnant – up to 322% of FPL –  Formerly AIM

7   C-CHIP County Children’s Health Initiative Program in three northern CA counties

8   Kids under 19 go in Medi-Cal if MAGI Income is below 266% of Federal Poverty Level.  While you can purchase coverage direct from an Insurance Company at Open or Special Enrollment, there is no PTC subsidy or premium tax credit.

Learn More ==> Western Poverty Page 72

9   Enhanced Silver – Cost Sharing  94, 87 & 73  – in addition to subsidies, you get lower deductibles & Co Pays.  94 is better than platinum which is 90 and 87 is better than gold which is 80 – metal level.

Silver 70  has a $2,500 Deductible and Standard Metal Levels, Bronze $5k deductible, Gold and Platinum $0 Deductible

10   Federal Poverty Level FPL   My Coverage Plan.com   – Definition

FPL gets  adjusted annually, IMHO the best way to calculate is to Click here to calculate your premium assistance and get proposals

Federal Poverty Level (FPL): “An income level based on the official poverty line as defined by the federal Office of Management and Budget and revised annually or at any shorter interval that the Secretary of Health and Human Services deems feasible and desirable.” 22 CCR § 50041.5; see also 10 CCR § 6410 

Subsidies now go to 600% ^{CA Health Line} *  But the Big Beautiful bill didn’t renew them?

Why Your Covered California Health Insurance Subsidy Dramatically Drops with an Income Increase  Kevin Knauss

11   Use our free calculator to see how much subsidy and enhanced silver benefit you might qualify for.  Less than 138% of FPL generally qualifies one for Medi-Cal.

Silver 94 – Under 138% Only if you can’t get Medi-Cal

12  Silver 94 – Under 138% Only if you can’t get Medi-Cal

13 Click here to calculate your premium assistance and get proposals

We are paid by Covered CA and the Insurance Companies to help you, when you appoint us as your agent NO CHARGE!  

covered ca.com/documents-to-confirm-eligibility

FAQ’s – on FPL Income Chart Frequently Asked Questions”

• Hi Steve,
  Been meaning to respond and give you updates. First off, thank you so much for your response back then with great information! You were right on many points.
    Thank you again Sara
  • See our webpage on Introduction to Medicare
    • Aged and Disabled Federal Poverty Level Program
• A means test is a determination of whether an individual or family is eligible for government benefits, assistance or welfare, based upon whether the individual or family possesses the means to do with less or none of that help. Means testing is in opposition to universal coverage, which extends benefits to everyone. Means testing increases the administrative burden^[1] and can create perverse incentives.^{[2]   Wikipedia}