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California Medicaid Income Requirements

The county Health and Welfare Department determines eligibility for California Medicaid, also known as Medi-Cal. Of the many deciding factors, your representative will take into account your income eligibility. Your income eligibility for Medicaid differs depending on your special needs, the ages of your children and your economic circumstances.

  1. Medicaid and the Federal Poverty Level

    • In order to know whether or not you are a candidate for Medicaid in California, you must first understand the Federal Poverty Level, or FPL. The FPL varies year to year and is used to determine at what income level you are considered to be living in poverty. The FPL differs in each state depending upon the cost of living for that area.

    Qualifying for Medicaid in California

    • Medi-Cal will review your income, monthly bills and assets to determine eligibility.

      Medi-Cal provides health care coverage for individuals and families who have income and resources below the state's established limits. The qualification process is determined when a representative from the Health and Welfare Department reviews your income and subtracts standard expenses including your house payment, utility payments and other monthly expenses. This then helps to determine your countable income. Your representative will also look at assets you own such as a home, cars, savings accounts and other types of assets to see if you meet the requirements for resources. Not everything you own is considered a countable asset.

    Income Requirements for Expecting Mothers and Infants

    • Mothers and newborns have higher income requirements for Medicaid in California.

      The Medicaid income requirement for pregnant women and children up to age 1 is 200 percent of the FPL. For instance, in 2009 the FPL income amount was $18,130. This means that a pregnant woman or a woman with a child under the age of 1 year must make at least $36,260 a year to support her child. If she does not meet this requirement, and does not have health insurance through her employer, she meets the income requirements to apply for Medicaid. This number varies depending on how many members are in the household.

    Income Requirements for Older Children

    • As your children age, your income requirements lessen when applying for Medicaid. A child age 1 to 5 requires an individual income of 133 percent of the FPL. A child age 6 to 19 requires an individual income level of 100 percent of the FPL. Depending on your income, this could mean you may lose your benefits as your child gets older.

    Medi-Cal Services for Others

    • Medi-Cal services are offered to those enrolled in certain government programs including SSI/SSP, Refugee Assistance, Foster Care or Adoptive Services, CalWorks and In-Home Supportive Services. You may also apply for Medi-Cal if you are over the age of 65, blind, disabled, under 21 or in a skilled nursing home. Contact your local county Health and Welfare Department to learn more about your eligibility.

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