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Disability Benefits101: Working with a disability in California
Aged and Disabled Federal Poverty Level Medi-Cal: Frequently Asked Questions
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1) What is Aged and Disabled Federal Poverty Level Medi-Cal?

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Aged and Disabled Federal Poverty Level Medi-Cal provides free, full scope Medi-Cal services for disabled or aged individuals who meet the income and asset requirements of the program. Blind people are also eligible, but must be determined disabled.

2) Does what I have in the bank and/or what I own, such as my home or car, affect my eligibility for Aged and Disabled Federal Poverty Level Medi-Cal?

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Yes. You are allowed to have assets up to $2,000 in value ($3,000 for a couple). Some of your assets, like your home and car, are not counted for this program. Click here for a list of additional exemptions.

Assets may include:

  • checking and savings accounts;
  • the value of stocks, bonds, and trust deeds;
  • additional cars or recreational vehicles; and
  • promissory notes and loans that are payable to you.

3) Is Aged and Disabled Federal Poverty Level Medi-Cal referred to in other ways?

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Yes. This Medi-Cal eligibility category has been referred to as “Aged, Blind and Disabled Medi-Cal” and was once called “133% Medi-Cal” when it began in January 2001.

4) Is this the only way to qualify for Medi-Cal?

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No. There are different ways you can qualify for Medi-Cal. Each Medi-Cal eligibility category has unique requirements. Besides the Aged and Disabled FPL program, DB101 has detailed information on the following Medi-Cal programs:

For information on other eligibility categories, speak with a Benefits Planner or a Medi-Cal eligibility worker.

5) How do I qualify financially for Aged and Disabled Federal Poverty Level Medi-Cal?

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To qualify for the Aged and Disabled Federal Poverty Level Medi-Cal, an individual's monthly total countable income (minus a Maintenance Needs Allowance and any health, vision, and dental insurance premiums) must be less than $1,081 through 3/31/2009 ($1,502 for a couple through 9/30/2008).

6) How much does Aged and Disabled Federal Poverty Level Medi-Cal cost?

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Nothing. There are no premiums or deductibles for Aged and Disabled Federal Poverty Level Medi-Cal.

7) What services does Aged and Disabled Federal Poverty Level Medi-Cal provide?

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Aged and Disabled Federal Poverty Level Medi-Cal provides free, full-scope Medi-Cal.

You may also have access to other Medi-Cal programs, including:

8) What prescription drug coverage comes with Aged and Disabled Federal Poverty Level Medi-Cal?

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You will be covered for drugs that are on Medi-Cal's approved list of prescription drugs. If you have both Medi-Cal and Medicare, the list of drugs that are covered depends on which plan you are enrolled in under Medicare Part D.

9) How do I apply for Aged and Disabled Federal Poverty Level Medi-Cal?

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To apply for Aged and Disabled Federal Poverty Level Medi-Cal, go to your county Medi-Cal officeOffsite Link and submit an application. Medi-Cal provides applications in eleven languages. You can download an applicationOffsite Link online, but you must still submit it in person or by U.S. mail.

10) How soon after applying will I be eligible for benefits from Aged and Disabled Federal Poverty Level Medi-Cal?

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On average, processing of an application takes between 30 to 90 days. The eligibility worker may enroll you in the program without conducting a medical determination of disability. For example, Social Security Disability Insurance (SSDI) beneficiaries have already met the disability rules for this program and do not need a disability determination.

11) Can I qualify for Aged and Disabled Federal Poverty Level Medi-Cal while I am eligible for private health coverage?

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Yes. Your enrollment in private health coverage will not jeopardize your participation in Aged and Disabled Federal Poverty Level Medi-Cal. Obtaining private health coverage may allow you to access providers or services you may not have had available to you on Medi-Cal alone. If you have private health coverage and are eligible for Medi-Cal, you may qualify for the Medi-Cal/HIPP program, which can pay for your insurance premiums.

When using private health coverage and Medi-Cal simultaneously, the private health coverage is billed first. After the private health carrier pays or denies a claim, Medi-Cal is then billed and will pay for services it covers.

12) How do I stay enrolled/eligible in Aged and Disabled Federal Poverty Level Medi-Cal? How often do I need to reapply?

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As long as you continue to meet disability and financial requirements, you will continue to be eligible for Aged and Disabled Federal Poverty Level Medi-Cal. This program verifies assets, income and earnings annually. If you get a job or your circumstances change, you may want to consider accessing Medi-Cal through another eligibility category (see FAQ 6).

13) Are there rules for immigrants to qualify for Aged and Disabled Federal Poverty Level Medi-Cal?

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Yes, you must meet Social Security’s rules for legal residencyOffsite Link and California's residency requirements.

14) Can I receive Aged and Disabled Federal Poverty Level Medi-Cal if I am married?

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Yes. If you are married and both you and your spouse are eligible for Aged and Disabled Federal Poverty Level (A & D FPL) Medi-Cal, then the income level for two people ($1,502 through 9/30/2008) is used. If your spouse is not eligible for A & D FPL Medi-Cal, then Medi-Cal uses deeming rules to determine if you are eligible for the program.

Contact your local county Medi-Cal officeOffsite Link for more information about how deeming rules work and how they can affect your eligibility for this program.

15) Can I work and receive Aged and Disabled Federal Poverty Level Medi-Cal?

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Yes. You can work and continue to be eligible for Aged and Disabled Federal Poverty Level Medi-Cal if your monthly total countable income (minus a Maintenance Need Allowance and health, vision, and dental insurance premiums) remains below $1,081 for an individual through 3/31/2009, or $1,502 for a couple (through 9/30/2008).

When determining eligibility in the program, Medi-Cal does not consider the entire amount of your earnings. Instead, they use a countable income calculation. See the program description or glossary entry for more information.

If you are working, Medi-Cal’s 250% California Working Disabled (250% CWD) Program may be a way to access Medi-Cal while earning income.

<< Prev | Medi-Cal (General) | SSI-Linked | A & D FPL | 250% CWD | Medically Needy | Medi-Cal/HIPP | Next >>
http://www.disabilitybenefits101.org/ca/programs/health_coverage/medi_cal/abd/faqs.htm