The Medicaid Income Limit is the most important criteria for deciding whether you qualify for Medicaid in your state. In this post, we are going to explain in detail the California Medicaid Income Limits for 2021. In California, Medicaid is also called Medi-Cal.
Based on this information, you will be able to determine whether your income qualifies you for California Medicaid (Medi-Cal) or not.
However, before we get into details about the income limit, we will first explain the Medicaid program in California and how it works.
Next, we will discuss who is eligible for Medicaid, including how eligibility works for various categories, including Children, Pregnant Women, and Adults.
What is Medicaid?
Medicaid is a federal and state health insurance program for people with a low income.
It provides free or low-cost health coverage to millions of Americans, including families and children, pregnant women, the elderly, and people with disabilities.
The Children’s Health Insurance Program (CHIP) offers health coverage to children in families with incomes too high to qualify for Medicaid, but who can’t afford private coverage.
How Many People are on Medicaid?
According to the Centers for Medicare & Medicaid Services, as of November 2020, here are the number of people enrolled in Medicaid and Chip in the entire United States:
- 78,521,263 individuals were enrolled in Medicaid and CHIP
- 72,204,587 individuals were enrolled in Medicaid
- 6,695,834 individuals were enrolled in CHIP
California Medicaid
The California Medicaid program provides medical coverage to low-income individuals and families.
As of 2020, the program, along with the Children’s Health Insurance Program (CHIP) covered about 12.3 million people as shown by the image below.
In California, Medicaid (Medi-Cal is managed by the California Department of Health Care Services (DHCS).
The DHCS is the backbone of California’s health care safety net, helping millions of low-income and disabled Californians.
DHCS funds health care services for about 13 million Medi-Cal beneficiaries.
About one-third of Californians receive health care services financed or organized by DHCS, making the Department the largest health care purchaser in California.
Who Can Get Medicaid in California?
You should apply for Medicaid if your income is low and you match one of the descriptions below:
- You think you are pregnant
- The parent or caretaker of a child and/or teenager under the age of 19.
- You are a child or teenager age 18 or under.
- An adult age 65 or older.
- You are legally blind.
- Living with a disability or disabled.
- You are in need of nursing home care.
California Medicaid Income Limit
The California Medicaid Income Limit is calculated as a percentage of the Federal Poverty Line.
To qualify, you must meet the California Medicaid Income limits listed below.
Here is the Federal Poverty Level (FPL) for 2021.
| 2021 Federal Poverty Levels for the 48 Contiguous States & D.C. | |||
| Household Size | Poverty Guideline for 48 states & DC | Alaska | Hawaii |
| 1 | $12,880 | $16,090 | $14,820 |
| 2 | $17,420 | $21,770 | $20,040 |
| 3 | $21,960 | $27,450 | $25,260 |
| 4 | $26,500 | $33,130 | $30,480 |
| 5 | $31,040 | $38,810 | $35,700 |
| 6 | $35,580 | $44,490 | $40,920 |
| 7 | $40,120 | $50,170 | $46,140 |
| 8 | $44,660 | $55,850 | $51,360 |
| Over 8 people | add $4,540 for each additional person | $5,680 | $5,220 |
Additionally, to be eligible for Medicaid, you cannot make more than the income guidelines outlined below:
- Children up to age 1 with family income up to 261 percent of FPL
- Any child age 1-5 with a family income up to 261 percent of FPL
- Children ages 6- 18 with family income up to 261 percent of FPL
- CHIP for children with family income up to 312%-317% percent of FPL
- Pregnant women with family income up to 208 percent of FPL
- Parents of minor children with family income up to 109 percent of FPL
- Individuals who are elderly, blind, and disabled with family income up to 100% of the FPL
- Adults without dependents under Medicaid expansion with income up to 133% of the FPL
California Medicaid Income Limit Charts
The California Medicaid eligibility income limit charts are divided by groups.
For example, the first chart is focused on income limits for children who qualify for Medicaid.
Similarly, the second chart below focuses on the Medicaid income limits for adults in California who qualify for Medicaid.
California Medicaid Income Limit for Children
Below is the income limit for children by age category. Find the age category your child falls into and you will see the income limit by household size.
| California Medicaid Income Limit – Children | ||||||
| Children Medicaid Ages 0-1 | Children Medicaid Ages 1-5 | Children Medicaid Ages 6-18 | Children Separate CHIP | |||
| % FPL | 100% | 261% | 261% | 261% | 312% | |
|
Household Size
|
1 | $12,880 | $33,617 | $33,617 | $33,617 | $40,186 |
| 2 | $17,420 | $45,466 | $45,466 | $45,466 | $54,350 | |
| 3 | $21,960 | $57,316 | $57,316 | $57,316 | $68,515 | |
| 4 | $26,500 | $69,165 | $69,165 | $69,165 | $82,680 | |
| 5 | $31,040 | $81,014 | $81,014 | $81,014 | $96,845 | |
| 6 | $35,580 | $92,864 | $92,864 | $92,864 | $111,010 | |
| 7 | $40,120 | $104,713 | $104,713 | $104,713 | $125,174 | |
| 8 | $44,660 | $116,563 | $116,563 | $116,563 | $139,339 | |
Next is the income limit for adults by category. Find the category you fall into and you will see the income limit by household size.
California has expanded Medicaid to include adults without dependents.
Therefore, adults without dependents can apply for Medicaid in California.
For an update on the Medicaid expansion debate and timeline in California, see our California Expansion update below.
California Medicaid Income Limit for Adults
| California Medicaid Income Limit – Adults | ||||||
| Pregnant Women Medicaid | Adults (Medicaid) Parent/ Caretaker | Seniors & People w/ Disabilities (Medicaid) | Adults (Medicaid) Expansion to Adults | |||
| % FPL | 100% | 208% | 109% | 100% | 133% | |
|
Household Size
|
1 | $12,880 | $26,790 | $14,039 | $12,880 | $17,130 |
| 2 | $17,420 | $36,234 | $18,988 | $17,420 | $23,169 | |
| 3 | $21,960 | $45,677 | $23,936 | $21,960 | $29,207 | |
| 4 | $26,500 | $55,120 | $28,885 | $26,500 | $35,245 | |
| 5 | $31,040 | $64,563 | $33,834 | $31,040 | $41,283 | |
| 6 | $35,580 | $74,006 | $38,782 | $35,580 | $47,321 | |
| 7 | $40,120 | $83,450 | $43,731 | $40,120 | $53,360 | |
| 8 | $44,660 | $92,893 | $48,679 | $44,660 | $59,398 | |
How to Read the California Medicaid Income Limits Charts Above
You cannot have an income higher than the Federal Poverty Level percentage described for your group to be eligible for Medicaid.
Similarly, when you identify the income group that applies to you, the income limit you see refers to the maximum level of income you can earn to qualify for benefits.
For example, if you are pregnant, to qualify for Medicaid, you cannot have an income higher than 206% of the Federal Poverty Level – which for a family of two is $36,234 as shown in the chart above.
How to Apply for California Medicaid (Medi-Cal)
There are 3 ways you can apply for Medicaid in California.
Option 1 – Apply online
You can apply online through the CoveredCA.com website, as shown by the image below.
CoveredCA.com is a joint partnership between Covered California and the Department of Health Care Services.
If you have an account, you can log in or create your CoveredCA.com account. Click here to be taken to the website.
Option 2 – Apply at CDSS Office Near You
You can apply in person at the California Department of Social Services (CDSS) office near you. Click here to locate a CDSS office.
Option 3 – Download Application
The Department of Health Care Services (DHCS) and Covered California have partnered to create a Single Streamlined Application for affordable health care coverage.
You can use the Single Streamlined Application to apply for a range of affordable health care coverage options, including free or low-cost Medi-Cal.
First, download the application, complete it, You can mail your completed and signed application to:
Covered California
P.O. Box 989725
West Sacramento, CA 95798-9725
Additionally, you can mail it to your local County Social Services Office.
California Medicaid Phone Number
Here’s how to contact Medi-Cal:
Call 1- (800) 541-5555
If you are outside of California, please call (916) 636-1980) for the Telephone Service Center.
The Service Center can help with:
1. Learning how to apply for Medi-Cal
2. Learning about Medi-Cal services
3. Finding a health care provider
4. Filing a complaint
For questions specific to Mental Health Services call 1-800-896-4042. TTY Line: 1-800-896-2512.
Monday through Friday 8 a.m. – 5 p.m. ( Except State Holidays and CA only)
California Medicaid Expansion Update
California’s Medicaid program (Medi-Cal) covers nearly 12.5 million people as of March 2020.
Of that total, nearly 3.7 million were eligible due to the ACA expansion of Medicaid, which took effect in 2014.
Undocumented immigrant children gained access to California Medicaid starting in May 2016.
Furthermore, as of January 2020, that eligibility applies to young adults through the age of 25.
As long as they qualify based on household income, children and young adults can enroll in Medicaid in California regardless of their immigration status.
Additionally, Gov. Jerry Brown signed SB4 into law in October 2015, and it eliminated the immigration status requirement for Medicaid eligibility for California residents 18 and under.
California Medicaid Income Limits Summary
We hope this post on California Medicaid Income Limits was helpful to you.
If you have any questions about Medicaid in the state of California, you can ask us in the comments section below.
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Be sure to check out our other articles about Medicaid.
Income limits for Florida Medicaid
Alabama Medicaid Income Limits and How to Apply
Alaska Medicaid Income Limits and Chart
The Health First Colorado (Medicaid) Income Limits
