|
|
Medi-Cal Update 2024-2 2024 FPL Value Changes
Medi-Cal 2024 FPL Value Changes
| Date | References | Clerical | Implementation |
| 03/13/2024 | ACWDL 24-02 | N/A | January 1, 2024 |
Background
The Federal Poverty Level (FPL) amounts change annually and are derived from FPL figures published by the U.S. Department of Health and Human Services in the Federal Register.
Changes
The 2024 monthly FPL amounts for Medi-Cal, Medi-Cal Access Program (MCAP), MCAP Linked Infants, and County Children's Health Initiative Program (CCHIP) have been updated.
The topic listed below in the Chart Handbook has been revised to reflect the changes:
Federal Poverty Level Programs Monthly Income Comparison Chart
Implementation
The 2024 FPL amounts are effective as follows:
- January 1, 2024- Modified Adjusted Gross Income (MAGI) coverage groups, Medicare Savings Programs (MSP) coverage groups who do not receive Title II Retirement, Survivors, and Disability Insurance (RSDI) income.
- March 1, 2024- MSP coverage groups who do receive Title II RSDI.
- April 1, 2024- Aged, Blind, and Disabled (ABD) FPL programs, 250% Working Disabled Program (WDP), and all other Medi-Cal programs.
Note: Eligibility will need to be run back to the specified effective date for individuals in these groups whom the FPL increase may positively impact.
Upon request from the beneficiary (or parent/legal guardian, AR), the EW can retroactively change eligibility for the following:
- Advanced Premium Tax Credit (APTC) individuals- eligibility can only be changed retroactively for those individuals who did not enroll in a Qualified Health Plan (QHP), did not pay a premium, or who did enroll in a QHP and pay a premium but have MC covered medical or dental expenses that were not covered by their QHP during the retroactive period- in this case, they may be eligible for retroactive MC out-of-pocket expense reimbursements (Conlan), but cannot be reimbursed for premiums paid to Covered CA QHPs.
- Individuals with a Share-of-Cost (SOC)- if redetermined eligible for zero or lower SOC, may be eligible for retroactive MC out-of-pocket expense reimbursements. (Conlan)
Data Systems
CalSAWS and CalHEERS were updated with the 2024 FPL amounts in February 2024. The Department of Health Care Services (DHCS) will send notices to individuals who may potentially be impacted by the new FPL values.
Forms
"Medi-Cal Budget Chart" (SCD 1470) and "CW-CF-MC Limits Chart" (SCD 2338) have been updated to reflect the 2024 FPL amounts.
Department of Employment & Benefits Services
Contact Person(s): Megan Turney, SSA BPIS, 408-755-7540