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Medi-Cal Update 2025-6 Unconditionally Available Income
Elimination of the Requirement to Apply for Other Income Benefits
| Date | References | Clerical | Implementation |
| 5/5/2025 | ACWDL 24-19, ACWDL 25-03 | N/A | June 1, 2025 |
Background
Federal regulations required applicants and members to take all necessary steps to obtain any income benefits they were entitled to as a condition of eligibility unless they could show good cause for not doing so. These types of benefits are referred to as “unconditionally available income”. If the requirement to apply for these types of income was not met, the member risked discontinuance of their Medi-Cal coverage. On August 25, 2023, through approval from the Centers for Medicare and Medicaid Services (CMS), the Department of Healthcare Services (DHCS) issued a waiver to temporarily suspend the requirement to apply for these benefits during the continuous coverage unwinding period. This waiver was then extended past the end of the unwinding period and through June 30, 2025.
Changes
Beginning June 1, 2025, the requirement to apply for benefits that are considered unconditionally available income will be permanently waived for Medi-Cal applicants and beneficiaries. The elimination of this requirement only applies to income-based benefits.
Workers shall no longer require the Medi-Cal applicant or member to apply for and accept unconditionally available income or other benefits that include, but are not limited to:
- Retirement Survivors Disability Insurance (RSDI) benefits from the Social Security Administration,
- Unemployment Insurance benefits (UIB),
- Pension benefits,
- Veterans' Income benefits (disability compensation, pensions, or education assistance),
- State Disability Insurance (SDI).
As a reminder, although applicants and members are no longer required to apply for unconditionally available income, workers should continue to educate them and offer guidance about income from available benefits they may be potentially eligible for.
The following topics in the MC Handbook have been updated to reflect this policy change:
Unconditionally Available Income,
Unemployment Insurance Benefits/Disability Insurance Benefits,
Retirement Survivors Disability Insurance,
Data Systems
CalSAWS will remove the non-compliance option reason in a future release.
Forms
The Single Streamlined Application (SSApp) will be revised to remove the language that informs applicants that applying for these types of benefits is a condition of eligibility for Medi-Cal.
Other Programs
This change applies only to the Medi-Cal program and does not change the rules for other social services programs such as California Work Opportunity and Responsibility to Kids (CalWORKS).
Department of Employment & Benefits Services
Contact Person(s): Megan Turney, SSA BPIS 408-755-7540