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Use of Medi-Cal Budget Worksheets for Non-MAGI MC
Completion of these forms is optional as CalSAWS automatically calculates the budget based on the information entered by the EW. However, in some circumstances a Letter of Authorization is required for a period that cannot be updated in CalSAWS; a MC Budget Worksheet is required.
Form MC 176M, Share of Cost Determination - MFBUs Which Do Not Include Long Term Care (LTC) Persons, is used for computing the share of cost (SOC) for all MFBUs which do not include persons in LTC.
Completion of Medi-Cal Budget Worksheets for Non-MAGI MC
Column I of MC 176M
Income of MFBU members applying as aged, blind, or disabled plus income of spouse or parent(s). No members are in LTC.
Column II of MC 176M
- Income of MFBU members not listed in Column I (those members who are not aged, blind, or disabled and their spouses). This would include persons who are AFDC-MN/MI linked. No members are in LTC.
- DO NOT include the income of family members who are Public Assistance (PA) or other PA (but four or nine month continuing persons' income must be included). DO NOT include the income of excluded children.
- Court ordered alimony or child support, or child support paid under an agreement with the District Attorney, is an income deduction AFDC MN/MI individuals.
Column III of MC 176M
- Count the income from computation on MC 176W, Part III, in which the spouse and/or children at home have unmet needs and there is an allocation from the spouse in LTC/B&C who is in a separate MFBU. This amount is added to the countable income.
- Allocations and Deductions
- When an excluded child does not have enough income to meet his/her needs, an amount from the parent's MFBU can be allocated to this child. The computation is done on MC 176W, Part I, and the amount of allocation is entered here. This amount of allocation is subtracted from the countable income.
- When some of a family member's income is used to determine PA eligibility, the amount is an allowable income deduction in the MFBU. That amount is entered here and subtracted from the countable income.
- ROUND the net nonexempt income to the nearest dollar. If $50 or more, round up to the nearest dollar. If $49 or less, round down to the nearest dollar.
- Maintenance Need
- Include the ineligible members (IE) and four and nine month continuing family members in the maintenance need.
- Any current SOC adjustments due to a previous month's overstated SOC or due to Hunt v. Kizer is entered.
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