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Budget Periods
The Affordable Care Act (ACA) allowed states to apply different budget periods to allow greater flexibility in how income can be counted to determine MAGI MC eligibility. California elected to use all available budget period methodologies as follows:
- Current Monthly Income (CMI);
- Reasonably Projected Annual Income (RPAI);
- Projected Annual Income (PAI) or System Calculated Annual Income (SCAI).
Budget periods offer different ways to use and apply reported income over a certain period of time. They can affect what income and over what time period the income is counted and may reduce some income for that specified period.
Income for MAGI MC is determined based on the budget period with the lowest income calculation between CMI (Current Monthly Income), RPAI (Reasonably Projected Annual Income), and System Calculated Annual Income (SCAI) which is determined in CalHEERS. Income for Covered CA exchange programs is determined based on PAI (Projected Annual Income). The use of any budget period and how it was determined should always be documented in the case Journal.
Medi-Cal (MC) budgeting is determined prospectively. When entering income into CalSAWS it is important to enter the income into the correct income specific windows. Entering income into CalSAWS is not dependent on a specific program; it is dependent on the type of income. CalSAWS automatically treats income differently depending on the rules for each program and program hierarchy.
Related Topics
Unconditionally Available Income
Reasonably Projected Annual Income