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Income Verification
Earned Income
Earned income can be verified using:
- One pay stub (most current pay stub available to the client; not required to have been issued within the last 30 days but must accurately reflect the amount reported on the application).
- Copy of federal tax return that accurately reflects current income. For self employment, last years tax documents are sufficient. For all other income, the tax documents must have been filed within 90 days to be used as verification
- Signed letter from employer showing the gross amount and date of paycheck
- Receipts showing gross earnings and expenses
- Business records (Profit and Loss Statements)
Earned income must be verified prior to approval and at redetermination, restoration or reapplication. If there is a discrepancy between the pay stub submitted and the amount reported on the application, the EW may request additional pay stubs to determine the correct monthly income.
If the client receives income and items listed above are not available, EW must obtain a sworn statement from the individual (as a last resort).
Individuals Paid in Cash
Individuals who are paid in cash often cannot provide proof of income. If all other options are exhausted (i.e. attempt to get employer statement, verification through the Federal Hub, etc.), the signature on an application is sufficient verification of income for clients paid in cash. Additionally, clients can provide a sworn statement as verification.
The Work Number
The Work Number is not to be utilized to obtain verification of income for MC only cases. It may however be used for combination CalFresh/CalWORKs and MC households. Additionally, if one individual is on CalFresh on one case, and Medi-Cal in another, the Work Number may be used to verify income on the Medi-Cal only case.
Unearned Income
Unearned income can be verified using:
- Award letter or most recent cost-of-living increase notice
- IEVS/PVS abstract or printout
- Current bank statement if the applicant has direct deposit or copy of the applicants current benefit check
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Note: The deposit or check may not reflect gross income if Medicare premiums are being deducted or an overpayment is being collected from the client’s check.
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- Signed statement from the person or organization providing the income.
If the client receives income and items listed above are not available, EW must obtain a sworn statement from the individual (as a last resort).
Unearned income must be verified prior to approval, and at each reapplication, restoration, or redetermination.
Zero Income
When a client reports zero income at Redetermination, the sworn statement on the Redetermination forms is sufficient verification of income.
If the client reports zero income, but there is an open employment record in CalSAWS for that individual, the EW must request verification that the job has ended.
Reasonable Explanation for Non-MAGI MC Income
The method of reasonable explanation is now included as part of the Medi-Cal eligibility verification process and allows the flexibility to request and accept a reasonable explanation to resolve income discrepancies for MAGI and Non-MAGI Medi-Cal at application and annual redeterminations. The reasonable explanation process will assist with the unwinding of the Covid-19 Public Health Emergency (PHE) and will continue after the PHE unwinding period has concluded.
As Non-MAGI Medi-Cal eligibility rules are not determined in CalHEERS, EWs can provide Non-MAGI applicants or beneficiaries an opportunity to explain discrepancies between self-attested income and discrepancies with data found in electronic sources, including (but not limited to):
• Medi-Cal Eligibility Data System (MEDS)
• Income Eligibility and Verification System (IEVS)
Reasonable Explanation guidance and examples can be found in [Applications] and [Redeterminations.]
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