Additional Six Months of TMC

Individuals who are eligible for the entire 6-month Initial TMC period may be eligible for up to 6 additional months of zero SOC MC immediately following Initial TMC if:

  • There is an eligible child residing in the home.
  • The family meets the TMC reporting requirements.
  • The parent/caretaker relative has earnings in one or more of the last 3 months of Initial TMC, unless the unemployment results from:
    • Involuntary loss of employment
    • Illness
    • Other good cause. 
  • The family's average net non-exempt earned income does not exceed 202% FPL based on the family size.

There is no property limit for Additional TMC. A separate approval NOA is not required for Additional TMC (59/5T).

If the family did not receive the Initial TMC for the entire 6-month period, then the family is not eligible for Additional TMC.

 

ExampleExample

The only child left the home in the 3rd month of the Initial TMC period. The family was terminated from TMC. In the 5th month, the child returned to the home. The family is eligible to receive the remaining two months (5th and 6th months) of the Initial TMC. However, the family is not eligible for Additional TMC because they did not receive the entire 6 months (i.e., no eligibility in the 4th month) of Initial TMC.

 

Exception: The family moved to another state in the first month of the Initial TMC period. Although the family continues to meet all the Initial TMC eligibility requirements, TMC must be discontinued because they are no longer California residents. The family returned to California in the 3rd month of the Initial TMC period. They may receive the remainder of the Initial TMC 6-month period and Additional TMC (if otherwise eligible) since the family continued to be eligible for TMC even though they did not actually receive the entire 6 months of Initial TMC.

 

Additional TMC must be discontinued as soon as a timely discontinuance NOA can be issued if none of the above criteria is met. Individuals who are ineligible for Additional TMC must have their eligibility determined for other MC and/or healthcare coverage programs. An EW will have to determine if there is potential Non-MAGI MC eligibility and mail a Non-MAGI MC Screening Packet.

Related Topics

Initial Six Months of TMC

Four-Month Continuing