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Transitional Medi-Cal/Four-Month Continuing
Due to current CalSAWS and CalHEERS system limitations to automatically place eligible clients on consumer protection programs when they are discontinued from Modified Adjusted Gross Income Medi-Cal (MAGI MC). Previously, EWs were instructed to leave individuals on Soft Pause in place of TMC. If a client reports an increase in earnings (or a decrease in income disregards) and are currently on Soft Pause as a TMC workaround, follow the table below:
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If... |
And... |
Then... |
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The EW who placed the individual on Soft Pause documented use of Soft Pause as a TMC workaround including when the TMC period began and ended, |
The individual is still in the middle of the documented TMC period, |
Leave the individual on Soft Pause until the end of the documented TMC period. |
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The documented TMC period has ended, |
The EW must not allow an additional TMC period. Evaluate for any other eligibility. |
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The EW who placed the individual on Soft Pause did not document the reason or when the TMC period began and ended, |
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The EW must allow a TMC period using the workaround in the Systems Announcement. |
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