Non-MAGI Approval - Aged

Case Situation (Intake)

Aged married sponsored non-citizen couple apply for Non-MAGI Medi-Cal. They receive income-in-kind housing, utilities and food and declare no property.

Refer to CalSAWS "Quick Guide - Sponsorship and Deemed Income" and "Job Aid (JA) Citizenship and Sponsorship - Add or Edit", for step-by-step instructions on how to add or edit citizenship and/or sponsorship records.

Enter all required information on the Individual Demographic Detail page, including Alien number in the A Number field.
On the Citizenship Status Detail page for couple:
1. Select appropriate document from the Document drop down list and the corresponding Section Code from the drop down list.
2. Complete all other required fields.
3. The SAVE list page will provide the option to search for SAVE abstract within a specific time frame which have been received by the System through the SAVE inbound interface.
4. Select Yes from the Sponsored drop down list.
5. Complete all other mandatory drop down lists.
If Sponsor's information is provided, enter all required information on the Sponsorship Detail page for couple (NOTE: In order to add a sponsorship record, the sponsor will need to be on the case as a case member. To add a person to an existing case, refer the "JA Add a Person to a Case or Program").
On the Customer Options page:
1. Select Full Medi-Cal Hierarchy from the Type drop down list (Verification Consent and Maintain Verifications are two types of customer options particularly important for MAGI MC).
2. Complete other mandatory fields.

Note: For Continuing cases, if an individual is currently active under MAGI aid code and turn 65 years of age, the EW must complete Medicare Detail page for Medicare benefit part A and B to trigger CalHEERS fail MAGI MC and to approve Non-MAGI MC. Soft Pause should also be lifted if needed.

5. On the Income List page select Income In-Kind-Unearned from the Income Category drop down list and continue entering each income in-kind (housing, utilities, food) on the Income Detail page (NOTE: Enter income for all household members as well as the income from the sponsor).

6. Complete other Data Collection pages relevant to the case.

7. Run EDBC, review budget and eligibility results on the Medi-Cal EDBC Summary page and Accept and Save results.

Review Income Determination page section to ensure income in-kind for each household member is correctly budgeted.
The Eligible Budget for MEDS page section signifies the Aid Code that will be sent to MEDS.

Click hereClick here for CalSAWS step-by-step process.

Transactions Generated by CalSAWS to MEDS

Add (EW20) transactions for the application month and future months are sent to MEDS. As CalSAWS considers each authorized month a closed period of eligibility, a TERM-DT and a TERM-REAS will be displayed on the INQM screen. Eligibility for the future month will appear under the Pending column until MEDS renewal.

Refer to MC HB Chapter 14: Non-MAGI Linkage and MFBUs, Section Medically Needy, Medically Indigent and Non-MAGI MC MFBUs and Chapter 15: Non-MAGI MC Income, for detailed information on Non-MAGI MC program and Chapter 20: Medicare Coverage, for Medicare coverage detailed information.

Non-MAGI Approval - Aged

Case Situation (Intake)

Transactions Generated by CalSAWS to MEDS

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