Covered CA and Medi-Cal Assets Limit

[masku]

My mother is looking to get new Health Insurance.

Her situation is:
- Income level is lower than FPL, will qualify for Medi-Cal
- Asset levels are higher than Medi-Cal limits

According to this, she would not qualify for Medi-Cal.

Would she be eligible for Covered CA Premium Tax Credit if she were to purchase insurance through Covered CA? The web site ways PTC is only availabe for income 138%-400% of FPL. But her income is below 100% FPL.

Please advise,. thanks!!

 

[mickeyma]

Why ask the insurance forum members, most of whom are based out of California. Call the Covered California office.

 

[Dave020]

She would not be eligible for premium tax credits or cost sharing subsidy at income below 138% FPL. She would be eligible for MAGI Medi-Cal. Here's where the system gets sticky...

If she applies directly to Medi-Cal they will apply the asset test and disqualify her. To get MAGI Medi-Cal she has to apply through Covered CA. Only other option would be to pay full premium for a plan either on Covered CA or off exchange (if she has a qualifying event).