1 What is my Household Size–
Try this Flow Chart for a simpler explanation
How many dependents are on your Tax Return? Section 151
Household Income includes all dependents on your return
4 MAGI based Medi-Cal One can get FREE Medi-Cal base on MAGI Income Line 37 of your 1040 – If your income falls below 138% of the CA Poverty Line on the chart above. There is no longer an asset test, nor estate recovery.
5 MAGI Medi-Cal for Pregnant Women
6 Medi-Cal Access Program If you’re pregnant – up to 322% of FPL – Formerly AIM
7 C-CHIP County Children’s Health Initiative Program in three northern CA counties
8 Kids under 19 go in Medi-Cal if MAGI Income is below 266% of Federal Poverty Level. While you can purchase coverage direct from an Insurance Company at Open or Special Enrollment, there is no PTC subsidy or premium tax credit.
Learn More ==> Western Poverty Page 72
9 Enhanced Silver – Cost Sharing 94, 87 & 73 – in addition to subsidies, you get lower deductibles & Co Pays. 94 is better than platinum which is 90 and 87 is better than gold which is 80 – metal level.
Silver 70 has a $2,500 Deductible and Standard Metal Levels, Bronze $5k deductible, Gold and Platinum $0 Deductible
FPL gets adjusted annually, IMHO the best way to calculate is to Click here to calculate your premium assistance and get proposals
Federal Poverty Level (FPL): “An income level based on the official poverty line as defined by the federal Office of Management and Budget and revised annually or at any shorter interval that the Secretary of Health and Human Services deems feasible
and desirable.” 22 CCR § 50041.5; see also 10 CCR § 6410
12 Silver 94 – Under 138% Only if you can’t get Medi-Cal – Learn More
13 Click here to calculate your premium assistance and get proposals
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Related Pages in
- More FAQ’s – on FPL Income Chart Frequently Asked Questions
Flow Chart from IRS Website – Eligibilty for APTC Advance Premium Tax Credit – Subsidy
Accepted proofs of income for Covered CA – IMHO your 1040 is the best one!
Federal Poverty Level (FPL) Chart
FPL calculator ONLY
Use ours which includes benefits & subsidies and online enrollment
Share of Cost (Cost Sharing Reduction) Medi-Cal – Doesn’t apply in CA! (≥100 to ≤150%) FPL – The rules for 100 to 138 are quite complex doesn’t apply in CA Learn More ===> Western Poverty & Law 375 booklet – email us
Steve Shorr on how to read & interpret the Income Chart
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Video Importance of Reporting Changes - Covered CA Video
Denial of benefits and possible criminal charges if you don't report changes in income!