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Income Eligibility Comparison Chart

Medi-Cal Eligibility1

HACCP Eligibility California Children’s Services (CCS) – All Family Sizes Household/Family Size (Including Parent(s)) 138% FPL2 266% FPL3 322% FPL4 600% FPL Family income of $40,000 or less 1 $20,783 $40,060 $48,494 $90,360 If a family's Adjusted Gross Income (AGI) is over $40,000, they may still qualify if their out- of-pocket medical expenses are expected to be more than 20% of their AGI. 2 $28,208 $54,371 $65,817 $122,640 3 $35,632 $68,682 $83,141 $154,920 4 $43,056 $82,992 $100,464 $187,200 5 $50,481 $97,303 $117,788 $219,480 6 $57,905 $111,614 $135,112 $251,760 7 $65,330 $125,925 $152,435 $284,040 8 $72,754 $140,236 $169,759 $316,320 Each Additional Add $7,425 Add $14,311 Add $17,324 Add $32,280

1 Please note that this chart only provides a snapshot of Medi-Cal eligibility and does not provide an exhaustive list of all Medi-Cal aid codes and categories (see Aid Codes Master Chart (aid codes) (ca.gov)), which correspond to variable FPL categories. Eligibility for Medi-Cal is subject to individuals meeting all applicable eligibility rules and requirements, including income limitations, and should be verified through submission of an application for Medi-Cal (see http://www.coveredca.com/apply/) or through contacting a local county human services agency (see County Offices (ca.gov)). 2 This includes adults between ages 19 to 65 up to 138% FPL. 3 This includes the Optional Targeted Low-Income Children’s Program (OTLICP), which is for children zero to 19 years of age up to 266% of the FPL. The OTLIC program under the Affordable Care Act is considered Modified Adjusted Gross Income (MAGI) Medi-Cal. 4 This includes both of the following: (1) County Children’s Health Initiative Program (CCHIP), which provides county-specific, full-scope medical, dental, mental health and vision benefits to children 18 years of age or younger with a modified adjusted gross income above 266 and up to and including 322%; and (2) Medi-Cal Access Program (MCAP) (Title XXI), which provides health care services (medical, dental and vision) through Medi-Cal Managed Care Plans with a premium to children whose family income is above 266 percent up to and including 322% FPL.