Children and Families

Who is Eligible?

Children Under 21: Children under 21 may be eligible to receive Medi-Cal benefits free or at a low cost. In many cases, children under 21 may still be eligible even if their parents or other family members are not eligible to Medi-Cal.

Pregnant Women: Free or low cost health care coverage for pregnant women is available under the Medi-Cal Program. You may be eligible to pregnancy related medical care even if you are not a citizen or legal resident of the US. You may also apply for pregnancy related only services under the Asset Waiver Program, if you meet the income limits.

Medi-Cal for Families: Families, including parents and legal guardians, may be eligible to Medi-Cal if they fall under one of the following categories:

  • Families where one or both parents are absent from the home.
  • Families where one or both parents are deceased.
  • When the parent who was the main income producer for the family is unemployed or working less than 100 hours per month. Families may also be eligible if the family’s total income from jobs is less than the Federal Poverty Level.
  • Families where one or both parents are unable to work because of illness or injury.

Health care for families who meet these conditions may be free or at a low cost.

What if I have Income?

Income Limits: You may be eligible to free Medi-Cal even if your family has income. If your gross income is more than Medi-Cal limits for your family size, your family will have a share-of-cost. The share-of-cost amount is what you and your family members must pay or promise to pay the medical provider before Medi-Cal will pay any portion of the medical expense.

Here is a chart showing the income limits based on the number of people in your family:

Persons

1

2

3

4

5

6

7

8

9

10

Limit

$600

$750

$934

$1100

$1259

$1417

$1550

$1692

$1825

$1959

Some families may also be eligible for free Medi-Cal if they are eligible, or might be eligible, for CalWORKS cash assistance.

Special Programs for Children and Pregnant Women

If your family does not qualify for free Medi-Cal and has a share of cost there are special programs, with no share of cost, available for children under 19 and pregnant women. To qualify for these programs, your family’s gross income must be at or below a certain percentage of the federal poverty level (FPL).

  • For pregnant women and infants under 1 year of age, the limit is 200% of the FPL.
  • For children 1 to 5 years old, the limit is 133% of the FPL.
  • For children 6 to 18 years old, the limit is 100% of the FPL.

Here is a chart showing the *April 2013 income limits based on the number of people in your family:

Federal Poverty Level Figures Effective 4-1-14*

No. of
persons

1

2

3

4

 5

7

8

9

10

10+ Add

200%

1945

2622

3299

3975

4652

5329

6005

6682

7359

8035

677

133%

1294

1744

2194

2644

3094

3544

3994

4444

4894

5344

450

100%

973

1311

1650

1988

2326

2665

3003

3341

3680

4018

339

*These amounts change every April

What if I Have Property?

Property Limits: Under Medi-Cal rules, some assets are exempt. If you own the home you live in, it will not be counted. Certain personal possessions, such as your furniture, clothing, and other personal items are also exempt. In some Medi-Cal programs, one car may be exempt.

The things that will count towards your family’s property limit may include (but are not limited to) the balances in any bank accounts you own, real estate that you do not use as a residence, boats or recreational vehicles.

Here is a chart showing the property limits based on the number of people in your family:

Persons

1

2

3

4

5

6

7

8

9

10

Limit

$2000

$3000

$3150

$3300

$3450

$3600

$3750

$3900

$4050

$4200

Asset Waiver Program

If your family is over the property limit for Medi-Cal there is a special program available for children under 19 and pregnant women. To qualify for this program, your family’s gross income must be at or below a certain percentage of the federal poverty level (FPL). If you qualify for this program, the value of all your family’s assets will be waived. If you are applying for Medi-Cal for a pregnant woman or a child under 19 only, you can request to be evaluated for just the Asset Waiver Program.

  • For pregnant women and infants under 1 year of age, the limit is 200% of the FPL.
  • For children 1 to 5 years old, the limit is 133% of the FPL.
  • For children 6 to 18 years old, the limit is 100% of the FPL.

Here is a chart showing the *April 2013 income limits based on the number of people in your family:

FEDERAL POVERTY LEVEL FIGURES EFFECTIVE 4-1-14*

No. of
Persons

1

2

3

4

5

6

7

8

9

10

200%

1945 

2622

3299

3975

4652

5329

6005

6682

7359

8035

133%

1294

1744

2194

2644

3094

3544

3994

4444

4894

5344

100%

973

1311

1650

1988

2326

2665

3003

3341

3680

4018

*These amounts change every April

Show all Categories
Back