EDD unemployment counting as income for Medi-Cal? Just got disqualified

Unfortunately yes, unemployment benefits DO count as income for Medi-Cal eligibility purposes. Unlike some other assistance programs, EDD payments are considered taxable income by the IRS and therefore get counted for Medi-Cal eligibility calculations. At $450/week, you're making about $1,950 monthly (4.33 weeks/month average), which puts you above that $1,564 threshold they mentioned. You might qualify for subsidized coverage through Covered California instead of Medi-Cal though! Don't go without coverage.

ya i had this same thing happen to me last year!!!! its STUPID that they count unemployment when ur literally out of work! but medi-cal has this threshold and they dont care where the $ comes from. you should check the letter for the EXACT date your coverage ends... usually u have till end of month

This is a complex situation that affects many unemployment recipients. Here's what you need to know: 1. Yes, EDD benefits count as income for Medi-Cal eligibility 2. However, Covered California should have automatically evaluated you for subsidized plans when you became ineligible for Medi-Cal 3. There's typically a transition period where your Medi-Cal remains active while you select a new plan 4. You have 60 days from the notice date as a Special Enrollment Period I suggest calling Covered California directly at 1-800-300-1506 to discuss your options. Due to high call volumes, it may be difficult to reach a representative. Some people have had success using Claimyr (claimyr.com) to connect with representatives faster - they have a video showing how it works: https://youtu.be/JmuwXR7HA10?si=TSwYbu_GOwYzt9km Don't delay, as maintaining continuous coverage is important for your prescriptions.

The entire system is DESIGNED to trap people in poverty! As soon as you start getting any kind of income to help yourself, they yanke away your healthcare!!! I lost my Medi-Cal last year because of unemployment and ended up with a $4700 hospital bill because of the gap in coverage. The system is BROKEN and nobody in government cares!!!

I went through this exact situation in January! Called Covered California and found out I qualified for a silver plan with a premium subsidy that made it only $67/month based on my unemployment income. Not as good as Medi-Cal but WAY better than nothing or full price. Make sure you tell them about your medications so they can help find a plan that covers them. The key is to not have any gap in coverage!

im confused about something... do u still get the full $450 after taxes? cuz EDD takes out taxes if u ask them to and maybe your actual income would be under the limit then??

Used Claimyr last month when dealing with both EDD and Covered California issues. Got through to both on the same day after weeks of trying on my own. The video on their site shows exactly how it works. Worth every penny when you're dealing with medication coverage!

UPDATE: I called Covered California this morning and finally got through after an hour on hold. The rep confirmed that my Medi-Cal coverage continues until the end of this month, and I qualified for a Silver 94 plan with a $28 monthly premium after subsidies! My medications will be covered with just a $5 copay. For anyone else dealing with this: definitely call them directly and go through the options. The letter made it seem more dire than it actually was. Thanks everyone for your help!!

This is such a frustrating situation that so many people face! I went through something similar about 6 months ago. One thing that really helped me was keeping detailed records of all my communications with Covered California and taking screenshots of any plan options they showed me. Also, if you're having trouble getting through to them by phone, try calling right when they open at 8 AM - I found the wait times were much shorter early in the morning. And don't forget to ask about any prescription assistance programs your medication manufacturers might offer as a backup while you're transitioning between plans. The good news is that once you get enrolled in a subsidized plan, the coverage is usually pretty solid. It's just that initial transition period that's stressful. Hang in there!

I'm dealing with this exact same situation right now! Got my Covered California letter last week saying I'm over the Medi-Cal income limit due to my unemployment benefits. It's so confusing because you'd think being unemployed would keep you eligible for state healthcare, but apparently the system doesn't see it that way. Reading through everyone's responses here has been incredibly helpful - especially seeing that there are actually affordable options through Covered California with subsidies. I had no idea about the Silver 94 plan or that they automatically evaluate you for other coverage when you lose Medi-Cal. My biggest concern is the gap in coverage. I have a chronic condition that requires monthly lab work and I can't afford to miss appointments or have my medication lapse. Has anyone had issues with providers accepting the new Covered California plans after transitioning from Medi-Cal? I'm worried my current doctors might not be in-network with whatever plan I end up with. Going to try calling them tomorrow morning at 8 AM like someone suggested. Fingers crossed I can get this sorted out quickly!

This thread has been so helpful for everyone dealing with this transition! One thing I haven't seen mentioned yet is that you can also check your eligibility and browse plan options online at CoveredCA.com before calling. Sometimes it's easier to see all your choices laid out on the website first, then call with specific questions about the plans that interest you. Also, if you're switching from Medi-Cal to a Covered California plan, make sure to ask about any differences in prescription formularies. While most Silver plans have good drug coverage, some medications might require prior authorization or step therapy that wasn't required under Medi-Cal. It's worth checking this before you finalize your plan selection, especially if you're on specialized medications. The income eligibility cliff between Medi-Cal and subsidized marketplace plans is definitely frustrating, but at least California has some of the most generous subsidies in the country. Many other states don't offer nearly as much help for people in this income bracket.

One thing that might help while you're navigating this transition - if you have any prescription refills due soon, try to get them filled while your Medi-Cal is still active (sounds like you have until end of month based on other comments). That way you'll have a buffer supply while you get your new coverage sorted out. I went through a similar situation last year and made the mistake of waiting until after my Medi-Cal ended to refill my prescriptions. Ended up paying full retail price for a month's supply of my medications while waiting for my new Covered California plan to kick in - definitely learned that lesson the expensive way! Also, when you do call Covered California, ask them about the effective date of your new coverage. Sometimes you can get it to start on the 1st of the next month with no gap, but other times there might be a brief waiting period depending on when you enroll. Better to know upfront so you can plan accordingly.

Just wanted to add my experience for anyone else going through this - I had the exact same situation happen to me about 8 months ago when my unemployment put me over the Medi-Cal income threshold. The initial panic is totally understandable, but there really are good options available! One thing that really helped me was using the Covered California website to create an account and start the application process online before calling. It saved a lot of time on the phone since they could pull up my partially completed application and we could focus on plan selection rather than basic info gathering. Also, don't forget to factor in your county when looking at plan options - some plans have better provider networks in certain areas. I'm in LA County and found that the Blue Shield Silver 94 plan had the most comprehensive network for my needs. The transition ended up being much smoother than I expected, and honestly my new Silver plan covers some things even better than Medi-Cal did (like mental health services). The system is definitely confusing but the subsidies really do make coverage affordable. Hang in there - you'll get through this!

I'm going through this exact same situation right now and this thread has been incredibly helpful! I just received my letter from Covered California yesterday saying I'm losing Medi-Cal eligibility due to my unemployment income putting me over the limit. Reading about everyone's successful transitions to Silver plans with reasonable premiums gives me so much hope. I was honestly panicking thinking I'd have to go without coverage or pay hundreds per month. The fact that there are subsidized options specifically designed for people in our income bracket is such a relief. I'm planning to call first thing Monday morning at 8 AM based on the advice here, and I'll definitely start the application online beforehand to save time. Has anyone had experience with how quickly the new coverage can start once you select a plan? I have a doctor's appointment scheduled for next week that I'm worried about. Thanks to everyone who shared their experiences - it's amazing how much less scary this feels now that I understand the process better!

I'm going through this transition right now too after getting my letter last week! This entire thread has been such a lifesaver - I had no idea there were Silver 94 plans available or that the subsidies could make coverage so affordable. One question for those who have already made the switch - how long did it take from when you called and selected your plan to when you actually received your insurance cards and could start using the new coverage? I'm trying to figure out if I need to reschedule some upcoming appointments or if there's typically a smooth handoff from Medi-Cal to the new plan. Also, did anyone have issues with their pharmacy systems updating to the new insurance? I get my prescriptions at CVS and I'm worried about confusion during the transition period. Thanks again to everyone sharing their experiences - it's made this whole process feel so much less overwhelming!

I just went through this exact transition about 3 months ago and wanted to share some additional tips that really helped me! First, if you're worried about prescription costs during the transition, ask your doctor if they have any sample packs of your medications. My doctor was able to give me a 2-week supply of samples when I explained my insurance situation, which bridged the gap perfectly. Also, when you call Covered California, ask specifically about the "Enhanced Silver" plans (like the Silver 94 mentioned above). These are only available to people with incomes between 100-250% of the federal poverty level, which includes most unemployment recipients. The cost-sharing reductions make them almost as good as Medi-Cal - I have $3 generic copays and $15 specialist visits. One more thing - if you have any ongoing treatments or procedures scheduled, make sure to ask about continuity of care provisions. Some plans will allow you to continue seeing out-of-network providers for up to 90 days while you transition to in-network doctors. This saved me from having to restart my physical therapy from scratch! The whole process took me about 2 weeks from start to finish, and honestly the new coverage has been great. Don't let the initial panic make you delay - the sooner you call, the more options you'll have!

I'm so sorry you're dealing with this stress right now! I went through this exact same situation about a year ago when my unemployment benefits put me over the Medi-Cal income threshold. It's such a catch-22 - you finally start getting some income assistance and then lose your healthcare coverage! From my experience, here are a few key things that helped me navigate the transition: 1. **Act quickly but don't panic** - You likely have coverage through the end of this month while you select a new plan, so you're not immediately without insurance. 2. **Ask about Silver 87 and Silver 94 plans** - These Enhanced Silver plans are specifically for people right above the Medi-Cal threshold. I ended up with Silver 87 for $45/month with $5 prescription copays. 3. **Get a 90-day supply of your medications now** - If possible, fill your prescriptions for the maximum allowed days while your Medi-Cal is still active. This gives you breathing room during the transition. 4. **Use the online portal first** - Start your application at CoveredCA.com to save time when you call. You can even chat with representatives online sometimes which has shorter wait times than phone calls. The whole process took me about 10 days from initial call to having my new insurance cards. The subsidized plans really are much more affordable than I expected - don't let the sticker shock of losing "free" Medi-Cal discourage you from exploring your options. You've got this!