EDD unemployment counting as income for Medi-Cal? Just got disqualified
Just got the worst news from Covered California yesterday - they sent me a letter saying I'm no longer eligible for my Medi-Cal coverage because my income exceeds their monthly limit of $1564.00. I'm currently receiving unemployment benefits at $450/week after losing my job in healthcare admin. Does EDD unemployment actually count against Medi-Cal eligibility? I honestly never thought unemployment would be considered income for healthcare eligibility purposes. I have ongoing prescriptions I need to fill next week and I'm freaking out about suddenly having no coverage. Has anyone dealt with this before? Do I need to appeal with Covered California or is this actually correct? Really appreciate any advice!!
16 comments
Giovanni Colombo
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.
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Amara Okafor
•Thanks for confirming. Ugh, this is awful timing... I just started my medications last month. Do you know if there's any kind of transition period or if my coverage is just immediately canceled? The letter wasn't super clear about when exactly I lose coverage.
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Fatima Al-Qasimi
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
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Amara Okafor
•Thanks for sharing your experience! I'll double-check the letter when I get home tonight. Did you end up finding affordable coverage through Covered California when this happened to you?
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StarStrider
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.
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Amara Okafor
•Thank you SO much for this detailed information! I didn't realize there's a transition period - that's a relief. I'll try calling them tomorrow morning and check out that service if I can't get through.
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Dylan Campbell
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!!!
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Sofia Torres
•This happened to my sister too. She had to choose between accepting unemployment or keeping her Medi-Cal. It's ridiculous that the safety nets don't work together better.
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Dmitry Sokolov
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!
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Amara Okafor
•$67/month sounds manageable - that's really helpful to know. I'll definitely mention my specific medications when I call. Did you have any issues transferring prescriptions to your new plan?
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Ava Martinez
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??
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Giovanni Colombo
•That's a good question, but unfortunately Medi-Cal eligibility is based on gross income before any tax withholdings. Even if OP has taxes withheld from their unemployment, the full $450/week is still counted for Medi-Cal purposes.
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Sofia Torres
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!
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Fatima Al-Qasimi
•did it actually work??? ive been trying to get thru to covered CA for 2 weeks!!!!
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Amara Okafor
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!!
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Dmitry Sokolov
•That's awesome news! Silver 94 is one of the best plans available through Covered California - practically as good as Medi-Cal for most services. Glad you got it sorted out!
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