AnimatedBanner

Medi-Cal Health Coverage for Families with Children

The Medi-Cal 1931b Program

The main criteria are listed below.

  • This Medi-Cal program is for families with deprived children who have countable income below the limits. (See page 3 on how to estimate countable family income.) 
  • A child is considered deprived when a parent is: absent from the home, deceased, incapacitated, or unemployed.
  • The family’s property cannot exceed the amounts listed below, based upon the main rules listed on pages 1 and 2.
    NOTE: Medi-Cal disregards property for certain pregnant women and certain children up to age 19. To apply for that program, please request a mail-in application if you do not already have one. If you are aged (65 or over), blind or disabled, an institutionalized spouse with a community spouse who does not want Medi-Cal for himself/herself, or a family or child who does not fit into the program rules and limits check the Medi-Cal program (income will not make you ineligible under that program).

Property is defined as “real property” and “personal property.” “Real property” is land, buildings, mobile homes which are taxed as real property, or life estates in real property. “Personal property” is any kind of liquid or nonliquid asset, i.e., cars, jewelry, stocks, bonds, financial institution accounts, boats, trucks, trailers, promissory notes, mortgages, and deeds of trust, etc. Property that is not counted in determining your eligibility is called “exempt” or “unavailable” property. Countable property (property which is not exempt or unavailable) is included in the “property reserve.” Your countable property must not exceed the property reserve limit. Any amount over the property reserve limit will make you and/or your family ineligible for Medi-Cal. To be eligible for Medi-Cal, you may reduce your property to the property reserve limit before the end of the month in which you are requesting Medi-Cal.


If you are unable to reduce your property to the property limit for a month beginning with the month of application, Principe v. Belshé rules may apply. These rules allow individuals to spend down their otherwise excess property retroactively on qualified medical expenses. Qualified medical expenses are medical expenses that were incurred in any month and that were unpaid in the same month where there was excess property for the entire month. Eligibility will be granted beginning with the month of application once verification has been provided to the county that payment of those qualified medical expenses has been made with the excess property.

Exempt home. Property used as a home is exempt. When an applicant or beneficiary is temporarily absent from the home for reasons such as illness, seasonal employment, visits, extreme climatic conditions, etc., the home will remain exempt if the applicant or beneficiary plans and appears to be able to return home when those circumstances no longer exist. This includes multiple dwelling units when the units cannot be sold separately.

 Real property listed for sale. Real property that the owner is making a good faith effort to sell shall be considered unavailable for no more than nine months.

 Property of certain individuals shall be exempt.

  • The separate and community property share of a stepparent who is not an applicant or beneficiary.
  • The exclusive personal property of a child who does not receive Medi-Cal under the Section 1931(b) program when eligibility is being determined for the rest of the family under the Section 1931(b) program.
  • Property which is considered in determining the eligibility of an SSI/SSP recipient even when owned separately by the Section 1931(b) program applicant or beneficiary.

Motor Vehicles. Your motor vehicles may be exempt if they are used for:

  • Self-employment, used on the job (taxi, truck driver, etc.), for income producing purposes even if only seasonally, or for long-distance travel (other than daily commuting) essential for employment (traveling sales, migrant farm worker going from job to job, etc.), even if temporarily unemployed.
  • Transporting a disabled individual living in the home.
  • A home (only one may be exempt on this basis).
  • Transporting the primary supply of fuel/water for the home.

Other motor vehicles will not be counted if the fair market value is under $4,650, or if the equity value is under $1,500.

Income producing property. Personal property that produces any income shall be exempt even if only producing income on a seasonal basis. This includes promissory notes, mortgages, deeds of trust, installment contracts, or agreements. This does not include nonbusiness financial accounts or instruments where cash is available upon demand. 

Personal property used in a trade or business. 

Household items and personal effects including TVs, VCRs, computers, and jewelry.

Pension funds or pension plans or KEOGHs which involve a contractual relationship with someone who is not living in the home with you and who is not your parent, stepparent, or spouse. 

All life insurance policies. 

Musical instruments and recreational items including collections, hobbies, guns, etc.

Livestock, poultry, or crops.

Individual items of personal property which would produce funds equal to or less than one-half of your property limit if sold.

Countable property equal to the amount of benefits paid under a state-certified, long-term care insurance policy.

Burial space items, irrevocable burial trusts, or irrevocable prepaid burial contracts. 

One revocable burial fund or revocable prepaid burial contract with a value of up to $1,500 per person. 

ESTIMATING YOUR INCOME ELIGIBILITY FOR THE SECTION 1931(b) PROGRAM

To estimate whether your family might be income eligible for the Section 1931(b) program, you need to determine whether your family’s Medi-Cal countable income is less than the income limits for the program. Medi-Cal may not count all of your family’s income. To estimate your family’s countable income, you may subtract from your total gross income the amounts described in the list below that you determine might be applicable to you.

*NOTE: The list below does not list all the kinds of income which may be subtracted from your family’s gross income when determining your family’s countable income. The rules listed below are simplified from rules that your county Medi-Cal office would use. As a result, the countable income you estimate may be different from the actual countable income that would be computed by your county Medi-Cal office and used by them to determine whether your family would be eligible for the Section 1931(b) program.

1. If you have your own business which generates revenue, figure your average monthly business expenses. Next, compute 40 percent of your business’ estimated yearly revenue and divide by 12 to compute a monthly average. Compare your business’ average monthly expenses to 40 percent of the business’ monthly revenue, and subtract the larger of these two amounts from your average monthly business revenue.

2. Subtract $90 from each family member’s monthly earnings (wages or salary from any employment). Only family members with earnings receive this deduction. Do not subtract this $90 from unearned income such as Unemployment Insurance Benefits or Social Security payments.

3. Subtract your monthly child care expenses from your family’s combined monthly earned income. There are limits on the amount of child care expenses you may subtract. You may subtract your actual monthly child care expenses up to $200 if your child is under two years of age. You may subtract your actual monthly child care expenses up to $175 if your child is two years of age or older.

4. Subtract the earnings of a child (18 years of age or younger) if he/she is enrolled in school at least half-time.

5. Subtract any grants, scholarships, or student loans received by a student from their college.

6. One-twelfth of your minimum year-end tax liability may be subtracted from monthly income from pensions. (Minimum year-end tax liability is the amount of your taxes you would owe if you took all legally available income exemptions and deductions.)

After you have subtracted from your family’s gross income any of the applicable amounts listed in 1–5 above, you are left with the estimated* countable income of your family. Compare this estimated countable income with the income limit for your size family provided in the following table. If your family’s countable income is less than the listed income limit, there is a good chance your family will be income-eligible for the Section 1931(b) program.

If your family’s countable income is greater than the listed income limit, you may still be eligible for another Medi-Cal program which allows families to become eligible through payment of a monthly “deductible.”

 

Income & Property Limits Chart Section 1931(b)  

Number of Persons Income

Income Limits
(Effective 4/1/2010)
Income at or below:

Property Limit

1

$ 931

$3,000

2

1,261

3,000

3

1,591

3,150

4

1,921

3,300

5

2,251

3,450

6

2,581

3,600

7

2,911

3,750

8

3,241

3,900

9

3,571

4,050

10

3,901

4,200 for 10 or more persons

For each additional person add:

330

N/A

 

 

 

 

 

 

 

 

 

 

 

 

 

Children must be under 18 years of age. (Note: Children age 18 to 21 may still be eligible under other Medi-Cal programs.)

  • Custodial parents must cooperate with the Local Child Support Agency when there is an absent parent. If parents do not cooperate with the child support agency requirements, only the parents will be ineligible for Medi-Cal; children remain eligible  

Applying for Medi-Cal 

If you would like to apply for Medi-Cal health coverage under Section 1931(b) you may: 

  • Apply in person by going to one of the Social Services Agency Offices and filling out an application
  • or Call our office and ask for a mail-in Medi-Cal application.  

Documents You Will Need to Bring When You Apply

Your Eligibility Worker (EW) will tell you exactly what documents you will need to provide as proof of identity, income, property, residence, and so on.  The following list contains examples of some of the most common items you may need to provide so that your EW can see if you are eligible for Medi-Cal benefits. 

Proof of Citizenship

  • Original Birth Certificate
  • Passport 

Proof of Identity

  • California Driver’s License or ID from the Department of Motor Vehicles (DMV)
  • Passport 

Proof of Social Security Number

  • Social Security Card Proof of application for Social Security Card    

Proof of Immigration Status

  • Permanent Resident Card/Green Card/ Alien Registration Card    

Proof of Property

  • Bank statements (checking and/or savings accounts)  
  • Car registrations Papers that show the value of property  

Proof of Income

  • Pay stub or employer’s documents  
  • Other papers that provide proof of monthly income (e.g., Social Security Award Letter, Unemployment check stub, and/or Disability check stub)

California Residency

  • Housing bill/receipt 
  • Utility bill