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Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

Loss of Coverage Due to Income Increase?

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Question: I am currently enrolled in covered california, MediCal, for 2014. I have been job hunting for a while, and I believe that I may be getting a job soon that pays above 138% of the poverty line (the limit for covered california). If I get this job, will I be required to drop MediCal immediately? By the end of the year? Within a certain number of months? Thank you.

Answer: Yes. it is your responsibility to notify Medi-Cal of your change in income. You will no longer be eligible for Medi-Cal once your household income exceeds 138% FPL. However, if your new household income is between 139% and 400% of FPL, you will be eligible for premium assistance and perhaps cost sharing reductions through Covered California.


“if your new household income is between 139% and 400% of FPL, you will be eligible for premium assistance”

Not if the employer sponsors a Qualified Health Plan that is within the 9.5% of MAGI calculation.

Technically, the PPACA and IRC provides for premium tax credits to taxpayers with household incomes between 100% and 400% of FPL. Those who are eligible for Medi-Cal are not eligible for premium tax credits.

A person whose newfound employment provides income that exceeds 138% of FPL would lose eligibility for Medi-Cal, but could still end up with income below 100% of FPL for the year at tax filing time — technically ineligible for premium tax credits — and it is unclear how the IRS plans to deal with apportioning the tax credits.

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