Article 10, Section 7 – Transitional Medi-Cal (TMC) Income

 

Table of Contents

 

Title

MPG Cite

General

10.07.01

Income Regulations

10.07.02

 

 


 

10.07.01  General

 

A.
General

The purpose of this section is to provide instructions for determining income eligibility to TMC.  To remain eligible for TMC, the family income cannot exceed 185% of the FPL.  Rules for determining income in TMC cases are different from regular Medi-Cal rules.

 

MPG LTR 434 (1/01)

ACWDL

90-06

 


 

10.07.02  TMC Income Regulations

 

A.
When to Evaluate Income Eligibility

Workers will evaluate income at three times during the 12-month TMC period.  Income will only be evaluated when Status Reports are returned.  TMC Status Reports are due in the fourth month of Initial TMC, and the first and fourth months of Additional TMC.

 

MPG LTR 434 (1/01)

ACWDL

00-01

 

B.
Evaluation Period

·   For TMC beneficiaries, the three-month period covered by the Status Report will be used to evaluate family income.

·   Current income changes reported by the beneficiary will not be used to anticipate income eligibility.

·   Income for the first three months of Initial TMC will only be used to determine income eligibility for the Additional TMC period.  It does not affect eligibility to the second three months of Initial TMC.

·   Income for the last three months of the Initial TMC period or first three months of the Additional TMC period will be used to determine income eligibility in the Additional TMC period.

 

MPG LTR 434 (1/01)

 

C.
Countable Income

People whose income will be counted in determining a family’s monthly gross income include:

·   All family members living in the home who were members of the MFBU during the month the family became ineligible for CalWORKs or Section 1931(b)

·   Any family member(s) who return(s) to the home and are eligible to TMC must have his/her income included.

 

MPG LTR 434 (1/01)

 

 

 

 

 

 

 

ACWDL

92-59

 

D.
Computing Monthly Gross Earnings

For TMC, gross monthly earned income cannot exceed 185% FPL.

·   Gross income includes any earned income, including the earned income of a child as well as the parent(s) and that of family members who are not eligible for TMC and are receiving Medi-Cal under another program such as Section 1931(b), MN or MI.  Sneede rules apply.

·   Earned income listed in MPG Article 10, Section 3 as exempt from consideration in regular Medi-Cal is not exempt from consideration in TMC.

·   Unearned income is not included in gross earned income for TMC.

·   Deductions allowed in TMC gross income computations are:

-  Health insurance premiums paid for by any family member

-  Actual out-of-pocket child care costs of the caretaker relative that are necessary for continued employment.  Out-of-pocket expenses mean what is actually paid for childcare.  Out-of-pocket expenses do not include childcare costs paid for by someone else or childcare costs that are reimbursed, such as Welfare to Work Child Care.

-  No other deductions are allowed in TMC.

·   Gross earned income is determined by adding the three months of reported countable income quarterly earnings less deductions, and then dividing this sum by three.

-  Fluctuating income is not treated differently, as is done in regular Medi-Cal.

-  Income is not apportioned over time as is done in regular Medi-Cal.

-  Reported changes in income are not used to anticipate future income levels.

·   MFBU size for determining 185% FPL is the current family size even if some family members are not TMC eligible.

·   Self employed people are not allowed the 40% deduction from their total business revenue as may be allowed in Section 1931(b).

 

MPG LTR 500 (6/02)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEPM

5B-9

 

E.
Discontinuances for Excess Income

The table below shows when TMC may be discontinued for excess income with adequate notice.

 

If excess income is reported during the ...

Then the case will be discontinued at the end of the ...

first 3 months of Initial TMC,

6th month of Initial TMC.

second 3 months of Initial TMC,

1st month of Additional TMC.

first 3 months of Additional TMC,

4th month of Additional TMC.

 

MPG LTR 500 (6/02)