Lanterman Consumer Eligibility for Full-Scope, Federally-Matched Medi-Cal - Stanford Intellectual and Developmental Disabilities Law and Policy Project (SIDDLAPP)

Note: Do not use this form to submit High Risk Data.

Lanterman Consumer Eligibility for Full-Scope, Federally-Matched Medi-Cal 2022

The following interactive form is designed to be an educational tool for understanding the various eligibility pathways that a hypothetical consumer might use to enroll in Full-Scope, Federally-Matched (FSFM) Medi-Cal. This tool and the information provided here, including the eligibility determination, are for informational purposes only and are not intended to be a substitute for legal or other professional advice. Consumers seeking information relevant to their specific circumstances should consult a professional Social Security and/or Medi-Cal Benefits Planner. All form responses are permanently deleted at the end of each day.

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Immigrant Status and Full-Scope, Federally-Matched (FSFM) Medi-Cal Eligibility
Note that undocumented immigrants and other immigrants without "qualified status" are not eligible for Full-Scope, Federally-Matched (FSFM) Medi-Cal. Additionally, qualified immigrants over age 20 are generally subject to the "five-year bar," which prohibits the receipt of FSFM Medi-Cal for five years after qualified status is obtained. Certain immigrant groups are exempt from this five-year bar.

Ineligibility for FSFM Medi-Cal due to immigration status does not mean the consumer is ineligible for Medi-Cal entirely. With the passage of SB 104, consumers under 26 are eligible for full-scope Medi-Cal regardless of immigration status as long as they meet all other Medi-Cal eligibility requirements. However, Medi-Cal funds for immigrants without “qualified” status are not matched by the federal government.

Because the goal of this interactive form is to illustrate potential eligibility pathways for accessing FSFM Medi-Cal, the form assumes that the consumer in question is either a U.S. citizen, a U.S. national, a "qualified" immigrant under age 21, or a "qualified" immigrant over age 20 who has held their status for more than five years.
Additional Disclaimers
This form focuses primarily on FSFM Medi-Cal eligibility on the basis of disability. For this reason, we do not consider adults aged 65 or older to be a separate group from all adults aged 26 or older. We also do not ask about non-disability-related characteristics that may result in Medi-Cal eligibility, such as pregnant people and adults with children. Consumers in these populations are often eligible for multiple Medi-Cal programs on the basis of these categorizations. The California Department of Health Care Services provides a more extensive list of characteristics of consumers who may be eligible for Medi-Cal programs.
Consumers seeking information relevant to their specific circumstances should consult a professional Social Security and/or Medi-Cal Benefits Planner.
Instructions
Begin by entering the consumer’s age in the field below. The appearance and order of subsequent questions depend on the user’s choice in the previous one. When no more questions appear, click on “Determine Eligibility” to get the potential eligibility pathway.
Consumer Age*
Please select the age range that applies to the consumer's age (in years).
Note: Do not round up the consumer's age. If the consumer has not yet reached their 18th birthday, select "Under 18." If the consumer has had their 18th birthday but not their 19th birthday, select "18." If the consumer has not yet had their 21st birthday, select "19-20." If the consumer has not yet had their 26th birthday, select "21-25."
Household Size*
What is the size of the consumer's household?
Please enter a number greater than or equal to 1.
Hidden
138FPL-rounded
138% of the FPL, rounded to whole number.
Hidden
138FPL-raw
138% of the FPL, not rounded.
Hidden
138FPL(round/raw)
Since DHCS rounds FPL values to the next higher dollar, we calculates if the rounded value is greater (or less than the raw number). If the rounded value is smaller than the raw number, we add 1 to the rounded value. For example, 9.4 would normally be rounded to 9; so we want to add 1 to make it 10.
Hidden
138% of the Federal Poverty Level (FPL)*
Based on the information entered above, 138% of the annual Federal Poverty Level (FPL), rounded up to the next higher dollar, for the consumer's household is:
138% of the Federal Poverty Level (FPL)*
Based on the information entered above, 138% of the annual Federal Poverty Level (FPL), rounded up to the next higher dollar, for the consumer's household is:
138% of the Federal Poverty Level (FPL)*
Based on the information entered above, 138% of the annual Federal Poverty Level (FPL), rounded up to the next higher dollar, for the consumer's household is:
138% of the Federal Poverty Level (FPL)*
Based on the information entered above, 138% of the annual Federal Poverty Level (FPL), rounded up to the next higher dollar, for the consumer's household is:
138% of the Federal Poverty Level (FPL)*
Based on the information entered above, 138% of the annual Federal Poverty Level (FPL), rounded up to the next higher dollar, for the consumer's household is:
138% of the Federal Poverty Level (FPL)*
Based on the information entered above, 138% of the annual Federal Poverty Level (FPL), rounded up to the next higher dollar, for the consumer's household is:
138% of the Federal Poverty Level (FPL)*
Based on the information entered above, 138% of the annual Federal Poverty Level (FPL), rounded up to the next higher dollar, for the consumer's household is:
138% of the Federal Poverty Level (FPL)*
Based on the information entered above, 138% of the annual Federal Poverty Level (FPL), rounded up to the next higher dollar, for the consumer's household is:
138% of the Federal Poverty Level (FPL)*
Based on the information entered above, 138% of the annual Federal Poverty Level (FPL), rounded up to the next higher dollar, for the consumer's household is:
138% of the Federal Poverty Level (FPL)*
Based on the information entered above, 138% of the annual Federal Poverty Level (FPL), rounded up to the next higher dollar, for the consumer's household is:
Consumer Income Level*
Is the annual income of the consumer's family less than or equal to 138% of the Federal Poverty Level (FPL) displayed above?
- Annual income is less than or equal to 138% FPL.
- Annual income is greater than 138% FPL.
Consumer Income Level*
Is the annual income of the consumer's family less than or equal to 138% of the Federal Poverty Level (FPL) displayed above?
- Annual income is less than or equal to 138% FPL.
- Annual income is greater than 138% FPL.
Consumer Income Level*
Is the annual income of the consumer's family less than or equal to 138% of the Federal Poverty Level (FPL) displayed above?
- Annual income is less than or equal to 138% FPL.
- Annual income is greater than 138% FPL.
CalWORKs*
Is the consumer currently enrolled in CalWORKs?
- The consumer is currently enrolled in CalWORKs.
- The consumer is NOT currently enrolled in CalWORKs.
Household Size*
What is the size of the consumer's household?
Please enter a number greater than or equal to 1.
Hidden
266FPL-rounded
266% of the FPL, rounded to whole number.
Hidden
266FPL-raw
266% of the FPL, not rounded.
Hidden
266FPL(round/raw)
266% of the Federal Poverty Level (FPL)*
Based on the information entered above, 266% of the annual Federal Poverty Level (FPL), rounded up to the next higher dollar, for the consumer's household is:
266% of the Federal Poverty Level (FPL)*
Based on the information entered above, 266% of the annual Federal Poverty Level (FPL), rounded up to the next higher dollar, for the consumer's household is:
266% of the Federal Poverty Level (FPL)*
Based on the information entered above, 266% of the annual Federal Poverty Level (FPL), rounded up to the next higher dollar, for the consumer's household is:
Family Income Level*
Is the consumer's family income level less than or equal to 266% of the Federal Poverty Level (FPL) displayed above?
- Family income is less than or equal to 266% FPL.
- Family income is greater than 266% FPL.
Title IV-E Programs*
Is the consumer enrolled in a Title IV-E program such as foster care, guardianship assistance, or adoption assistance?
- The consumer is enrolled in a Title IV-E program.
- The consumer is NOT enrolled in a Title IV-E program.
Title IV-E Programs*
Is the consumer enrolled in a Title IV-E program such as foster care, guardianship assistance, or adoption assistance?
- The consumer is enrolled in a Title IV-E program.
- The consumer is NOT enrolled in a Title IV-E program.
Title IV-E Programs*
Is the consumer enrolled in a Title IV-E program such as foster care, guardianship assistance, or adoption assistance?
- The consumer is enrolled in a Title IV-E program.
- The consumer is NOT enrolled in a Title IV-E program.
Former Foster Care Recipient*
Was the consumer in foster care on their 18th birthday or a later date?
- The consumer was in foster care on their 18th birthday or a later date.
- The consumer was NOT in foster care on their 18th birthday or a later date.
SSA Disability Status*
Has the Social Security Administration (SSA) determined that the consumer meets the medical criteria for disability?
- The consumer has been determined by SSA to meet the medical criteria for disability.
- The consumer has NOT been determined by SSA to meet the medical criteria for disability.
SSA Disability Status*
Has the Social Security Administration (SSA) determined that the consumer meets the medical criteria for disability?
- The consumer has determined by SSA to meet the medical criteria for disability.
- The consumer has NOT been determined by SSA to meet the medical criteria for disability.
Available Assets*
Are the countable assets available to the consumer less than or equal to the $2,000 limit required to qualify for Supplemental Security Income (SSI)?
Note that countable assets exclude up to $2,000 of parental assets for single-parent households and up to $3,000 for two-parent households.
Note, in addition, that consumers who have CalABLE accounts can have up to $100,000 saved in a CalABLE account and still potentially qualify for SSI.
- Countable assets are less than or equal to $2,000.
- Countable assets are above $2,000.
Marital Status*
What is the consumer's marital status?
- Single
- Married
Available Assets*
Are the countable assets available to the consumer less than or equal to the $2,000 limit required to qualify for Supplemental Security Income (SSI)?
Note that countable assets exclude up to $2,000 of parental assets for single-parent households and up to $3,000 for two-parent households.
Note, in addition, that consumers who have CalABLE accounts can have up to $100,000 saved in a CalABLE account and still potentially qualify for SSI.
- Countable assets are less than or equal to $2,000.
- Countable assets are above $2,000.
Available Assets*
Are the countable assets available to the consumer and their spouse less than or equal to the allowable $3,000 limit required to qualify for Supplemental Security Income (SSI)?
Note that countable assets exclude up to $2,000 of parental assets for single-parent households and up to $3,000 for two-parent households.
Note, in addition, that consumers who have CalABLE accounts can have up to $100,000 saved in a CalABLE account and still potentially qualify for SSI.
- Countable assets are less than or equal to $3,000.
- Countable assets are above $3,000.
Living at home*
Does the consumer live at home with their parents or relative caregiver?
- The consumer lives at home with their parents or relative caregiver.
- The consumer does NOT live at home with their parents or relative caregiver.
Living at home*
Does the consumer live at home with their parents or relative caregiver?
- The consumer lives at home with their parents or relative caregiver.
- The consumer does NOT live at home with their parents or relative caregiver.
Substantial Gainful Activity*
Eligibility for SSI-linked Medi-Cal requires that the consumer not be engaged in Substantial Gainful Activity (SGA). This means that in 2022, a non-blind consumer’s earnings (net of impairment-related work expenses) cannot exceed $1,350. The SSA does not consider SGA when determining SSI eligibility for blind consumers.
Which of the following options best describes the consumer?
- Blind consumer
- Non-blind consumer earning less than or equal to $1,350
- Non-blind consumer earning more than $1,350
Level of Care Requirement*
Has the consumer been certified by a Qualified Intellectual Disability Professional to require the level of care (LOC) provided by an Intermediate Care Facility for the Developmentally Disabled (ICF-DD)?
Further information on the LOC requirements for each type of ICF-DD is available in Title 22 §§ 51343, 51343.1 and 51343.2 of the California Code of Regulations.
- The consumer has been certified to require ICF-DD LOC.
- The consumer has NOT been certified to require ICF-DD LOC.
Level of Care Requirement*
Has the consumer been certified by a Qualified Intellectual Disability Professional to require the level of care (LOC) provided by an Intermediate Care Facility for the Developmentally Disabled (ICF-DD)?
Further information on the LOC requirements for each type of ICF-DD is available in Title 22 §§ 51343, 51343.1 and 51343.2 of the California Code of Regulations.
- The consumer has been certified to require ICF-DD LOC.
- The consumer has NOT been certified to require ICF-DD LOC.
Level of Care Requirement*
Has the consumer been certified by a Qualified Intellectual Disability Professional to require the level of care (LOC) provided by an Intermediate Care Facility for the Developmentally Disabled (ICF-DD)?
Further information on the LOC requirements for each type of ICF-DD is available in Title 22 §§ 51343, 51343.1 and 51343.2 of the California Code of Regulations.
- The consumer has been certified to require ICF-DD LOC.
- The consumer has NOT been certified to require ICF-DD LOC.
Substantial Gainful Activity*
Eligibility for SSI-linked Medi-Cal requires that the consumer not be engaged in Substantial Gainful Activity (SGA). This means that in 2022, a non-blind consumer’s earnings (net of impairment-related work expenses) cannot exceed $1,350. The SSA does not consider SGA when determining SSI eligibility for blind consumers.
Which of the following options best describes the consumer?
- Blind consumer
- Non-blind consumer earning less than or equal to $1,350
- Non-blind consumer earning more than $1,350
Substantial Gainful Activity*
Eligibility for SSI-linked Medi-Cal requires that the consumer not be engaged in Substantial Gainful Activity (SGA). This means that in 2022, a non-blind consumer’s earnings (net of impairment-related work expenses) cannot exceed $1,350. The SSA does not consider SGA when determining SSI eligibility for blind consumers.
Which of the following options best describes the consumer?
- Blind consumer
- Non-blind consumer earning less than or equal to $1,350
- Non-blind consumer earning more than $1,350
SSI Income Limit*
To be eligible for SSI, the consumer’s countable monthly income must not exceed the applicable maximum monthly Supplement Security Income/State Supplementary Payment (SSI/SSP) benefit amount for California. Note that the consumer’s countable monthly income may include income deemed from their parent(s). The 2022 maximum monthly SSI/SSP benefit amount for California can be found here.
Is the consumer’s countable monthly income less than the applicable maximum monthly SSI/SSP benefit amount for California?
- Countable monthly income is below the applicable benefit amount.
- Countable monthly income is equal to or more than the applicable benefit amount.
SSI Income Limit*
To be eligible for SSI, the consumer’s countable monthly income must not exceed the applicable maximum monthly Supplement Security Income/State Supplementary Payment (SSI/SSP) benefit amount for California. The 2022 maximum monthly SSI/SSP benefit amount for California can be found here.
Is the consumer’s countable monthly income less than the applicable maximum monthly SSI/SSP benefit amount for California?
- Countable monthly income is below the applicable benefit amount.
- Countable monthly income is equal to or more than the applicable benefit amount.
SSI Income Limit*
To be eligible for SSI, the consumer’s countable monthly income must not exceed the applicable maximum monthly Supplement Security Income/State Supplementary Payment (SSI/SSP) benefit amount for California. Note that if the consumer’s spouse is ineligible for SSI, the consumer’s countable monthly income may include income deemed from their spouse. The 2022 maximum monthly SSI/SSP benefit amount for California can be found here.
Is the consumer’s countable monthly income less than the applicable maximum monthly SSI/SSP benefit amount for California?
- Countable monthly income is below the applicable benefit amount.
- Countable monthly income is equal to or more than the applicable benefit amount.
Pickle Amendment*
Consumers who become ineligible for SSI due to increases in cost-of-living adjustments in their Social Security benefits can retain eligibility for Medi-Cal under the Pickle Amendment. More specifically, a consumer may be eligible for Medi-Cal under the Pickle Amendment, if they meet all of the following requirements:
- were simultaneously eligible to receive both SSI and Social Security benefits in some month after April 1977;
- are currently eligible for and receiving Social Security benefits;
- are currently ineligible for SSI; and
- would qualify for SSI after deducting cost-of-living adjustments for Social Security benefits received since the last month they were eligible for both SSI and Social Security benefits.
A more detailed discussion of the eligibility criteria for Medi-Cal under the Pickle Amendment can be found here.
Does the consumer meet the eligibility criteria to receive Medi-Cal under the Pickle Amendment?
- The consumer is eligible under the Pickle Amendment.
- The consumer is NOT eligible under the Pickle Amendment.
Section 1619(b)*
Disabled consumers returning to work often exceed the SGA thresholds and/or countable income limits discussed above. However, through Section 1619(b) of the Social Security Act, such consumers who meet other non-income SSI requirements but exceed the SGA thresholds and/or countable income limits can still retain SSI-linked Medi-Cal coverage if they meet all of the following requirements:
- They were eligible for an SSI cash payment for at least 1 month;
- They need Medi-Cal coverage to continue working; and
- Their (individual) gross income does not exceed the program's 2022 threshold for California ($55,439 for blind consumers and $54,082 for non-blind consumers).
Does the consumer meet all the eligibility requirements for Section 1619(b)?
- The consumer meets all the eligibility requirements for Section 1619(b).
- The consumer does NOT meet the eligibility requirements for Section 1619(b).
Spouse's SSA Disability Status*
Has the Social Security Administration (SSA) determined that the consumer's spouse meets the medical criteria for disability?
- The consumer's spouse has been determined by SSA to meet the medical criteria for disability.
- The consumer's spouse has NOT been determined by SSA to meet the medical criteria for disability.
Note: If the consumer and their spouse have both been determined by the Social Security Administration (SSA) to be "disabled" but do not qualify for Full-Scope, Federally-Matched (FSFM) Medi-Cal as a couple, it is still possible that they may each qualify on their own under different criteria. Married consumers found to be likely ineligible according to this form even though both spouses meet the SSA medical criteria for disability should consult a professional Social Security and/or Medi-Cal Benefits Planner for additional information.
Aged, Blind, and Disabled Federal Poverty Level (ABD FPL) Program*
For disabled consumers with incomes too high for SSI-linked FSFM Medi-Cal, California offers a less stringent income-tested program based on calculations using the consumer’s countable monthly income: the Aged, Blind, and Disabled Federal Poverty Level (ABD FPL) program, also known as the Aged & Disabled Federal Poverty Level (A&D FPL) program. In addition to other requirements, to qualify for these programs, a consumer’s net non-exempt monthly income must not exceed the program’s income limit. Consumers who are single can calculate their net non-exempt monthly income by following this set of instructions or by using the ABD FPL Income Eligibility Form. The income limit for the ABD FPL program is 138 percent of the applicable FPL, which in 2022 is $1,482 for an individual.
Which of the following options applies to the consumer?
- The consumer's net non-exempt monthly income is less than $1,482.
- The consumer's net non-exempt monthly income is greater than or equal to $1,482.
Aged, Blind, and Disabled Federal Poverty Level (ABD FPL) Program*
For disabled consumers with incomes too high for SSI-linked FSFM Medi-Cal, California offers a less stringent income-tested program based on calculations using the consumer’s countable monthly income: the Aged, Blind, and Disabled Federal Poverty Level (ABD FPL) program, also known as the Aged & Disabled Federal Poverty Level (A&D FPL) program. In addition to other requirements, to qualify for these programs, a consumer’s net non-exempt monthly income must not exceed the program’s income limit. Consumers who are single can calculate their net non-exempt monthly income by following this set of instructions or by using the ABD FPL Income Eligibility Form. The income limit for the ABD FPL program is 138 percent of the applicable FPL, which in 2022 is $1,482 for an individual.
Which of the following options applies to the consumer?
- The consumer's net non-exempt monthly income is less than $1,482.
- The consumer's net non-exempt monthly income is greater than or equal to $1,482.
Aged, Blind, and Disabled Federal Poverty Level (ABD FPL) Program*
For disabled consumers with incomes too high for SSI-linked FSFM Medi-Cal, California offers a less stringent income-tested program based on calculations using the consumer’s countable monthly income: the Aged, Blind, and Disabled Federal Poverty Level (ABD FPL) program. In addition to other requirements, to qualify for these programs, a consumer’s net non-exempt monthly income must not exceed the program’s income limit. Married couples where both spouses are disabled and want to apply for ABD FPL can calculate their net non-exempt monthly income by following this set of instructions or by using the ABD FPL Income Eligibility Form. The income limit for the ABD FPL program is 138 percent of the applicable FPL, which in 2022 is $2,004 for a couple.
Which of the following options applies to the consumer?
- The consumer and their spouse have a net non-exempt monthly income less than $2,004.
- The consumer and their spouse have a net non-exempt monthly income greater than or equal to $2,004.
Aged, Blind, and Disabled Federal Poverty Level (ABD FPL) Program*
For disabled consumers with incomes too high for SSI-linked FSFM Medi-Cal, California offers a less stringent income-tested program based on calculations using the consumer’s countable monthly income: the Aged, Blind, and Disabled Federal Poverty Level (ABD FPL) program, also known as the Aged & Disabled Federal Poverty Level (A&D FPL) program. In addition to other requirements, to qualify for these programs, a consumer’s net non-exempt monthly income must not exceed the program’s income limit. Consumers who are married but whose spouse is not eligible and/or does not want to apply for the ABD FPL program can calculate their net non-exempt monthly income by following this set of instructions or by using the ABD FPL Income Eligibility Form.
The income limit for the ABD FPL program is 138 percent of the applicable FPL, which in 2022 is $1,482 for an individual.
Which of the following options applies to the consumer?
- The consumer's net non-exempt monthly income is less than $1,482.
- The consumer's net non-exempt monthly income is greater than or equal to $1,482.
Working Disabled Program*
For disabled consumers who are working and whose incomes are too high for SSI-linked FSFM Medi-Cal, California offers a less stringent income-tested program based on the consumer’s countable monthly income, the Working Disabled Program.
To qualify for the Working Disabled Program, a consumer must be working and must report any work activity or service they are paid for to their local county welfare department. There are no minimum hours or amount they must earn in order to be eligible. For example, the consumer's work activity could be regularly picking up recyclable items to earn income.
In addition to other requirements, to qualify for these programs, a consumer’s countable monthly income must not exceed the program’s income limit. The income limit for the Working Disabled Program is 250 percent of the applicable FPL, which in 2022 is $2,684 for an individual.
Which of the following options applies to the consumer?
- The consumer's countable monthly income is less than or equal to $2,684.
- The consumer's countable monthly income is greater than $2,684.
Working Disabled Program*
For disabled consumers who are working and whose incomes are too high for SSI-linked FSFM Medi-Cal, California offers a less stringent income-tested program based on the consumer’s countable monthly income, the Working Disabled Program.
To qualify for the Working Disabled Program, a consumer must be working and must report any work activity or service they are paid for to their local county welfare department. There are no minimum hours or amount they must earn in order to be eligible. For example, the consumer's work activity could be regularly picking up recyclable items to earn income.
In addition to other requirements, to qualify for these programs, a consumer’s countable monthly income must not exceed the program’s income limit. The income limit for the Working Disabled Program is 250 percent of the applicable FPL, which in 2022 is $2,684 for an individual.
Which of the following options applies to the consumer?
- The consumer's countable monthly income is less than or equal to $2,684.
- The consumer's countable monthly income is greater than $2,684.
Spousal Deeming
If the consumer’s spouse is ineligible for SSI, the consumer’s countable monthly income may include income deemed from their spouse. This affects qualification for income-tested programs for which disabled consumers with incomes too high for SSI-linked FSFM Medi-Cal could be eligible.
Does the consumer's countable monthly income include income deemed from their spouse?
- The consumer's countable monthly income includes income deemed from their spouse.
- The consumer's countable monthly income does NOT include income deemed from their spouse.
Working Disabled Program*
For disabled consumers who are working and whose incomes are too high for SSI-linked FSFM Medi-Cal, California offers a less stringent income-tested program based on the countable monthly income for the consumer's household, the Working Disabled Program.
To qualify for the Working Disabled Program, a consumer must be working and must report any work activity or service they are paid for to their local county welfare department. There are no minimum hours or amount they must earn in order to be eligible. For example, the consumer's work activity could be regularly picking up recyclable items to earn income.
In addition to other requirements, to qualify for these programs, a consumer’s countable monthly income must not exceed the program’s income limit. When spousal deeming does not apply, the household size used to determine the applicable income limit for the Working Disabled Program is 1. The income limit for the Working Disabled Program is 250 percent of the applicable FPL, which in 2022 is $2,684 for a married consumer when spousal deeming does not apply.
Which of the following options applies to the consumer?
- The consumer's countable monthly income is less than or equal to $2,684.
- The consumer's countable monthly income is greater than $2,684.
Working Disabled Program*
For disabled consumers who are working and whose incomes are too high for SSI-linked FSFM Medi-Cal, California offers a less stringent income-tested program based on the countable monthly income for the consumer's household, the Working Disabled Program.
To qualify for the Working Disabled Program, a consumer must be working and must report any work activity or service they are paid for to their local county welfare department. There are no minimum hours or amount they must earn in order to be eligible. For example, the consumer's work activity could be regularly picking up recyclable items to earn income.
In addition to other requirements, to qualify for these programs, a consumer’s countable monthly income must not exceed the program’s income limit. When spousal deeming applies, the household size used to determine the applicable income limit for the Working Disabled Program is 2. The income limit for the Working Disabled Program is 250 percent of the applicable FPL, which in 2022 is $3,630 for a consumer's household when spousal deeming applies.
Which of the following options applies to the consumer?
- The consumer's countable monthly household income is less than or equal to $3,630.
- The consumer's countable monthly household income is greater than $3,630.
Level of Care Requirement*
Has the consumer been certified by a Qualified Intellectual Disability Professional to require the level of care (LOC) provided by an Intermediate Care Facility for the Developmentally Disabled (ICF-DD)?
Further information on the LOC requirements for each type of ICF-DD is available in Title 22 §§ 51343, 51343.1 and 51343.2 of the California Code of Regulations.
- The consumer has been certified to require ICF-DD LOC.
- The consumer has NOT been certified to require ICF-DD LOC.
Level of Care Requirement*
Has the consumer been certified by a Qualified Intellectual Disability Professional to require the level of care (LOC) provided by an Intermediate Care Facility for the Developmentally Disabled (ICF-DD)?
Further information on the LOC requirements for each type of ICF-DD is available in Title 22 §§ 51343, 51343.1 and 51343.2 of the California Code of Regulations.
- The consumer has been certified to require ICF-DD LOC.
- The consumer has NOT been certified to require ICF-DD LOC.
Home and Community-Based Services Developmental Disability Waiver*
California's Home and Community-Based Services Developmental Disability (HCBS-DD) Waiver is a program for consumers with intellectual or developmental disability (I/DD) that meet the ICF-DD LOC requirements. If the consumer participates in the program, only their income and assets (not the family's) would be included in eligibility decisions.
Does the consumer participate in the HCBS-DD waiver?
- The consumer participates in the HCBS-DD Waiver.
- The consumer does NOT participate in the HCBS-DD Waiver.
Home and Community-Based Services Developmental Disability Waiver*
California's Home and Community-Based Services Developmental Disability (HCBS-DD) Waiver is a program for consumers with intellectual or developmental disability (I/DD) that meet the ICF-DD LOC requirements. If the consumer participates in the program, only their income and assets (not the family's) would be included in eligibility decisions.
Does the consumer participate in the HCBS-DD waiver?
- The consumer participates in the HCBS-DD Waiver.
- The consumer does NOT participate in the HCBS-DD Waiver.
Home and Community-Based Services Developmental Disability Waiver*
California's Home and Community-Based Services Developmental Disability (HCBS-DD) Waiver is a program for consumers with intellectual or developmental disability (I/DD) that meet the ICF-DD LOC requirements. If the consumer participates in the program, only their income and assets (not the family's) would be included in eligibility decisions.
Does the consumer participate in the HCBS-DD waiver?
- The consumer participates in the HCBS-DD Waiver.
- The consumer does NOT participate in the HCBS-DD Waiver.
Home and Community-Based Services Developmental Disability Waiver*
California's Home and Community-Based Services Developmental Disability (HCBS-DD) Waiver is a program for consumers with intellectual or developmental disability (I/DD) that meet the ICF-DD LOC requirements. If the consumer participates in the program, only their income and assets (not the family's) would be included in eligibility decisions.
Does the consumer participate in the HCBS-DD waiver?
- The consumer participates in the HCBS-DD Waiver.
- The consumer does NOT participate in the HCBS-DD Waiver.
Available Assets*
Are the assets available to the consumer's Medi-Cal Family Budget Unit (MFBU) at or below the allowable limit ($3,000 for a 2-person MFBU, and +$150 for each additional member)?
- Assets are less than or equal to the allowable limit.
- Assets are above the allowable limit.
Available Assets*
Are the assets available to the consumer's Medi-Cal Family Budget Unit (MFBU) at or below the allowable limit ($3,000 for a 2-person MFBU, and +$150 for each additional member)?
- Assets are less than or equal to the allowable limit.
- Assets are above the allowable limit.
Available Assets*
Are the assets available to the consumer's Medi-Cal Family Budget Unit (MFBU) at or below the allowable limit ($3,000 for a 2-person MFBU, and +$150 for each additional member)?
- Assets are less than or equal to the allowable limit.
- Assets are above the allowable limit.
Available Assets*
Are the assets available to the consumer's Medi-Cal Family Budget Unit (MFBU) at or below the allowable limit ($3,000 for a 2-person MFBU, and +$150 for each additional member)?
- Assets are less than or equal to the allowable limit.
- Assets are above the allowable limit.
Available Assets*
Are the assets available to the consumer's Medi-Cal Family Budget Unit (MFBU) at or below the allowable limit ($3,000 for a 2-person MFBU, and +$150 for each additional member)?
- Assets are less than or equal to the allowable limit.
- Assets are above the allowable limit.
Available Assets (excluding parental resources)*
Are the consumer's individual countable assets (i.e., excluding parental assets) valued at less than or equal to the $2,000 allowable limit?
- Individual countable assets are less than or equal to the allowable limit.
- Individual countable assets are above the allowable limit.
Available Assets (Post Institutional Deeming)*
Are the consumer's individual countable assets (i.e., excluding parental assets) valued at less than or equal to the $2,000 allowable limit?
- Individual countable assets are less than or equal to the allowable limit.
- Individual countable assets are above the allowable limit.
Available Assets (Post Institutional Deeming)*
Are the consumer's individual countable assets (i.e., excluding parental assets) valued at less than or equal to the $2,000 allowable limit?
- Individual countable assets are less than or equal to the allowable limit.
- Individual countable assets are above the allowable limit.
Available Assets (Post Spousal Impoverishment Rules)*
After applying Spousal Impoverishment Rules, are the consumer's individual countable assets less than or equal to the $2,000 allowable limit?
- Individual countable assets are less than or equal to the allowable limit.
- Individual countable assets are above the allowable limit.
Note: This interactive form is designed to be an educational tool for understanding the various eligibility pathways that a hypothetical consumer might use to enroll in Full-Scope, Federally-Matched (FSFM) Medi-Cal. This tool and the information provided here, including the eligibility determination, are for informational purposes only and are not intended to be a substitute for legal or other professional advice. Consumers seeking information relevant to their specific circumstances should consult a professional Social Security and/or Medi-Cal Benefits Planner. All form responses are permanently deleted at the end of each day.

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Lanterman Consumer Eligibility for Full-Scope, Federally-Matched Medi-Cal 2022

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