Reference: ACWDLs 00-57 and 00-68

In determining eligibility for the A&D FPL, count the income of the applicant and his/her spouse or the income of the parent if the applicant is a child.

If there is one parent and one child eligible for this program, treat them as two individuals (in separate MFBUs) and not as a couple.

Individuals in board and care are eligible for this program and are entitled to the $315 personal care services deduction. If an individual would be eligible for the A&D FPL program by paying a health care premium (such as a premium for an HMO or the Medicare Part B premium) but would not be eligible if he/she did not pay the premium, the individual could choose to pay the premium in order to remain eligible for $0 SOC Medi-Cal under the A&D FPL program.

For example, if a Medi-Cal recipient received Social Security benefits that exceeded the A&D FPL program net income limit by $40, and the state pays the $50 Medicare Part B premium, that Medi-Cal recipient could ask the county to request the state to stop paying the Part B premium. The recipient, by choosing to pay the $50 Part B premium instead of having the state pay the premium would get a $50 net income deduction. The $50 deduction would reduce countable net income to $10 below the A&D FPL program limit. The Medi-Cal recipient would thus be eligible for $0 SOC Medi-Cal under the A&D FPL program.

Medi-Cal eligibility programs should be reviewed in the following order:

• Pickle
• §1931(b)
• A&D FPL
• Medically Needy

Note: This ACWDL erroneously advises that §1931(b) eligibility should be evaluated before Pickle eligibility.