California Department of Social Services - State Hearings Division
Notes from the Training Bureau - December 10, 2002

Following are answers to some of the questions in this ACWDL:

¨ New FPLs become effective in April of each year. The A&D FPL program limit for an individual is determined by adding $230 to 100% of the FPL for an individual and $310 to 100% of the FPL for a couple. Do not count the annual Social Security cost of living adjustments that an individual receives in January of each year until the new FPL limits are increased in April of that year. A&D FPL income limits cannot be less than the SSI/SSP levels for an individual or a couple.

¨ Health care premiums may be used as a deduction for purposes of determining eligibility for the A&D FPL except for the IHSS deduction.

¨ However, a Medi-Cal beneficiary may not choose to pay his/her own Medicare Part B premium once the Part B premium buy-in starts (usually after the individual has received Medi-Cal for two months) in order to become eligible for the A&D FPL program. The DHS is participating in a Medicare Buy-In agreement and that agreement requires the department to pay the Part B premium for all cash grant and medical assistance only beneficiaries. The A&D FPL is a medical assistance only program.

¨ If one member of a couple can qualify for the A&D FPL program based on income while the other member cannot, the couple may apply for the A&D FPL for only one member. The person who does not qualify for the A&D FPL may choose not to receive Medi-Cal, or to receive Medi-Cal under the medically needy (MN) program with a share of cost.