CMSP ACL 14-02: CMSP Policy on Determination of Other Health Coverage Under Expanded Medi-Cal and Covered California
Earlier this year, the CMSP Governing Board issued guidance regarding eligibility for CMSP after the expansion of Medi-Cal and implementation of Covered California. All applicants will be considered for MAGI Medi-Cal and Covered California before being evaluated for CMSP. For full details, read the letter here.
For applications subject to the Covered California open enrollment period, applicants not otherwise eligible for Medi-Cal must provide evidence to the county of a Covered California application and, when required, evidence of the first month’s premium payment.
- Applicants who provide the evidence will receive CMSP coverage for the period between the application date and the start of Covered California coverage.
- Applicants who fail to provide evidence will be denied eligibility for CMSP due to non-compliance. The start date of CMSP aid will be the first of the month after Covered California enrollment ends.
For applications not subject to the Covered California open enrollment period, applicants not otherwise eligible for Medi-Cal must provide evidence that any Covered California coverage was terminated due to lack of monthly premium payment and attestation that no special circumstances for enrollment exist.
- If no special circumstances exist, the county will determine an applicant’s CMSP eligibility.
- If a special circumstance exists, the applicant must provide evidence of application to Covered California and evidence of the first month’s premium payment.
- If no evidence is provided, the county will deny the CMSP application.