DHCS MEDIL I 14-27: Application Process for Retroactive Medi-Cal Coverage (5/15/14)

DHCS issued this letter to provide updated guidance on retroactive Medi-Cal coverage as a result of the Affordable Care Act.  Individuals could previously request retroactive coverage before a year from the date of service by completing an MC 210A for each month in which retroactive coverage was requested.

For ongoing MAGI cases, counties will ask for information in addition to the MC 210A when the information is needed to complete the determination.  If a current MAGI beneficiary is requesting retroactive months prior to December 31, 2013, eligibility would be based on non-MAGI rules.  For applications for retroactive months where no ongoing coverage is requested, counties must complete a SAWS 2 Plus for the other months requested.

The non-MAGI applications will continue to use the MC 210A along with property and income verification as needed.