Program Descriptions by FPL Enclosure 3
| FPL Percentage | Program Description |
|---|---|
| 100% FPL | = Qualified Medicare Beneficiary (QMB) Program |
| 108% FPL | = ACA Title XXI CHIP Expansion Children Ages 6-19 |
| 109% FPL | = ACA Parents and Caretaker Relatives |
| 114% FPL | = ACA Parents and Caretaker Relatives Not Eligible for the ACA New Adult Group due to non-Financial Eligibility Criteria such as 65 years of age or older or Enrollment in Medicare Parts A or B (109% FPL, Plus 5% MAGI Disregard) |
| 120% FPL | = < Specified Low-Income Medicare Beneficiaries (SLMB) |
| 128% FPL | = Disabled Individuals in New Adult Group |
| 133% FPL | = ACA Children and Title XXI Expansion Children Ages 6-19 |
| 135% FPL | = < Qualified Individual 1 Program (QI-1) |
| 138% FPL | = ACA New Adults Ages 19-64; and= FPL Program for Aged & Disabled |
| 142% FPL | = ACA and Title XXI Expansion Children Ages 1-6 |
| 160% FPL | = ACA Optional Targeted Low-Income Children (OTLIC) Program starting point for premiums |
| 185% FPL | = Transitional Medi-Cal (TMC) (Pre-ACA) |
| 200% FPL | = Qualified Working Disabled Individuals= Refugee Medical Assistance (RMA) |
| 202% FPL | = Transitional Medi-Cal (TMC) (Post ACA) *(ACWDL will be released when implemented) |
| 208% FPL | = ACA and Title XXI Expansion Infants Ages 0-1 |
| 213% FPL | = Full-Scope Coverage for ACA Pregnant Persons |
| Above 213% to 322% FPL | = Medi-Cal Access Program (MCAP)= Medi-Cal Access Infant Program (MCAIP) |
| 250% FPL | = Working Disabled Program |
| 266% FPL | = ACA OTLIC |
| Above 266% to 322% FPL | = County Children’s Health Initiative Program (C-CHIP) |
| 400+% FPL | = Unsubsidized Coverage |
| $35.00 | = Maintenance Need for Resident in LTC Facility |
Notes: “=” means: eligible if budget unit income is equal to or less than income limit “<” means: eligible if budget unit income is less than income limit “>” means: eligible if budget unit income is greater than income limit
MSP includes Qualified Medicare Beneficiary (QMB), Specified Low-Income Beneficiary (SLMB) and Qualified Individual (QI-1) Programs. For applicants and recipients of the Medicare Savings Programs (MSPs) not receiving RSDI Title II Income, the FPL figures are effective January 1, 2026. For applicants and recipients of MSPs receiving RSDI Title II income, the new FPL figures are effective March 1, 2026.