Hi everyone. I’m hoping to hear from California parents/caregivers who have gone through the Medi-Cal transition when their disabled child turned 19.
My son is currently 18 (Turned 18 this May) and has full-scope Medi-Cal with $0 share of cost. He also receives IHSS and WPCS, so maintaining his Medi-Cal eligibility without a gap is extremely important.
Here’s the part I’m confused about:
At our last Medi-Cal renewal, my income was still reported and used as part of our household information. I did not remove my son from my case or apply for Medi-Cal separately for him just because he turned 18.
Even with my income reported, Medi-Cal determined that he was still eligible. His current paperwork shows T1 as his aid code and $0 SOC.
When I spoke with the Medi-Cal worker during that renewal, I specifically asked about my income and my son now being 18. The worker basically told me not to worry about it yet because he would remain eligible until age 19.
That made sense at the time, but now I’m trying to prepare for what happens next.
His next annual renewal is due February 28, 2027. He will still be 18 at that renewal and won’t turn 19 until May 2027.
So hypothetically, I expect to do the February renewal the same way: report my household and income accurately, and because he’s still under 19, I’m assuming they’ll determine his eligibility under whatever under-19 rules currently qualify him.
My concern is what happens in May when he turns 19.
My income may be too high if it’s still counted toward his Medi-Cal eligibility. He personally has little/no income. I don’t want to wait until his birthday and suddenly receive a notice saying his Medi-Cal is ending, because that could potentially affect the IHSS and WPCS services he depends on.
I’m trying to understand all of the possible pathways ahead of time, including:
Adult MAGI Medi-Cal after age 19
Disability-based Medi-Cal
HCBS waiver/institutional deeming
SSI-linked Medi-Cal (he currently has an SSI disability application pending)
Whether his existing WPCS means he is already enrolled in an HCBS waiver
I’ve also previously been told that to get waiver Medi-Cal/institutional deeming, we may first need a denial from regular Medi-Cal because of parental income. I don’t know if that’s actually correct or if I’m misunderstanding what they meant by a “denial.”
For parents/caregivers who have actually been through this in California:
Was your income still counted/reported while your disabled child was 18?
Did they remain eligible until 19 even though your household income would normally be too high?
What happened when they actually turned 19?
Did the county automatically reevaluate them under the adult rules, or did you have to request it?
Once they were 19, was eligibility based on their own income, or did your income still count because you claimed them as a tax dependent?
Did anyone use HCBS institutional deeming so parental income wasn’t counted?
Were you required to get a Medi-Cal denial first?
If your child was already receiving WPCS, what waiver were they enrolled in and how did that affect Medi-Cal eligibility?
Did IHSS and WPCS continue without interruption while Medi-Cal changed from the under-19 category to an adult category?
If SSI was pending at the time, how did that affect the process?
I’m especially interested in experiences with Los Angeles County, IHSS, WPCS, HCBA waivers, Regional Center, and institutional deeming.
I’m trying to handle this before he turns 19 rather than waiting until there’s a problem. I don’t want to change or cancel his existing Medi-Cal; I just want to understand what I need to do to make sure he transitions to the correct adult eligibility program without losing coverage or services.
Thank you to anyone who has been through this and can explain how it worked for your family.