Cal. Code Regs. tit. 22 § 50197

Current through Register 2024 Notice Reg. No. 11, March 15, 2024
Section 50197 - Retroactive Eligibility
(a) In addition to the period of eligibility specified in Section 50195, an applicant shall be eligible for Medi-Cal in any of the three months immediately preceding the month of application or reapplication if all of the following requirements are met in that month:
(1) The county department determines that the applicant would have been eligible for one of the programs specified in Section 50201, except as specified in (c), had an application been made.
(2) The applicant received health services.
(3) The applicant was not previously denied Medi-Cal for the month in question, unless the application was denied for one of the following reasons:
(A) County error.
(B) The applicant's failure to cooperate, when that failure, or the applicant's subsequent failure to reapply, was due to circumstances beyond the control of the applicant.
(b) The request for retroactive eligibility shall be made in accordance with Section 50148 and shall be treated as any other application, except that persons applying on the basis of disability shall have their disability determined prior to determining retroactive eligibility.
(c) A person 21 years of age or older shall not be retroactively eligible as a medically indigent person unless either of the following conditions exist.
(1) The person was residing in a skilled nursing or intermediate care facility during any part of both:
(A) The month of application.
(B) The month for which retroactive eligibility is requested.
(2) The person is a woman with a confirmed pregnancy.

Cal. Code Regs. Tit. 22, § 50197

1. Change without regulatory effect renumbering former section 50710 to new section 50197 filed 9-19-2000 pursuant to section 100, title 1, California Code of Regulations (Register 2000, No. 38).
2. Change without regulatory effect amending subsections (a) and (a)(2) and NOTE filed 6-21-2012 pursuant to section 100, title 1, California Code of Regulations (Register 2012, No. 25).

Note: Authority cited: Section 20, Health and Safety Code; and Sections 10725 and 14124.5, Welfare and Institutions Code. Reference: Sections 14005.4, 14019, 14019.6, 14142 and 14145, Welfare and Institutions Code.

1. Change without regulatory effect renumbering former section 50710 to new section 50197 filed 9-19-2000 pursuant to section 100, title 1, California Code of Regulations (Register 2000, No. 38).
2. Change without regulatory effect amending subsections (a) and (a)(2) and Note filed 6-21-2012 pursuant to section 100, title 1, California Code of Regulations (Register 2012, No. 25).