page 17-2 - welcome to the county of santa clara verified by the federal data services hub (federal...
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page 17-2 Medi-Cal HandbookMAGI MC Income
17. MAGI MC Income
17.1 Reported Income
Both the Single Streamline Application (SSApp/CCFRM604) and the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS) allow clients to provide their Current Monthly Income (CMI) and Projected Annual Income (PAI).
Single Streamline Application
In Step 2 of the SSApp, the application has the following questions which relate to CMI:
Revised: 10/26/16 Update # 16-35
Medi-Cal Handbook page 17-3MAGI MC Income
The SSApp also has the following question which relates to PAI:
Floating View and Summary View
In Floating View and Summary View, PAI income is displayed separately from CMI (Earned/Self-Employed Income and Unearned Income). If the PAI fields are blank (as in the example below), the client has not attested to PAI in CalHEERS.
17.2 Income Verification
When EDBC is run for a MAGI case, information from CalWIN is sent to CalHEERS and verified by the Federal Data Services Hub (Federal Hub), or “e-verified”. E-verification is not a valid form of verification for all types of Medi-Cal or other programs.
MAGI MC Cases
The eHIT results from the Federal Hub are sufficient for MAGI income verification.
Mixed MC Cases (MAGI and Non-MAGI)
The eHIT results from the Federal Hub are sufficient for MAGI income verification, however, paper verification is required for Non-MAGI individuals. [Refer to eHIT Chapter 18]
Update # 16-35 Revised: 10/26/16
page 17-4 Medi-Cal HandbookMAGI MC Income
Mixed Cases (APTC/CSR/QHP and MAGI MC)
The eHIT results from the Federal Hub are sufficient for MAGI, APTC/CSR, QHP income verification.
Combo Case
The other program (i.e. CalWORKs or CalFresh) methodology takes priority when calculating and verifying income.
17.3 Current Monthly Income
Current Monthly Income (CMI) is entered as actually received (i.e weekly, biweekly, semi-weekly, etc.) in the appropriate income-related windows. CalWIN calculates the CMI based on actual income.
CMI should be entered for every individual who reports income, regardless of whether or not they report Projected Annual Income (PAI).
17.4 Projected Annual Income
For income that fluctuates month to month, the SSApp specifically asks for the PAI. CalHEERS also asks for PAI information and e-verifies PAI and CMI separately.
PAI is not required for a MC eligibility determination and benefits should never be denied or discontinued for failure to provide PAI verification.
Note:PAI will not be counted in the CalWIN budget for Non-MAGI MC or any other program.
Revised: 10/26/16 Update # 16-35
Medi-Cal Handbook page 17-5MAGI MC Income
17.4.1 How CalHEERS E-Verifies PAI and CMI
CalHEERS calculates a monthly income amount from the PAI for comparison purposes. CalHEERS will always use the lower of the two monthly amounts to determine eligibility when both have been e-verified. If the lower amount is e-verified, it will e-verify the higher amount as well.
If. . . Then. . .
Both amounts are e-verified, CalHEERS will use the lower amount for eligibility.
The lower amount is e-verified, CalHEERS will use the lower amount for eligibility and automatically e-verify the higher amount so eligibility does not pend.
The higher amount is e-verified, CalHEERS may not e-verify the lower amount and verification may need to be requested. [Refer to “When to Request Verification,” page 17-6]
17.4.2 When to Enter PAI in CalWIN
PAI is only entered in the Display Projected Annual Income Detail window for individuals who attest to PAI that is more beneficial than their CMI. [Refer to “Income Flowchart,” page 17-8.]
Examples of when PAI is used:
• When PAI is below the MAGI limit and CMI is above the MAGI limit. • When both PAI and CMI are under the MAGI limit, but the CMI makes a child
eligible to a premium aid code and the PAI makes the child eligible to a non-premium aid code.
• When PAI and CMI are both above the MAGI limit, and PAI is lower than CMI.
CMI must continue to be entered as actually received (i.e weekly, biweekly, semi-weekly, etc.) in the appropriate income-related windows, even when PAI is entered in CalWIN. Because PAI is used as a last resort, it should not be entered until it has been verified.
Update # 16-35 Revised: 10/26/16
page 17-6 Medi-Cal HandbookMAGI MC Income
17.4.3 When to Request Verification
When a client reports PAI and CMI, verification is not necessarily required for both. Follow the table below for requesting verification.
17.4.4 Display Projected Annual Income Detail window
The table below lists the CalWIN field in the Display Projected Annual Income Detail window, the CalHEERS field where the information can be found, and what to enter in CalWIN.
If. . . And. . . Then. . . Exception
Both amounts are within the MAGI limit,
One or both are e-verified,
No further verification is required.
If the unverified amount would qualify a child for a non-premium aid code and the e-verified amount qualifies a child for a premium aid code, request verification of the lower amount.
Neither is e-verified, Request verification of CMI.
One amount is over MAGI, one amount is below,
Only the amount above MAGI is e-verified,
Request verification of the amount below MAGI to see if the client is MAGI eligible.
Only the amount below MAGI is e-verified,
No further verification is required.
Both amounts are over MAGI (mixed households),
One or both are e-verified,
No further verification is required.
Neither is e-verified, Request verification of the lower amount.
CalWIN Field CalHEERS Field What to Enter in CalWIN
Effective Begin Date N/A The date PAI was reported
Calendar Year For Year Year the PAI record was created
PAI Begin Date Record Created Date the PAI record was created.
Revised: 10/26/16 Update # 16-35
Medi-Cal Handbook page 17-7MAGI MC Income
Guidelines for Entering PAI in CalWIN
• Never enter $0 PAI when the client has not attested to any PAI. • Never enter PAI for dependents or other household members when they do not
have their own annual income. PAI is individual-based; adding incorrect PAI will cause the household income to increase.
• When a PAI record is open and a client reports new CMI, but does not report PAI, the PAI should be end dated. A new record should only be opened when the client reports new PAI that is more beneficial to the client than CMI.
End Dating PAI
PAI should be end dated when an income change is reported.
• If no PAI is reported, end date the entry in the Display Projected Annual Income Detail window and update the CMI.
• If a new PAI amount is reported, determine whether the new PAI is more beneficial to the client. If it is, end date the existing PAI entry and create a new entry. If the PAI is not more beneficial, end date the existing PAI entry and update the CMI.
The Effective Begin Date in the Display Projected Annual Income Detail window should not be updated on an existing row unless it was entered in error at initial entry. To update or end PAI, enter an end date in PAI End Date and create a new row when applicable.
There can only be one PAI amount that covers the same PAI Begin and End Date range. An error message will display in the following scenarios:
Projected Annual Income
You Expect PAI amount.
PAI End Date Record Superceded Date the PAI ended.
Effective End Date N/A Not a fillable field. PAI is ended by PAI End Date, not Effective End Date.
Admin Verification N/A How it was verified in CalWIN.
State Verification N/A Verification from CalHEERS.
CalWIN Field CalHEERS Field What to Enter in CalWIN
Update # 16-35 Revised: 10/26/16
page 17-8 Medi-Cal HandbookMAGI MC Income
• When an existing PAI record is not end dated and an EW tries to add a new PAI entry with the same calendar year.
• When the new PAI Begin Date overlaps with the PAI Date Range (PAI Begin Date to PAI End Date) on an existing PAI entry.
17.4.5 Individuals With No PAI Who Are Pending Eligibility for PAI Verification
Individuals who have no PAI, but have household members that do, may pend for not having PAI verification. To grant those individuals eligibility, complete the following steps:
1. Log in to CalHEERS.
2. Enter the CalHEERS Case ID.
3. Select any individual from the appropriate case and click [Manual Verification].
4. Select the individual who is pending in CalWIN to open the Personal Verification page.
5. On the Personal Verification page, scroll down to “MAGI Medi-Cal Projected Annual Income”. The drop-down in the Verification Status column should say Pending.
6. Select Pass from the drop-down in the Verification Status column.
7. Click [Save].
8. Repeat Step 1 through 7 for any other household members who are pending for PAI but have no attested PAI.
Revised: 10/26/16 Update # 16-35
Medi-Cal Handbook page 17-9MAGI MC Income
9. On the Household Verifications page, click [Redetermine Eligibility]. This will send a CEW Through Portal Change DER to CalWIN. Process the Change DER. Refer to Ch. 21, “CEW Through Portal Change DERs,” page 21-38.
10. Once EDBC is run, the individual(s) should no longer be pending.
Note:THIS SHOULD NOT BE USED FOR ANY OTHER SCENARIO. If individuals do have PAI and are pending for PAI, the verification must be requested and processed as usual.
17.5 Income Flowchart
Follow the flowchart below to determine which income type should be used:
Update # 16-35 Revised: 10/26/16
page 17-10 Medi-Cal HandbookMAGI MC Income
Example 1
Maria files taxes as Head of Household and claims one child as a dependent. She reports PAI of $24,240 and CMI of $1,900 for a HH of 2. The PAI works out to $2,020 monthly which is e-verified and qualifies the child for T1. The CMI is not e-verified, but would qualify the child for T2. Both are under MAGI limits, but CMI qualifies the child for a non-premium aid code. A request is sent for CMI verification and Maria provides verification. Only CMI will be entered in CalWIN and used to determine eligibility.
Flowchart for Example 1
Revised: 10/26/16 Update # 16-35
Medi-Cal Handbook page 17-11MAGI MC Income
Example 2
Michael files taxes as Single. He reports PAI of $12,000 and CMI of $1,800. The PAI works out to $1,000 monthly. PAI and CMI are both e-verified. PAI and CMI will be entered in CalWIN and PAI will be used to determine eligibility.
Flowchart for Example 2
Update # 16-35 Revised: 10/26/16
page 17-12 Medi-Cal HandbookMAGI MC Income
Example 3
Darius files taxes as Single. He reports PAI of $12,000 and CMI of $1,900. The PAI works out to $1,000 monthly. CMI is e-verified and above MAGI. PAI is not e-verified and is below MAGI. PAI verification is requested and Darius does not provide any verification. CMI should be entered in CalWIN and will be used to determine eligibility.
Flowchart for Example 3
17.6 Income of a Tax Dependent
The income of a tax dependent (qualifying child or qualifying relative) or child who is not expected to be required to file taxes is excluded from the tax household’s MAGI income calculation. Income of children and tax dependent is counted in determining MAGI household income when a child or tax dependent is expected to be required to file a tax return.
The EW can accept the tax filing requirement as reported by the client for the benefit year that they are applying for.
Revised: 10/26/16 Update # 16-35
Medi-Cal Handbook page 17-13MAGI MC Income
Note:Supplemental Security Income (SSI) and Social Security benefits (i.e. Retirement, Survivor’s, Disability Insurance) are not counted for the purposes of determining whether a tax dependent will be required to file a tax return. However, if the tax dependent does have a tax filing requirement then the dependent’s Social Security benefits will be counted toward the household’s MAGI income.
If the Expected to be Required to File Taxes this Year [Y/N] field in Display Tax Filer Detail is marked No the income will not count in the MAGI MC budget.
17.7 Self-Employment Income
The amount the client enters or provides on the application should be the net taxable income from self-employment activities, which is the amount after applying expenses and deductions permitted by the IRS. IRS rules for determining taxable net profit income from self-employment may result in a negative number (a net income loss). The negative number may be used to offset other income the individual reports on their application and, may result in zero countable income for MAGI MC.
Update # 16-35 Revised: 10/26/16
page 17-14 Medi-Cal HandbookMAGI MC Income
The amount that is entered on the SSApp is the amount that should be transmitted to CalHEERS which the Federal Hub uses to determine whether that amount is reasonably compatible. If it is not determined to be reasonably compatible, paper verifications of income must be provided (i.e. IRS Form 1040, Schedules C, E, K-1, etc.)
The IRS rules are different from the rules for determining net income from self-employment for Non-MAGI eligibility. The IRS deductions for MAGI are broader than those allowed for Non-MAGI net income from self-employment and rental property calculations.
17.8 CalWIN Income and Deduction Types
Income and deductions may be counted differently between Modified Adjusted Gross Income (MAGI) Medi-Cal (MC) and Advanced Premium Tax Credit (APTC). CalWIN has a feature that indicates if the income is counted or not counted when the income type is selected from the CalWIN drop-down menu. (CalWIN displays the CalHEERS income type which shows whether the income is counted or not counted). The tables in this chapter provide information of how various income and deduction types are (or are not) counted for both MAGI MC and APTC and which are the corresponding CalWIN types.
The income and deduction tables in this chapter do not apply to Non-MAGI MC. For Non-MAGI MC income information, refer to Non-MAGI Income Ch. 25.
Revised: 10/26/16 Update # 16-35
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
17.9 I
The rresponding line on the IRS Form 1040. It al EERS and/or Internal Revenue Service (IRS g between the various types in CalWIN and be available in this chapter. Once Cal ordingly.
0
Other Inc e CalWIN Window
$25 weekcompensAmerican
Acceleratsettlemenfor costs the insurelimit
Acceleratsettlemenfinancial
enter ext Box
Activity n
6/16 Update # 16-35
15 Income
ncome Types
following table provides various income types for MAGI MC and APTC, including its coso shows if the income is counted in the MC eligibility determination. Income from CalH) Form 1040 can be entered into several CalWIN windows. Due to the current mappin
CalHEERS only partial information, related to income, deductions and expenses, mayWIN and/or CalHEERS provide additional information, this chapter will be updated acc
Table 17-1: Income Types (or Losses) from IRS Form 104
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
ly supplement to unemployment ation payment authorized by the Recovery
N/A Not Counted
Not Counted
ed death benefits/viatical ts if the insured is chronically ill of qualified long term care or if d is terminally ill not in excess of
N/A Not Counted
Not Counted
ed death benefits/viatical ts paid to persons with a
interest in the insured’s business
21 Counted Counted Choose “Other” and Income Type in the T
ot for profit, Pub.535 21 Counted Counted
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Adoption Collect Unearned Income Detail
Alaska Pe
Alimony r pport • Collect Child/Spousal Detail
• Collect Unearned Income Detail
AmeriCorEducation
AmeriCorCorps Sti
AmeriCorEducation
yments Collect Unearned Income Detail
Austrian gpayments
Ball v. Sw Collect Unearned Income Detail
Bartering
Black Lun Collect Unearned Income Detail
Bribes
Blood, placompensparts
Other Inc e CalWIN Window
6/16 Update # 16-35
16 Income
assistance payments N/A Not Counted
Not Counted
rmanent Fund dividends 21 Counted Counted
eceived 11 Counted Counted AR - Alimony Received
Alimony - Spousal Su
ps State/National Stipend and Award
21 Counted Counted
ps National Civilian Community pend and Education Award
21 Counted Counted
ps Vista Stipend and al Award
21 Counted Counted MS - Miscellaneous
AmeriCorps Vista Pa
eneral social insurance N/A Not Counted
Not Counted
oap payment N/A Not Counted
Not Counted
, 1099-B, Pub. 525 21 Counted Counted
g benefit payments
21 Counted Counted
sma, sperm, egg, embryo, or ation received for other body
21 Counted Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Business
on
on
has r reports
no rly rents ber
no gularly ber
ncome
nt to eed item
• Collect Rental Income Detail
• Collect Room & Board Detail
• Collect Unearned income Detail
CalFresh
Other Inc e CalWIN Window
6/16 Update # 16-35
17 Income
(or loss), Schedule C or C-EZ 12 Counted Counted SE - Self-Employment
• Lump sum from trade/business of self-employed pers
• Lump sum not fromtrade/business of self-employed persnon-recurring
• R & B/Room rent: business license oincome for taxes
• R & B/Room rent: business lic regulato non-family mem
• R & B/Room rent: business license rerents to family mem
• Self Employment i
• Third Party paymevendor for a non-n
benefits N/A Not Counted
Not Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Cancellat
• intende• amoun• amoun• with re
not in eresiden
Cancellatintended amounts dischargemortgagecost of yoimprovem
Collect Unearned Income Detail
Capital g Collect Unearned Income Detail
Carpool p
Child Sup Collect Child/Spousal Detail
Clergy hoexcess orespectiv
Clergy hoexcess orespectiv
Other Inc e CalWIN Window
6/16 Update # 16-35
18 Income
ion of non-business debt
d as a giftts not in excess of insolvencyts discharged in bankruptcygard to mortgage cancellation, xcess of the cost of the principal ce plus improvements, 1099-C
N/A Not Counted
Not Counted
ion of non-business debt, unless as a gift, that is in excess of • of insolvency • amounts d in bankruptcy • with regard to cancellation, in excess of the ur principal residence plus ents, 1099-C
21 Counted Counted CD - Cancelled Debts
Cancelled Debts
ain (or loss), Schedule E 13 Counted Counted CG - Capital gains
Capital Gains
ayments N/A Not Counted
Not Counted
port N/A Not Counted
Not Counted
using and utility allowance not in f market rate and actual cost ely
N/A Not Counted
Not Counted
using and utility allowance in f market rate and actual cost ely
21 Counted Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Clinical trexpenses
Clinical trand amou$2,000, 11396a(e)
County G
Coverdal
Court awcompensbreach ofon awardinfringem
Collect Unearned Income Detail
Court awpersonal distress adamagescompensbreach ofon awardinfringem
Credit CaPayment
urance
e
Collect Unearned Income Detail
Other Inc e CalWIN Window
6/16 Update # 16-35
19 Income
ails participation to the extent of incurred plus $2,000
N/A Not Counted
Not Counted
ial participation remuneration nts in excess of expenses minus 099-Misc and 42 U.S.C. Section (14)
21 Counted Counted
eneral Assistance cash grant N/A Not Counted
Not Counted
e education savings account 21 Counted Counted
ards/judgments/settlements for ation for lost wages/profits, contract, pension rights, interest s, patent or copyright ent and punitive damages
21 Counted Counted CA- Court Awards
Court Awards
ards/judgments/settlements for injury or sickness/emotional nd other compensatory property . This does not include ation for lost wages/profits, contract, pension rights, interest s, patent or copyright ent and punitive damages
N/A Not Counted
Not Counted
rd Insurance or Disability 21 Counted Counted MS - Misc. • Credit disability inspayments
• Credit life insurancpayments
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Disabilitydisability employer1099-A
enefits y
Collect Unearned Income Detail
Disabilityprivate diinsuranceemployer
Disabilityresulting action, no
Collect Unearned Income Detail
Disaster payments
Diversion
Down pa
Earned in
Economic
Employerbenefits fsalary redflexible sp
Other Inc e CalWIN Window
6/16 Update # 16-35
20 Income
Income -taxed (taxed private insurance premiums paid for by ) Pubs 525 and 907, 1099 and
21 Counted Counted MS - Misc. Disability Insurance Bfrom private compan
Income- untaxed (untaxed sability income -premiums not paid by ) Pubs 525 and 907
N/A Not Counted
Not Counted
payments received for injuries directly from a terrorist or military t including training exercises
N/A Not Counted
Not Counted
relief payments (qualified )
N/A Not Counted
Not Counted
cash assistance N/A Not Counted
Not Counted
yment assistance N/A Not Counted
Not Counted
come tax credit N/A Not Counted
Not Counted
stimulus payments (federal) N/A Not Counted
Not Counted
contributions to certain pretax unded by an employee’s elective uction, such as amounts for ending account
N/A Not Counted
Not Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Employmdifferentiacost-of-livdeferred services;vacation,strike andfor stock and reimbtransportexpensescommissfringe benbasis (incand transunder a pemployerduring peemployeremployerunemployfinanced services
alaries, ions,
spouse
gs, nuses &
r ceed
Collect Earned Income Detail
Energy C
Endowmebefore depaid upon
Other Inc e CalWIN Window
6/16 Update # 16-35
21 Income
ent (Wages; salary; back pay; l wage payments; Government ing allowances; Non-qualified
compensation; notes received for severance pay; sick pay; annual leave, and paid holidays; lockout benefits, cash payments appreciation rights; allowances ursements for travel,
ation, or other business ; commissions; advance
ions; tips; bonuses; awards; and efits not provided on a pre-tax
luding non-clergy housing, meals portation), disability pension lan that is paid for by your , guaranteed annual wages paid riod of unemployment by under a union agreement, paid supplemental ment benefits from an employer fund, fees received by clergy for performed, and other, W-2
7 Counted Counted • Census Income
• Earnings, wages, sbonuses, commissmilitary pay
• Excess income of
• Pre-strike - Earninwages, salaries, bocommissions
• Reimbursements oadvances which exexpenses
• Sick Pay
• Striker Picket Pay
• Therapeutic wages
• Tips
onservation Subsidy
nt Contracts paid as a lump sum ath, not in excess of costs or death to a beneficiary
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Endowmebefore deapplicablcontract)
Farm inco and Collect Unearned Income Detail
Federal I
Foreign Enon-taxab
e able),
Collect Earned Income Detail
Foster cahome
Foster caand trans
Gamblingraffles, Fo
ry, Collect Unearned Income Detail
Gifts/Cas Collect Unearned Income Detail
Health sa
Other Inc e CalWIN Window
6/16 Update # 16-35
22 Income
nt Contracts paid as a lump sum ath in excess of costs (not
e a veteran’s endowment
21 Counted Counted
me (or loss), Schedule F 18 Counted Counted FF - farming or fishing income
Income from Fishing Farming
ncome Tax Return N/A Not Counted
Not Counted
arned Income (taxable and le), Form 2555
21 Count Gross
Count Gross
FI - Foreign Earned Income (taxable and non-taxable) Form 2555
Foreign Earned Incom(taxable and non-taxForm 2555
re, maintaining a space in your 21 Counted Counted
re or other Title IV-E payments itional housing
N/A Not Counted
Not Counted
winnings: gambling, lottery, rm W2-G
21 Counted Counted MS - Misc. Winnings (bingo, lottegambling, etc)
h Contributions N/A Not Counted
Not Counted
vings account 21 Counted Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Hobby innot expec
HolocausNazi PersPayment
Collect Unearned Income Detail
Host or h
Income fror Sched
Income frproperty
sonal ss
• Collect Rental Income Detail
• Collect Room & Board Detail
Income Inbenefits)
Collect inkind Income Detail
Income Tnot deduc
Indian finIndian Finprofit-maenterprise
Individuadistributio
InheritancIRA or inh
Other Inc e CalWIN Window
6/16 Update # 16-35
23 Income
come, or from an activity you did t to see a profit
21 Counted Counted
t victims restitution/Victims of ecution/German Reparation
N/A Not Counted
Not Counted
ostess gift or gratuity 21 Counted Counted
om illegal activities (Schedule C ule-C-EZ)
21 Counted Counted
om the rental of personal (not business income)
21 Counted Counted Rent from real or perproperty not a busine
-Kind (non-taxable fringe Pub 525
N/A Not Counted
Not Counted
ax Refund (Federal and State, if ted on Federal Income Tax)
N/A Not Counted
Not Counted
ancing grants under title IV of the ancing Act of 1974 to expand
king Indian-owned economic s on or near reservations
N/A Not Counted
Not Counted
l Retirement Account (IRA) ns, 1099-R
15b Counted Counted RP - Retirement/ pension
IRA Distributions
e or taxable portion of inherited erited pension
N/A Not Counted
Not Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Interest in1099-INT
Other
nt to d
ents
RKs t
t
Interest ininterest cfederal ra
Other Inc e CalWIN Window
6/16 Update # 16-35
24 Income
come (taxable and non-taxable), 8a & 8b
Counted Counted IN - Interest income (taxable and non-taxable) 1099-INT
• Interest Income
• Contract of sale ofProperty/Interest
• Interest on paymereplace an excluderesource
• Interest portion of Retirement refund
• Loan interest paymreceived by client
• Interest on CalWORestricted Accoun
• Trust Fund InteresDistributed
come not received because the harged was below the applicable te
21 Counted Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
In-Home caregiverprovider wresides wreceives
• In-Hom• Nursin• Person• IHSS P• Comm• IHSS-
In-Home
• Restau• Advanc
Japanesewhether f
Collect Unearned Income Detail
Job Corp
Jury duty Collect Earned Income Detail
Kickback
KinGAP p
Life insurprice, e.gof the ins
Other Inc e CalWIN Window
6/16 Update # 16-35
25 Income
Supportive Services (IHSS) wages paid to an enrolled ho, regardless of relationship,
ith the MC beneficiary who those services from the:
e Operations Waiverg Facility/Acute Hospital Waiveral care Services Programlus Option
unity first Choice OptionResidual Program
N/A Not Counted
Not Counted
N/A
Supportive Services
rant Meals Allowancee Payments for Caregiver
N/A Not Counted
Not Counted
N/A
or Aleutian reparation payment rom the United States or Canada
N/A Not Counted
Not Counted
N/A
s earnings/stipend 21 Counted Counted
pay in excess of costs 21 Counted Counted JD - Jury Duty Pay
Jury Duty/Court
s 21 Counted Counted
ayments N/A Not Counted
Not Counted
N/A
ance proceeds turned over for . surrender in excess of the cost urance
21 Counted Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Life insurincludingpayments
Loan pro Collect Unearned Income Detail
Long-termamount –
Long-term– 1099 LT
Lost, stolpayments
Manufact
Medical S(Archer-M
Military a
Mortgagesection 2
Needs-ba
Netherlan
Net Operfrom othe
Other Inc e CalWIN Window
6/16 Update # 16-35
26 Income
ance proceeds upon death, non-taxable annuity /proceeds
N/A Not Counted
Not Counted
N/A
ceeds N/A Not Counted
Not Counted
care benefits – non-taxable 1099 LTC
N/A Not Counted
Not Counted
care benefits – taxable amount C
21 Counted Counted
en, or damaged property N/A Not Counted
Not Counted
urer incentive payments 21 Counted Counted
avings Account edicare), Pub. 969
21 Counted Counted
llowances N/A Not Counted
Not Counted
assistance payments under 35 of the National Housing Act
N/A Not Counted
Not Counted
sed assistance N/A Not Counted
Not Counted
ds WUV victims of persecution N/A Not Counted
Not Counted
ating Loss Carryover, Subtract r line 21 income, Pub. 536
21 Subtract Losses
Subtract Losses
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Nutrition Assistancfor the El
Ordinary/
rest: t
rest:
Collect Unearned Income Detail
Other gai s), from Collect Unearned Income Detail
Paid Fam
PensionsRetiremeendowmeand taxab
e Collect Unearned Income Detail
ities
t
tirement
Other Inc e CalWIN Window
6/16 Update # 16-35
27 Income
benefits (Supplemental Nutrition e Program, Nutrition Programs derly or Disabled.
N/A Not Counted
Not Counted
qualified dividends, 1099-DIV 9a Counted Counted OQ - Ordinary/qualified dividends, 1099-DIV
• Dividends
• Dividends and inteIrregular/infrequen
• Dividends and inteRegular
ns (or losses), Form 4797 14 Counted Counted OG - Other gains (or losses), Form 4797
Other gains (or losse4797
ily Leave, 1099-G 21 Counted Counted
, Department of Defense nt Board military retirement, nt contracts paid as annuities le annuities, 1099-R
16b Counted Counted RP - Retirement/ pension
• Annuities/InsurancCompany
• Civil Service Annu
• Foreign Pension
• Pension/Retiremenpayments
• Public Employees Retirement
• State Teachers Re
• Military benefits
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Pension pemployeecontributito tax
Physical distress p
Principal
Prizes an awards Collect Unearned Income Detail
Public asassistancgeneral a
Pulitzer, N
Qualified
Qualifiedflexible sp
Radiationpayment
Other Inc e CalWIN Window
6/16 Update # 16-35
28 Income
ayments that were paid by the (such as premiums of ons that were previously subject
N/A Not Counted
Not Counted
injury, illness, or emotional ayments
N/A Not Counted
Not Counted
payments on loans N/A Not Counted
Not Counted
d awards 21 Counted Counted Winnings, prizes and
sistance payments, general e, Bureau of Indian Affairs ssistance
N/A Not Counted
Not Counted
oble or similar prize 21 Counted Counted
Tuition Program, Pub. 970 21 Counted Counted
reservist distribution from health ending account, W-2, Pub 525
21 Counted Counted
exposure compensation N/A Not Counted
Not Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Railroad non-taxab
nt
nt bility
nt Total bility
Collect Unearned Income Detail
Recoveriwhich a cRefunds/itemized
ReemploAssistancagency, 1
Refugee
Refugee program DepartmeJustice su(VOLAG)
Reimbursincurred
ReimbursFee
Other Inc e CalWIN Window
6/16 Update # 16-35
29 Income
retirement benefits (taxable and le), RRB1099
20a & 20b
Counted Counted RB - Railroad retirement benefits (taxable and non- taxable), RRB-1099
• Railroad Retireme
• Railroad RetiremeOccupational DisaBenefit
• Railroad Retireme& Permanent DisaBenefit
es of amounts deducted or for redit was taken an earlier year. reimbursements/rebates of deductions
21 Counted Counted
yment Trade Adjustment e payments made by a state 099-G
21 Counted Counted
cash assistance N/A Not Counted
Not Counted
reception and replacement one-time payments by the nt of State or Department of ch as Voluntary Agency
payments
N/A Not Counted
Not Counted
ements not in excess of costs N/A Not Counted
Not Counted
ement for Employment Agency 21 Counted Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Relocatio Collect Unearned Income Detail
Relocatiodue to floCommun
Rental ofself-empl
ersonal iness
ult unit lling on
ersonal s week
ersonal hours
• Collect Unearned Income Detail
• Collect Earned Income Detail
Rental reS-CorporSchedule
ersonal or
f trade
use of
• Collect Earned Income Detail
• Collect Unearned Income Detail
Renter’s
Other Inc e CalWIN Window
6/16 Update # 16-35
30 Income
n assistance payments N/A Not Counted
Not Counted
n and Rehabilitation payments ods under the Housing and ity Development Act
N/A Not Counted
Not Counted
personal property – not oyment
21 Counted Counted MS-Misc. • Rent from real or pproperty not a bus
• Rent from unit of mdwelling/other dweprop exmt as PR
• Rental other real/pproperty < 20 hour
• Rental other real/pproperty > or = 20 week
al estate, royalties, partnerships, ations, Trusts, etc. (or loss), E
17 Counted Counted RR - Rental or royalty income
• Rent from real or pproperty business appreciable effort
• Royalties as part oor business or frompublication of work
• Royalties paid for property
tax credit (California) N/A Not Counted
Not Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Repaymeof origina
Reverse
Rewards
Ricky Ra
Roth IRAQualified
Salary oremployer
Scholarshnot used
Scholarshused for l
SDI, not tinsurance
Other Inc e CalWIN Window
6/16 Update # 16-35
31 Income
nt of bona fide loan not in excess l loan
N/A Not Counted
Not Counted
Annuity Mortgage N/A Not Counted
Not Counted
21 Counted Counted
y hemophilia relief fund N/A Not Counted
Not Counted
, 401K, 403(b), or 457(b) Distribution
N/A Not Counted
Not Counted
wages from a decedents’ (received by a surviving spouse)
N/A Not Counted
Not Counted
ips, awards, fellowship grants for living expenses, Pub. 970
21 Not Counted
Counted
ips, awards, fellowship grants iving expenses, Pub, 970
21 Counted Counted
reated as unemployment benefits
N/A Not Counted
Not Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Self-empSchedule
on
has r reports
ncome
on
no rly rents ber
no gularly ber
nt to eed item
• Collect Earned Income Detail
• Collect Rental Income Detail
• Collect Room & Board Detail
• Collect Unearned Income Detail
Other Inc e CalWIN Window
6/16 Update # 16-35
32 Income
loyment (in excess of expenses), K-1, Schedule SE
21 Counted Counted SE • Lump sum from trade/business of self-employed pers
• R & B/Room rent: business license oincome for taxes
• Self Employment i
• Lump sum not fromtrade/business of self-employed persnon-recurring
• R & B/Room rent: business lic regulato non-family mem
• R & B/Room rent: business license rerents to family mem
• Third Party paymevendor for a non-n
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Social senon-taxab
isabled
lity
ed Adult
based , or child
Collect Unearned Income Detail
ent Collect Unearned Income Detail
ors
er's
Collect Unearned Income Detail
Sponsor’immigran
State taxstate tax
Other Inc e CalWIN Window
6/16 Update # 16-35
33 Income
curity benefits (taxable and le), SSA-1099
20a & 20b
Counted Counted SD - Social Security Disability
• SSA/RSDI - Blind
• SSA/RSDI: Blind DAdult Child (DAC)
• SSA/RSDI: Disabibenefits
• SSA/RSDI: DisablChild (DAC)
• SSA/RSDI: incomeon parent, spousedisability
SR - Social Security Retirement
• SSA/RSDI: Retirembenefits
SO - Social Security Survivors
• SSA/RSDI: Survivbenefits
• SSA/RSDI: Widowbenefits
s income given to a sponsored t
N/A Not Counted
Not Counted
•
refund in excess of prior year deducted
21 Counted Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
State or FcompensInsuranceunemployRailroad Trade ReUnemploDisaster AssistancUnemploAirline De1099-G
ss
ent gross
Collect Unearned Income Detail
Stolen pr
Strike an earned Collect Unearned Income Detail
SupplemSupplembenefits
Collect Unearned Income Detail
Taxable rstate/loca
izens t
s
Other Inc e CalWIN Window
6/16 Update # 16-35
34 Income
ederal unemployment ation, 1099-G State Disability (SDI), when treated as ment compensation, 1099-G
Unemployment benefits, 1099-G adjustment allowances, 1099-G yment assistance under the Relief and Emergency e Act of 1974, 1099-G yment assistance under the regulation Act of 1974 Program,
19 Counted Counted UE - Unemployment
• UIB: Disaster
• UIB: lump sum gro
• UIB: regular paym
operty received 21 Counted Counted
d lockout benefits 21 Counted Counted UE - Unemployment
• Strike Benefits Un
ental Security Income/State entary Payment (SSI/SSP)
N/A Not Counted
Not Counted
efunds, credits, or offsets of l income taxes
10 Counted Counted TR - Taxable refunds, credits, or offsets of state/local income taxes
• CA FTB Senior CitTax Postponemen
• Income tax Refund
• Property tax refund
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Unearnedexpensescorporatio
Collect Inkind Income Detail
Unemplo
Utility reb
Veteran’sattendanctheir fami
VA agent
VA childre
VA comppayments
VA deathmember after Sep
VA depenbenefits
VA disabithe vetera
VA educaallowance
Other Inc e CalWIN Window
6/16 Update # 16-35
35 Income
income in-kind/personal paid by another, including a n
21 Counted Counted
yment benefits paid by a union 21 Counted Counted
ates 21 Counted Counted
Administration (VA) aid and e benefits paid to the veteran or
lies
N/A Not Counted
Not Counted
orange benefits N/A Not Counted
Not Counted
n with certain birth defects N/A Not Counted
Not Counted
ensated work-therapy program N/A Not Counted
Not Counted
gratuity paid to a survivor of a of the Armed Forces who died tember 10, 2001
N/A Not Counted
Not Counted
dent-care assistance program N/A Not Counted
Not Counted
lity compensation paid either to n or their families
N/A Not Counted
Not Counted
tion, training or subsistence s
N/A Not Counted
Not Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
VA grantswheelcha
VA grantswho lost t
VA insurapaid eithebeneficiaveteran’sdeath
VA insurathe VA
Veteran’sCompens
Veteran’s
VA pensiotheir fami
Veteran’sstate or pservice in
Victims o
Other Inc e CalWIN Window
6/16 Update # 16-35
36 Income
for homes designed for ir living
N/A Not Counted
Not Counted
for motor vehicles for veterans heir sight or the use of their limbs
N/A Not Counted
Not Counted
nce proceeds and dividends r to veterans or their
ries, including the proceeds of a endowment policy paid before
N/A Not Counted
Not Counted
nce interest left on deposit with N/A Not Counted
Not Counted
Filipino Veterans Equity ation Trust
N/A Not Counted
Not Counted
North Vietnam POW/MIA N/A Not Counted
Not Counted
n benefits paid to the veteran or lies
N/A Not Counted
Not Counted
bonus payment paid by any olitical subdivision because of a combat zone
N/A Not Counted
Not Counted
f crimes payments N/A Not Counted
Not Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Vocationaand cashservices,due to dis
Volunteer
• Peace housinfood, a
• Nationsupporfor out-Retired(RSVPor Sen
• Service(SCORservice
• Voluntereimbumeals,trainingcounse
Walker v.
Weatheriemergenheating/c
Whistlebl
Other Inc e CalWIN Window
6/16 Update # 16-35
37 Income
l rehabilitation goods, services received, not in return for but for training and rehabilitation ability
N/A Not Counted
Not Counted
Work amounts:
Corps living allowances for g, utilities, household supplies, nd clothingal Senior Service Corps tive services or reimbursements of-pocket expenses from the Senior Volunteer Program ), Foster Grandparent Program, ior Companion Program Corps of Retired Executives E) amounts for supportive s or out-of-pocket expenseser tax counseling
rsements for transportation, and other expenses you have in for, or actually providing tax ling for the elderly
N/A Not Counted
Not Counted
Bayer payment N/A Not Counted
Not Counted
zation, home energy assistance, cy repair, or replacement of ooling devices
ower’s award 21 Counted Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Withholdioverpaymsource
Work traiamount pgreater thfor public
Worker’sor their su
Workforc
Work traia state wexceed wpublic we
Other Inc e CalWIN Window
6/16 Update # 16-35
38 Income
ng from a benefit to repay an ent from the same income
N/A Not Counted
Not Counted
ning program payments – entire aid by a state welfare agency if an what would otherwise be paid welfare benefits
21 Counted Counted
compensation paid to the worker rvivors
N/A Not Counted
Not Counted
e Investment Act payments N/A Not Counted
Not Counted
ning program payments made by elfare agency if the total does not hat would have been paid in lfare benefits
N/A Not Counted
Not Counted
ome Types or Losses
1040 Line #
MAGI MC APTC
CalHEERS Income Type CalWIN Income Typ
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
17.9.1
The corresponding line on the IRS Form 104
Income D on Type CalWIN Window
Alimony p Collect Other Expense Detail
Businessperformin
es of ing artists
Collect Other Expense Detail
Deductibltax
f tax
Collect Other Expense Detail
Domestic tion Collect Other Expense Detail
Educator es Collect Other Expense Detail
Health Sa ccount Collect Other Expense Detail
6/16 Update # 16-35
39 Income
Deductions and Expenses
following table provides various deduction types for MAGI MC and APTC, including its0.
Table 17-2: Income Deduction Types from IRS Form 1040
eduction Types1040 Line #
MAGI MC APTC
CalHEERS Deduction Type CalWIN Deducti
aid 31a Deducted Deducted AL- Alimony Alimony Paid
expenses of reservists, g artists, etc.
24 Deducted Deducted BE -Business expenses of reservists, performing artists, etc.
Business expensreservists perform
e part of self-employment 27 Deducted Deducted DS- Deductible part of self-employment tax
Deductible part oself-employment
production activities 35 Deducted Deducted DP- Domestic production activities
Domestic ProducActivities
expenses 23 Deducted Deducted EE- Educator expenses
Educator expens
vings Account 25 Deducted Deducted HS- Health Savings Account
Health Savings A
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Hobby incexpensesnot expec
fit activity Collect Other Expense Detail
IRA dedu Collect Other Expense Detail
Moving e Collect Other Expense Detail
Penalty osavings
withdrawal Collect Other Expense Detail
Rental of expenses
l property Collect Other Expense Detail
Self-empldeduction
alth ion
Collect Other Expense Detail
Income D on Type CalWIN Window
6/16 Update # 16-35
40 Income
ome expenses, or from an activity you did t to see a profit
Deducted Deducted HE- Hobby income expenses, or expenses from an activity you did not expect to see a profit
Hobby or non-proexpenses
ction 32 Deducted Deducted ID- IRA deduction
IRA Deduction
xpenses 26 Deducted Deducted ME- Moving Expenses
Moving Expenses
n early withdrawal of 30 Deducted Deducted EW- Penalty on early withdrawal of savings
Penalty on early of savings
personal property Deducted Deducted PP- Rental of personal property expenses
Rental of personaexpenses
oyed health insurance 29 Deducted Deducted SH- Self-employed health insurance deduction
Self-employed heinsurance deduct
eduction Types1040 Line #
MAGI MC APTC
CalHEERS Deduction Type CalWIN Deducti
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Self-EmpSimple, a
nt
nt ries
nt
nt Labor
nt Property iums
nt Business
nt Room & s
nt Farming es
nt Other enses
nt Raw ds
nt
Collect Other Expense Detail
Income D on Type CalWIN Window
6/16 Update # 16-35
41 Income
loyment Pension (SEP), nd qualified deduction
28 Deducted Deducted QD - Self-employed SEP, Simple, and qualified deduction
• Self-EmploymeDepreciation
• Self-EmploymeEmployee Sala
• Self-EmploymeEntertainment
• Self-EmploymeCosts
• Self-EmploymeInsurance Prem
• Self EmploymeLicense
• Self-EmploymeBoard Expense
• Self-Employme& Fishing Loss
• Self-EmploymeNecessary Exp
• Self-EmploymeMaterial & Goo
• Self EmploymeTransportation
eduction Types1040 Line #
MAGI MC APTC
CalHEERS Deduction Type CalWIN Deducti
Revised: 10/2
page 17- Medi-Cal HandbookMAGI MC
Student lo rest • Collect Income Expense Detail (student)
• Collect Other Expense Detail
Tuition an(not paid
ellaneous
datory Fees
ion
Collect Income Expense Detail (student)
Income D on Type CalWIN Window
6/16 Update # 16-35
42 Income
an interest 33 Deducted Deducted SL- Student loan interest
Student loan inte
d fees paid by individual by financial aid)
36 Deducted Deducted TF - Tuition and fees paid by individual (not paid by financial aid)
• Education MiscExpenses
• Education Man
• Education Tuit
eduction Types1040 Line #
MAGI MC APTC
CalHEERS Deduction Type CalWIN Deducti
Medi-Cal Handbook page 17-43MAGI MC Income
17.10CalWIN Income and Expenses NOT Mapped to CalHEERS
The following tables contain CalWIN Income and Expense Types that are not mapped to any value in CalHEERS and therefore will not count for MAGI MC or APTC/CSR. These Income Types may NOT count for MAGI MC or APTC/CSR due to CalHEERS functionality limitations. Ensure countable income is included in the final eligibility determination. [Refer to Budgeting Ch. 9]
Example:Income Type: Net Countable Income for Medi-Cal is entered in order to count the income for MC but not for another program. This Income Type will NOT count for MAGI MC or APTC/CSR.
17.10.1 Income
Table 17-3: CalWIN Income Types NOT Mapped to CalHEERS
CalWIN Income Type Window in CalWIN
Adoption Assistance Program Income Collect Unearned Income Detail
Ball v. Swoap payments Collect Unearned Income Detail
Basic Education Oppt Grant-BEOG • Collect Unearned Income Detail
• Display Student Financial Aid Detail
BIA • Collect Unearned Income Detail
• Display Student Financial Aid Detail
BIA Educational Grants/Loans • Collect Unearned Income Detail
• Display Student Financial Aid Detail
Black Lung Collect Unearned Income Detail
BOGG • Collect Unearned Income Detail
• Display Student Financial Aid Detail
Bureau of Indian Affairs general assistance payments (BIAGA)
Collect Unearned Income Detail
CA Franchise Tax Board Renter's Credit Collect Unearned Income Detail
Update # 16-35 Revised: 10/26/16
page 17-44 Medi-Cal HandbookMAGI MC Income
Cal Grant A • Collect Unearned Income Detail
• Display Student Financial Aid Detail
Cal Grant B • Collect Unearned Income Detail
• Display Student Financial Aid Detail
Cal Grant C • Collect Unearned Income Detail
• Display Student Financial Aid Detail
Cal-learn Bonus • Collect Unearned Income Detail
• Display Student Financial Aid Detail
CalWORKs Collect Unearned Income Detail
CalWORKs Diversion (Diversion period is greater than 4 months)
Collect Unearned Income Detail
CalWORKs Diversion (Diversion period is less than 4 months)
Collect Unearned Income Detail
CalWORKs Homeless Assistance Collect Unearned Income Detail
CAPI Collect Unearned Income Detail
CAPI ISM Collect Unearned Income Detail
Carl D Perkins Loan • Collect Unearned Income Detail
• Display Student Financial Aid Detail
Cash Contributions Private Non Profit Collect Unearned Income Detail
Cash Contributions Public Non Profit Collect Unearned Income Detail
CGSL: California Guaranteed Student Loan • Collect Unearned Income Detail
• Display Student Financial Aid Detail
Child/Spousal Support DA-Current Disregard • Collect Child/Spousal Detail
• Collect Unearned Income Detail
Child/Spousal Support DA-Excess Collect Child/Spousal Detail
Child/Spousal Support DA-Pass-On Paid to Client Collect Child/Spousal Detail
Child/Spousal Support DA-Prior Disregard Collect Child/Spousal Detail
Child/Spousal Support DA-Prior Retained Collect Child/Spousal Detail
Child/Spousal Support Direct From A/P or DA Collect Child/Spousal Detail
College Assistant Migrant Program Display Student Financial Aid Detail
CalWIN Income Type Window in CalWIN
Revised: 10/26/16 Update # 16-35
Medi-Cal Handbook page 17-45MAGI MC Income
CW/FS Non-MFG Direct Child Support EXEMPT for Food Stamps
Collect Child/Spousal Detail
Disaster Relief and Disaster Emergency Assistance payments
Collect Unearned Income Detail
Education Awards/Scholarships for Teens Display Student Financial Aid Detail
Energy Crisis Assistance-Energy Conserv. Prog./Low Inc. Energy Assist.
Collect Unearned Income Detail
Executive Volunteer Program Payment for supportive services
• Collect Earned Income Detail
• Collect Unearned Income Detail
FFEL: Federal Family Education Loan • Collect Unearned Income Detail
• Display Student Financial Aid Detail
FISL: Federally Insured Student Loans Display Student Financial Aid Detail
Foster Care Collect Unearned Income Detail
GA/GR Collect Unearned Income Detail
GA/GR Grant Amount Prior to CW eligibility Collect Unearned Income Detail
GA/GR Other Exempt Collect Unearned Income Detail
GA/GR Other Non-exempt Collect Unearned Income Detail
Gifts: Cash Collect Unearned Income Detail
Holocaust Restitution Payment Collect Unearned Income Detail
Holocaust Restitution Payment: interest on retained funds Collect Unearned Income Detail
In kind for CAAP - Other Collect Inkind Income Detail
In kind for CAAP - Stabilization Collect Inkind Income Detail
In kind for CAAP GA Collect Inkind Income Detail
In kind for CAAP SSIP, CALM, PAES Collect Inkind Income Detail
In Kind Housing-shared w/1 GA Collect Inkind Income Detail
In Kind Housing-shared w/2 GA Collect Inkind Income Detail
In Kind Housing-shared w/3 GA Collect Inkind Income Detail
In-Kind Clothing Collect Inkind Income Detail
In-Kind Food Collect Inkind Income Detail
In-Kind Housing Collect Inkind Income Detail
In-Kind Utilities Collect Inkind Income Detail
CalWIN Income Type Window in CalWIN
Update # 16-35 Revised: 10/26/16
page 17-46 Medi-Cal HandbookMAGI MC Income
Japanese-American/Aleutians Restitution Payment Collect Unearned Income Detail
KinGAP Collect Unearned Income Detail
Life ins/death benefits: individual beneficiary not owner of policy
Collect Unearned Income Detail
Life ins/death benefits: individual is beneficiary and owner of policy
Collect Unearned Income Detail
Loan principal payments received by client Collect Unearned Income Detail
Manual Cash Grant Collect Unearned Income Detail
MFG - Child Support • Collect Unearned Income Detail
• Collect Child/Spousal Detail
MFG - SSA Disability from Absent Parent • Collect Unearned Income Detail
• Collect Child/Spousal Detail
National Science Scholars Program • Collect Unearned Income Detail
• Display Student Financial Aid Detail
NDSL: National Direct Student Loan • Collect Unearned Income Detail
• Display Student Financial Aid Detail
Net Countable Income for CalWORKs Collect Unearned Income Detail
Net Countable Income for CAPI Collect Unearned Income Detail
Net Countable Income for Food Stamps Collect Unearned Income Detail
Net Countable Income for Foster Care Collect Unearned Income Detail
Net Countable Income for General Assistance Collect Unearned Income Detail
Net Countable Income for IHSS Collect Unearned Income Detail
Net Countable Income for KinGAP Collect Unearned Income Detail
Net Countable Income for Medi-Cal Collect Unearned Income Detail
Net Countable Income for Medi-Cal-CMSP Collect Unearned Income Detail
Net Countable Income for RCA Collect Unearned Income Detail
Other Education loans, grants, scholarships, fellowships Non-exempt
Display Student Financial Aid Detail
Other Education loans, grants, scholarships, fellowships, Exempt
Display Student Financial Aid Detail
Other Government disability Collect Unearned Income Detail
CalWIN Income Type Window in CalWIN
Revised: 10/26/16 Update # 16-35
Medi-Cal Handbook page 17-47MAGI MC Income
Paul Douglas Teacher Scholarship Program • Collect Unearned Income Detail
• Display Student Financial Aid Detail
Pell Grant • Collect Unearned Income Detail
• Display Student Financial Aid Detail
PLUS: Parent Loan Student Program • Collect Unearned Income Detail
• Display Student Financial Aid Detail
Radiation Exposure Compensation Collect Unearned Income Detail
RCA: Refugee Cash Assistance Collect Unearned Income Detail
Reimbursements or Advances that do not exceed Expenses
• Collect Earned Income Detail
• Collect Unearned Income Detail
Relocation Assistance Payments Collect Unearned Income Detail
Retroactive SSI/SSP, including lump sums Collect Unearned Income Detail
Ricky Ray Hemophilia Relief Fund Act Payments Collect Unearned Income Detail
SDI/DIB/FMLA Gross Collect Unearned Income Detail
SEOG: Supplemental Educational Opportunity Grant Pgm
• Collect Unearned Income Detail
• Display Student Financial Aid Detail
SLS: Supplemental Loans For Students • Collect Unearned Income Detail
• Display Student Financial Aid Detail
SSI Only - Aged Collect Unearned Income Detail
SSI Only - Blind Collect Unearned Income Detail
SSI Only - Disabled Collect Unearned Income Detail
SSI/SSP or SSP only - Aged Collect Unearned Income Detail
SSI/SSP or SSP only - Blind Collect Unearned Income Detail
SSI/SSP or SSP only - Disabled Collect Unearned Income Detail
SSIG: State Student Incentive Grants • Collect Unearned Income Detail
• Display Student Financial Aid Detail
Stafford Loan Subsidized/Unsubsidized • Collect Unearned Income Detail
• Display Student Financial Aid Detail
Susan Walker v Bayer Corp payments Collect Unearned Income Detail
TANF Out Of State Collect Unearned Income Detail
CalWIN Income Type Window in CalWIN
Update # 16-35 Revised: 10/26/16
page 17-48 Medi-Cal HandbookMAGI MC Income
Title IV Educational Grant/Loan • Collect Unearned Income Detail
• Display Student Financial Aid Detail
Training Allowance from Ancillary Payment Collect Unearned Income Detail
Training incentive payments/work allowances under Manpower programs
Collect Earned Income Detail
Tribal TANF funds - CE Collect Unearned Income Detail
Tribal TANF funds - not CE Collect Unearned Income Detail
Victims of Crime Program Collect Unearned Income Detail
Work Incentive Collect Earned Income Detail
Work Study CalWORKs • Collect Earned Income Detail
• Display Student Financial Aid Detail
Work Study State/Federal • Collect Earned Income Detail
• Display Student Financial Aid Detail
Worker's Compensation - Permanent Collect Unearned Income Detail
Worker's Compensation - Temporary Collect Unearned Income Detail
Worker's Compensation - Vocational Rehab Collect Unearned Income Detail
CalWIN Income Type Window in CalWIN
Revised: 10/26/16 Update # 16-35
Medi-Cal Handbook page 17-49MAGI MC Income
17.10.2 Expenses
Table 17-4: CalWIN Expenses NOT Mapped to CalHEERS
CalWIN Expense Type Window in CalWIN
Apartment/House/Condo/Trailer,etc. Rent
Blind Work Expenses • Collect Income Expense Detail
• Collect Other Expense Detail
Board and Care • Collect Medical Expense Detail
Car Pool • Collect Income Expense Detail
• Collect Income Expense Detail (student)
Child/Dependent Care Collect Income Expense Detail
Child/Spousal Support paid • Collect Income Expense Detail
• Collect Other Expense Detail
Coal Display Shelter/Food Expense Detail
Coal Oil Display Shelter/Food Expense Detail
Condominium Fees
Conservator/Guardian fees • Collect Income Expense Detail
• Collect Other Expense Detail
Education Books and Supplies Collect Income Expense Detail (student)
Education Dependent/Child Care Collect Income Expense Detail (student)
Education Equipment and Supplies Collect Income Expense Detail (student)
Education Food & Housing Collect Income Expense Detail (student)
Education Loan Origination Fees Collect Income Expense Detail (student)
Education Special Clothing Collect Income Expense Detail (student)
Education Transportation Collect Income Expense Detail (student)
Electricity Display Shelter/Food Expense Detail
Update # 16-35 Revised: 10/26/16
page 17-50 Medi-Cal HandbookMAGI MC Income
Energy Assistance Display Shelter/Food Expense Detail
Equipment and Property Rental • Collect Income Expense Detail
• Collect Other Expense Detail
Federal/State Tax • Collect Income Expense Detail
• Collect Other Expense Detail
Fees necessary to obtain income • Collect Income Expense Detail
• Collect Other Expense Detail
FICA • Collect Income Expense Detail
• Collect Other Expense Detail
Firewood Display Shelter/Food Expense Detail
Food
Food and Shelter
Funeral/Cremation/Burial Collect Other Expense Detail
Garbage Display Shelter/Food Expense Detail
Gas Display Shelter/Food Expense Detail
IHSS SOC pd to provider: family member in the home • Collect Income Expense Detail
• Collect Medical Expense Detail
IHSS SOC pd to provider: not family member in home • Collect Income Expense Detail
• Collect Medical Expense Detail
Impairment Related Work Expenses • Collect Income Expense Detail
• Collect Other Expense Detail
Interest on Loans for Capital Assets or Goods • Collect Income Expense Detail
• Collect Other Expense Detail
Interest on real property loan • Collect Income Expense Detail
• Collect Other Expense Detail
Legal Fees • Collect Income Expense Detail
• Collect Other Expense Detail
Mandatory Homeowners Assoc. Fees
Mandatory Payroll Deductions • Collect Income Expense Detail
• Collect Other Expense Detail
CalWIN Expense Type Window in CalWIN
Revised: 10/26/16 Update # 16-35
Medi-Cal Handbook page 17-51MAGI MC Income
Meals • Collect Income Expense Detail
• Collect Other Expense Detail
Medical Expenses not Covered by Insurance • Collect Income Expense Detail
• Collect Medical Expense Detail
Medical Insurance - Involuntary • Collect Income Expense Detail
• Collect Medical Expense Detail
Medical Premiums • Collect Income Expense Detail
• Collect Medical Expense Detail
Medicare Premiums - Part A
Medicare Premiums - Part B
Mortgage
Natural Gas Display Shelter/Food Expense Detail
Other Benefit Overpayment Adjustment
Other Tax deductions Collect Other Expense Detail
Other Utilities Display Shelter/Food Expense Detail
Phone/Internet/Other Communication-Standard • Collect Income Expense Detail
• Display Shelter/Food Expense Detail
Propane/Butane Display Shelter/Food Expense Detail
Property Taxes and Assessments • Collect Income Expense Detail
• Collect Other Expense Detail
Public Transportation - Bus • Collect Income Expense Detail
• Collect Other Expense Detail
Public Transportation - Train • Collect Income Expense Detail
• Collect Other Expense Detail
Real Property Insurance Premiums • Collect Income Expense Detail
• Collect Other Expense Detail
Real/Rental Property Upkeep & Repairs • Collect Income Expense Detail
• Collect Other Expense Detail
SDI/DIB Overpayment Adjustment Client Caused • Collect Income Expense Detail
• Collect Other Expense Detail
CalWIN Expense Type Window in CalWIN
Update # 16-35 Revised: 10/26/16
page 17-52 Medi-Cal HandbookMAGI MC Income
SDI/DIB Overpayment Adjustment not Client Caused • Collect Income Expense Detail
• Collect Other Expense Detail
Septic Tank Display Shelter/Food Expense Detail
Sewer Display Shelter/Food Expense Detail
Space Rent
Sponsor's Rental Expenses Collect Other Expense Detail
SSA/RSDI Insurance Overpayment Adjustment Collect Other Expense Detail
Support for a Disabled Relative • Collect Income Expense Detail
• Collect Other Expense Detail
Tips Allocated but Not Received • Collect Income Expense Detail
• Collect Other Expense Detail
UIB Overpayment Adjustment Client Caused Collect Other Expense Detail
UIB Overpayment Adjustment not Client Caused Collect Other Expense Detail
Unreimbursed Cost of Home Repair Due to Disaster Collect Other Expense Detail
Utility
Water Display Shelter/Food Expense Detail
Wood Pellets Display Shelter/Food Expense Detail
CalWIN Expense Type Window in CalWIN
Revised: 10/26/16 Update # 16-35
Medi-Cal Handbook page 17-53MAGI MC Income
Table 17-5: Income Types NOT Counted
(Not found in IRS Form 1040 or in CALWIN income windows)
Non-Income Types Also Known As
$25 weekly supplement to unemployment compensation payment authorized by the American Recovery and reinvestment Act of 2009
Accelerated death benefits/viatical settlements if the insured is chronically ill for costs of qualified long-term care or if the insured is terminally ill not in excess of limit
Austrian general social insurance payments
CalFresh benefits
Cancellation of non-business debt:
intended as a gift,
amounts not in excess of insolvency, or
amounts discharged in bankruptcy or,
with regard to mortgage cancellation, not in excess of the cost of your principal residence plus improvements, 1099-C
Carpool payments
Clergy housing and utility allowance not in excess of market rate and actual cost respectively
Clinical trials participation to the extent of expenses incurred plus $2,000
Court awards/judgments/settlements for personal injury or sickness/emotional distress and other compensatory property damages. This does not include compensation for lost wages/profits, breach of contract, pension rights, interest on awards, patent or copyright infringement, or punitive damages.
Disability Income -untaxed (untaxed private disability income insurance -premiums not paid by employer) Pubs 525 and 907
Disability payments received for injuries resulting directly from a terrorist or military action, not including training exercises
Diversion cash assistance
Down payment assistance
Update # 16-35 Revised: 10/26/16
page 17-54 Medi-Cal HandbookMAGI MC Income
Earned income tax credit • Earned Income Tax Credit: actual...
• Earned Income Tax Credit: received...
Economic stimulus payments (federal)
Employer contributions to certain pretax benefits funded by an employee’s elective salary reduction,
Contributions earmarked
Endowment Contracts paid as a lump sum before death not in excess of costs, or paid upon death to a beneficiary
Federal Income Tax Return Income Tax refund
Fringe benefits provided on a pre-tax basis by an employer, such as transportation benefits, parking, or moving expenses
Home and Community Based Waiver Caregiver Wages
Housing and Urban Development Section 8 Rental Vouchers or Benefits
Federal Housing Assistance
In-Home Supportive Services
• Restaurant Meals Allowance
• Advance Payments for Caregiver
• IHSS Advance pay to IPW recipient-New Affid
• IHSS Advance pay to IPW recipient-Old/No Affid
• IHSS Advance pay to Residual recipient-New Affid
• IHSS Advance pay to Residual recipient-Old/No Affid
Income Tax Refund – Federal Income Tax Refund – State – if not deducted on Federal Income Tax in which case it would be income
Income Tax refund
Indian financing grants under title IV of the Indian Financing Act of 1974 to expand profit-making Indian-owned economic enterprises on or near reservations
Inheritance or taxable portion of inherited IRA or inherited pension
Inheritance in form of cash, securities or other liquid assets
Loan proceeds
Long-Term Care benefits (LTC) – non-taxable amount 1099-LTC
Lost, stolen or damaged property payments
Military allowances (BAH, BAS) Military Benefits
Non-Income Types Also Known As
Revised: 10/26/16 Update # 16-35
Medi-Cal Handbook page 17-55MAGI MC Income
Military hostile fire/imminent danger pay
Mortgage assistance payments under section 235 of the National Housing Act
Needs-based assistance
Netherlands WUV victims of persecution
Nutrition benefits (Supplemental Nutrition Assistance Program, Nutrition Programs for the Elderly or Disabled)
Pension payments that were paid by the employee (such as premiums or contributions) that were previously subject to tax
Physical injury, illness or emotional distress payments
Refugee reception and replacement program one-time payments by the Dept. of State or Dept. of Justice, such as Voluntary Agency (VOLAG) payments
VOLAG Resettlement Income
Renter’s tax credit (California)
Repayment of bona fide loan not in excess of original loan
Reverse Annuity Mortgage
Roth IRA, 401K, 403(b), or 457(b) Qualified Distribution
• IRA Distribution
• 401K Interest Income
• 401k Principal Income
Sponsor’s income given to a sponsored immigrant
Veteran’s Administration (VA) aid and attendance benefits paid to the veteran or their families
• Vet A&A Paymt recvd by non Pickle person for care of Pickle fam mem
• Vet A&A Paymt recvd for care of one who is not a Pickle-elig fam mem
• Veteran's A&A Payments received by the surviving spouse of a veteran
• Veteran's A&A Payments received by the veteran
Veteran’s Administration agent orange benefits Agent Orange Settlements
Veteran’s Administration children with certain birth defects
Non-Income Types Also Known As
Update # 16-35 Revised: 10/26/16
page 17-56 Medi-Cal HandbookMAGI MC Income
Veteran’s Administration compensated work-therapy program payments
Veteran’s Administration death gratuity paid to a survivor of a member of the Armed Forces who died after September 10, 2001.
Veteran’s Administration dependent-care assistance program benefits
Veteran’s Administration disability compensation paid either to the veteran or their families
Veteran's Benefits-Disability
Veteran’s Administration education, training or subsistence allowances and allowances
• Veterans Education Assistance Program (VEAP)
• Veterans Education GI Bill
• Veterans Student Service Program
Veteran’s Administration grants for homes designed for wheelchair living
Veteran’s Administration grants for motor vehicles for veterans who lost their sight or the use of their limbs.
Veteran’s Administration insurance interest left on deposit with the VA
Veteran’s Administration insurance proceeds and dividends paid either to veterans or their beneficiaries, including the proceeds of a veteran’s endowment policy paid before death
Veteran’s Administration pension benefits paid to the veteran or their families
Veterans Benefits/Pensions
Veteran’s bonus payment paid by any state or political subdivision because of service in a combat zone
Increase due to deployment to combat zone
Veteran’s Filipino Veterans Equity Compensation Trust
Veteran’s North Vietnam POW/MIA Compensation (FED) to persons captured/interned by North Vietnam
Vocational rehabilitation goods, services and cash received, not in return for services, but for training and rehabilitation due to disability
Non-Income Types Also Known As
Revised: 10/26/16 Update # 16-35
Medi-Cal Handbook page 17-57MAGI MC Income
Volunteer Work Amounts:
Peace Corps living allowances for housing, utilities, household supplies, food and clothing
Nat’l Senior Service Corps supportive services or reimbursements for out-of-pocket expenses from the Retired Senior Volunteer Program (RSVP); Foster Grandparent Program; or Senior Companion Program.
Service Corps of Retired Executives (SCORE) amounts for supportive services or out-of-pockets expenses
Volunteer tax counseling reimbursements for transportation, meals, and other expenses you have in training for, or actually providing tax counseling for the elderly.
Weatherization, home energy assistance, emergency repair or replacement of heating/cooling devices
Withholding from a benefit to repay an overpayment from the same income source
Workforce Investment Act payments
Non-Income Types Also Known As
Update # 16-35 Revised: 10/26/16