Applications Received For Insurance Affordability Programs Through Other Eligibility Pathways

The number of Insurance Affordability Programs (IAPs) applications received through other eligibility pathways. Other eligibility pathways include applications transferred through transition from Advanced Premium Tax Credits (APTC) to Medi-Cal, as well as applications submitted through Hospital Presumptive Eligibility (HPE), through Express Lane, or the Medi-Cal Access Program (MCAP) during a reporting period. APTC to Medi-Cal batch data is reported by CalHEERS and MEDS and consists of individuals who are no longer eligible for APTC but are eligible for Medi-Cal. Another eligibility pathway is Express Lane Eligibility (ELE), which is a program that waives the need for a Medi-Cal eligibility determination for 12 months if the individual is enrolled in CalFresh. Hospital Presumptive Eligibility (HPE) applications are submitted through qualified HPE Providers. ELE and HPE data are reported by DHCS and commencing with this report, MCAP applications are reported by MAXIMUS Inc. This dataset is part of public reporting requirements of set forth in the California Welfare and Institutions Code 14102.5.

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Data and Resources

Additional Info

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Field Value
Contact Email [email protected]
Program Medi-Cal Eligibility Division / Program Review Branch / Data Analytics Section
Homepage URL http://www.dhcs.ca.gov
Temporal Coverage

2016 Quarter 1 to 2023 Quarter 4
Spatial/Geographic Coverage

California
Geographic Granularity Statewide
Language English
Frequency Quarterly
De-Identification Method

http://www.dhcs.ca.gov/dataandstats/Pages/PublicReportingGuidelines.aspx
Data Collection Tool

CALHEERS and MEDS
License Terms of Use
Limitations Use of this data is subject to the CHHS Terms of Use and any copyright and proprietary notices incorporated in or accompanying the individual files.
Additional Limitations

Some presented eligible counts are considered preliminary and subject to change. Eligibility for Medi-Cal may occur retroactively and it may take time for eligibility determinations to be processed and reported to DHCS. As such, eligibility data is approximately 96% complete for the current month, 98% complete within one month, and over 99% complete within 2 months. Eligibility counts for a specific month are considered complete for statistical reporting purposes 12 months after the month’s end.
Last Updated March 26, 2024, 22:07 (UTC)