Effective April 1, 2021, ADAP will use the 2021 U.S. Department of Health and Human Services Federal Poverty Level (FPL).
For Modified Adjusted Gross Income (MAGI) Medi-Cal referral, $17,775 (138% of FPL)represents the maximum income level for MAGI Medi-Cal for a family size of one. Additional maximum income levels for clients with family sizes greater than one are provided on page three for your reference.
California State Tax Returns
The cutoff date for accepting 2019 state tax returns for income documentation for ADAP and PrEP-AP eligibility is April 15, 2021. After this date only 2020 state taxes will be accepted unless proof of an extension is provided.
Internal Revenue Service Federal Tax Returns
The cutoff date for accepting 2019 federal tax returns for income documentation for ADAP and PrEP-AP eligibility is May 17, 2021. After this date, only 2020 federal tax returns will be accepted unless proof of an extension is provided.
Please contact your OA Advisor if you have any questions regarding the information provided in this memo.
Thank you,
Sharisse Kemp, MSW
ADAP Branch Chief
California Department of Public Health
Enclosure
2021 Federal Poverty Guidelines
1
| $12,880
| $17,775
| $64,400
|
ā2
| ā$17,420
| ā$24,040
| ā $87,100
|
ā3
| ā$21,960
| ā$30,305
| ā$109,800
|
| 4ā | ā$26,500
| ā$36,570
| ā$132,500
|
ā5
| ā$31,040
| ā$42,836
| ā$155,200
|
ā6
| ā$35,580
| ā$49,101
| ā$177,900
|
ā7
| ā$40,120
| ā$55,366
| ā$200,600
|
ā8
| ā$44,660
| ā$61,631
| ā$223,300
|
For families/households with more than 8 persons, add $4,540 for each additional person.
*Modified Adjusted Gross Income