What happens if I don't report my income change to Medi-Cal?

If you don't report an income increase to Medi-Cal, you risk having your benefits reduced or stopped and may face costly repayments for overpaid benefits, as well as potential penalties or even fraud charges for intentionally hiding income, leading to coverage loss, and needing to pay back advance subsidies from Covered California. You must report changes within 10 days to your county office to keep your benefits accurate and avoid financial penalties.

Do you have to report income changes to Medi-Cal?

If your income, address, or household situation changes at any time during the year, please report these changes within 10 days rather than waiting for the annual renewal process.

What happens if you forget to update income Medi-Cal?

If you don't report the change, you could have to pay money back when you file your federal tax return. The amount you pay for your health insurance every month. In addition to your premium, you usually have to pay other costs for your health care, including a deductible, copayments, and coinsurance.

What happens if you accidentally forgot to report income?

Often, the IRS will recalculate your tax return by including the missing income and determining the amount of tax they think that you owe. This can include penalties and interest. If you realize that you didn't include some income on your tax return, you can file an amended return that includes the missing information.

How does Medi-Cal verify your income?

Medi-Cal verifies income electronically through databases like the IRS and EDD, but if there are discrepancies or data isn't found, they'll request documents like recent pay stubs, tax returns, employer letters, or bank statements to confirm earned (wages, self-employment) and unearned (benefits, pensions) income for eligibility, often asking for proof from the last 90 days or previous tax year. 

How Do I Report Changes to My Medi-Cal Application? - InsuranceGuide360.com

How often does Medicaid check your income?

They will check when you submit an application and on an annual basis, but checks can occur at any time. While agencies can look at account balances, they can't view your personal bank statements. Other information used to determine Medicaid eligibility often comes from public records.

What is the 3 month rule for Medi-Cal?

An applicant for MC, CW, SSI/SSP, or RCA may be eligible to receive MC for any of the three (3) months immediately before the month of application. Any written request for retroactive coverage must be considered an application.

Can I get in trouble for not reporting income?

In California, it is illegal to intentionally pay less than you owe on your taxes. This means that if you are filing a personal tax return, you can't intentionally under-report your income, lie on your tax return or fail to file a tax return altogether. Doing so is criminal tax fraud.

What happens if I forget to report my income?

If you don't report every 2 weeks, your payment will stop. We'll tell you which dates you must report on and when your reporting will start. If you report late, your payment will be late. If your Centrelink online account is linked to myGov, sign in now to report your income.

What are the biggest tax mistakes people make?

Avoid These Common Tax Mistakes

• Not Claiming All of Your Credits and Deductions. ...
• Not Being Aware of Tax Considerations for the Military. ...
• Not Keeping Up with Your Paperwork. ...
• Not Double Checking Your Forms for Errors. ...
• Not Adhering to Filing Deadlines or Not Filing at All. ...
• Not Fixing Past Mistakes. ...
• Not Planning for Next Year.

What happens if you lie to Medi-Cal?

When claim or amount at issue is $950 or less: Misdemeanor - six months county jail and/or $1,000 fine.

Will I have to pay back Medi-Cal?

You generally don't have to pay back regular Medi-Cal benefits while alive, but California's Dept. of Health Care Services (DHCS) may seek repayment from your estate after your death for certain costs, especially if you were 55 or older and had assets. Exceptions exist, and you might owe if you had specific services like long-term care, or if you had an overpayment. For most people, paying back Medi-Cal isn't a concern unless there's a serious issue like an overpayment or a large estate claim after death. 

What triggers a Medicaid investigation?

Common red flags that trigger investigations

Phantom billing: Submitting claims for services that were never actually provided. Kickback arrangements: Exchanging money or benefits for patient referrals. Duplicate billing: Sending the same claim more than once to obtain multiple payments.

Does Medi-Cal check your tax returns?

To qualify for Medi-Cal, you must live in the state of California and meet certain rules. You must give income and tax filing status information for everyone who is in your family and is on your tax return. You also may need to give information about your property. You do not have to file taxes to qualify for Medi-Cal.

Does Medi-Cal check your bank account?

Yes, Medi-Cal can and does check bank accounts through automated systems (Asset Verification System) to verify financial eligibility, though rules changed in 2024, removing asset limits for most, but not all, programs; however, for Long-Term Care (LTC) or if you have a disability/are over 65, assets and bank balances are still reviewed, and you must report income accurately to avoid issues, as they can match your SSN to accounts for audits. 

What happens if I don't report earnings?

Unreported Income IRS Penalties

If you forgot to report side income taxes, the IRS charges several penalties depending on the situation. Here are the main ones: Failure-to-file penalty: 5% of the unpaid tax per month, up to 25%. Failure-to-pay penalty: 0.5% of the unpaid tax per month, up to 25%.

How much income can I not report?

The minimum income amount to file taxes depends on your filing status and age. For 2025, the minimum income for Single filing status for filers under age 65 is $15,750 . If your income is below that threshold, you generally do not need to file a federal tax return.

Does IRS catch all unreported income?

IRS audit unreported income is a primary reason taxpayers face examination. The IRS uses automated systems and third-party reporting to detect income you failed to report. Understanding these triggers is key to staying compliant.

What happens if income is not declared?

What are the penalties for not declaring income? Penalties for tax evasion vary depending on the severity. For most accused of or who come forward for not declaring income, the penalties are not as harsh. You usually have to repay the amount of tax due plus interest.

How do I report income change to Medi-Cal?

To report an income change to Medi-Cal, you must update your information within 10 days via BenefitsCal.com, your local county Medi-Cal office (in-person, phone, mail), or through your Covered California account if enrolled there, using options like online portals, apps, or direct contact to ensure continued eligibility and avoid losing coverage. 

What is the new law for Medi-Cal in California?

California has several new medical laws effective in late 2025/early 2026, focusing on privacy (shielding reproductive health info), private equity oversight (restricting PE/hedge fund influence in physician practices via SB 351), Medi-Cal access (SB 530 improving provider directories), and prescription reporting (removing testosterone/mifepristone from CURES system by AB 82), alongside changes to Covered California subsidies and the return of Medi-Cal asset tests, impacting access and affordability. 

How far back does Medi-Cal look at income?

What if I transfer assets and need long-term care? If you move into a nursing home, Medi-Cal will look at any assets you gave away in the 30 months before you entered the facility. This is called a look-back period.