California Notice of Action Medi-Cal: How to Read and Respond
What a Notice of Action Is
A Notice of Action (NOA) is the official letter your parent's county welfare department sends whenever it makes a decision about their Medi-Cal or Medicare Savings Program case. Approvals, denials, benefit changes, and discontinuances all come as NOAs. The letter is generated automatically by CalSAWS and arrives by mail.
The front page states the action being taken, the effective date, and the regulatory basis for the decision. The back of the notice — sometimes called the "NA Back 9" — contains appeal instructions, hearing request deadlines, and a brief explanation of your parent's rights.
If your parent receives a NOA and you do not have an authorized representative designation (Form MC 382) on file, the county sent the notice only to your parent. You may not even know a denial happened until your parent mentions it or you notice the Part B premium is still being deducted months later.
Reading the Key Parts
The action line. This tells you what the county did: approved coverage, denied the application, discontinued existing coverage, or changed the benefit level. For MSP cases, you are looking for language about Aid Code 80 (QMB), 8C (SLMB), 8D (QI), or 8A (QDWI).
The reason. The NOA states why the action was taken, typically referencing a section of the California Welfare and Institutions Code or Title 22 of the California Code of Regulations. Common denial reasons for MSP applications include income over the program limit, assets exceeding $130,000 (individual) or $195,000 (couple) under the 2026 reinstated thresholds, or failure to provide requested documentation within 30 days.
The effective date. This is the date the action takes effect. For discontinuances, this is the date your parent's MSP coverage ends. The gap between the NOA mailing date and the effective date is your window to act.
The aid-paid-pending line. If your parent already has active MSP coverage and the county is discontinuing or reducing it, the NOA tells you whether requesting a hearing will keep benefits running while the case is decided. This is called "aid paid pending" under California State Hearing rules. The hearing request must be filed on or before the effective date of the proposed action (or within 10 days of the NOA mailing date), under the state-hearing guidance.
Common NOA Scenarios for MSP Applicants
Denial for excess income. The NOA states gross income exceeded the program threshold. Before accepting this, check whether the county correctly applied the $20 general unearned income disregard. If your parent's gross Social Security is $1,345 per month and the QMB gross limit is $1,330, the $20 disregard brings countable income to $1,325 — under the limit. Request a hearing if the disregard was not applied.
Denial for excess assets. Since January 2026, county workers verify assets against the $130,000 single / $195,000 couple threshold. If the NOA says assets are over the limit, review what the county counted. The primary home is fully exempt regardless of value. One vehicle used for the applicant's or a household member's transportation is exempt. Irrevocable burial funds are exempt. Retirement accounts in regular periodic payout are exempt. If the county included any of these as countable assets, that is an error.
Discontinuance for failure to provide information. If your parent does not respond to Form MC 355 within 30 calendar days, the county must attempt a "Second Contact" — a phone call or written reminder — before proposing adverse action. If no second contact was made, raise that procedural issue at a hearing.
Program transfer notice. Sometimes a NOA notifies your parent that they are being moved from one MSP tier to another — for example, from QMB (full cost-sharing coverage) to SLMB (Part B premium only) because their income increased. Review the income calculation to confirm the shift is correct.
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How to Respond
If the NOA is a denial or discontinuance you believe is wrong, request a state fair hearing through the California Department of Social Services. The hearing request form is on the back of the NOA or available at the CDSS website. File it within 90 calendar days from the date the NOA was mailed — but if you need aid paid pending to keep current coverage active, meet the earlier applicable deadline stated on the notice and under the state-hearing guidance.
Gather supporting documents: the most recent Social Security benefit letter (showing gross income), bank statements (showing assets under the limit), and any correspondence from the county. A HICAP counselor or legal aid attorney can help you prepare, though appointment wait times at HICAP run 3 to 6 weeks during peak periods.
Our California Medicare Savings Programs & Extra Help Guide includes a Notice of Action decoder that maps common denial codes to specific responses, plus templates for hearing requests and evidence organization.
Get Your Free California — Medicare Savings Program Eligibility Checklist
Download the California — Medicare Savings Program Eligibility Checklist — a printable guide with checklists, scripts, and action plans you can start using today.