Medi-Cal Changes

Starting January 1, 2026, when you apply for or renew your Medi-Cal, we will look at what you own. This is called an asset check. Assets are things you own that have value.

WHO THIS APPLIES TO:

You may be affected if you :

• Are age 65 and older and meet the household income limit for Medi-Cal.
• Have a disability (physical, mental, or developmental).
• Live in a nursing home.
• Are in a family that makes too much money to qualify under federal tax rules.

IMPORTANT TO KNOW:

• The most you can own (asset limit) is $130,000 for one person.
• You can add $65,000 for every extra person in your family. The maximum is 10 people.
• Assets that count include:
• Bank accounts
• Cash
• More than one house or vehicle
• Assets that don't count include:
• The home you live in
• One Vehicle
• Household items
• Some savings, like retirement accounts
• If you have Medi-Cal, we look at your assets every year when you renew.
• The income rules for Medi-Cal have not changed.

See the Help Center for more information.

Starting January 1, 2026, some adults will no longer be able to sign up for full-scope Medi-Cal coverage based on their immigration status. 

WHO THIS APPLIES TO:

You may be affected if:

• You are undocumented (you live in the U.S. without legal permission), or
• You are a lawfully present immigrant who is 19 or older and not pregnant

IMPORTANT TO KNOW:

• If you already have Medi-Cal, you can stay covered no matter your immigration status.
• To keep your Medi-Cal, you must:
• Fill out your renewal form every year
• Still meet the Medi-Cal rules (like income and living in California)
• Use your benefits and renew on time. If you don’t, your Medi-Cal could end.
• If your Medi-Cal ends, you have 90 days to fix the problem and keep your coverage.

If you miss that 90-day window, you won’t be able to get full-scope Medi-Cal again. You can only apply for restricted Medi-Cal, which covers:

• Emergency care
• Pregnancy-related care
• Nursing home care

Who can still get full-scope Medi-Cal:

• Children under 19
• Pregnant people
• You must still meet all Medi-Cal rules, like income and living in California.

Pregnancy coverage lasts through your whole pregnancy and up to one year after it ends.

Starting July 1, 2026, some Medi-Cal members will stop getting full-scope dental services as part of their coverage due to changes in state law.

WHO THIS APPLIES TO:

This change affects Medi-Cal members who are:

• Age 19 or older, and
• Are not pregnant or postpartum, and
• Are lawfully present immigrants who:
• Have had a Green Card for less than five years and are not exempt from the five-year waiting period.
• Are classified as PRUCOL (Permanently Residing Under Color of Law).
• Qualify through a state-funded expansion or a humanitarian program (e.g., for victims of trafficking or crime).
• Have another immigration status that does not qualify for full-scope Medi-Cal under federal rules.

IMPORTANT TO KNOW:

If this change applies to you, you will get all full-scope Medi-Cal services, except for non-emergency dental services.

• You can still get care for urgent dental needs, including: 
• Serious tooth pain
• Infections
• Tooth extractions
• You will also get full-scope dental if you are pregnant, and you will get it for one year after your pregnancy ends.
• Your immigration status does affect pregnancy-related dental coverage.

Starting July 1, 2027, some Medi-Cal members will need to pay a small monthly fee (called a premium) to keep their full-scope Medi-Cal.

WHO THIS APPLIES TO:

• Californians who are between 19 and 59 years old, and
• Are not pregnant, and
• Are lawfully present immigrants and:
• Have had a Green Card for less than 5 years and don’t qualify for an exception
• Are classified as PRUCOL (Permanently Residing Under Color of Law – a type of immigration status that allows you to stay in the U.S. but doesn’t qualify for full federal benefits)
• Qualify through a state-funded or humanitarian program (like for victims of trafficking or crime)
• Have another immigration status that does not qualify for full Medi-Cal under federal rules

IMPORTANT TO KNOW:

• If this change applies to you, you will need to pay a small fee each month to keep your full Medi-Cal.
• If you don’t pay, your Medi-Cal will change.
• You will only get restricted Medi-Cal, which covers:
• Emergency care
• Pregnancy-related care
• Nursing home care

Starting January 1, 2027,some adults will need to work or volunteer to get or keep Medi-Cal. If this applies to you, the county Medi-Cal office will send you a letter. 

WHO THIS APPLIES TO:

Medi-Cal members and people applying for Medi-Cal who are:

• Age 19 to 64 years old, and
• Don’t meet any of the exemptions listed directly below.

EXEMPTIONS:

These new work or volunteer rules do not apply to:

• Children (0–18).
• Older Adults (65+).
• Pregnant people, including one year postpartum, regardless of birth outcome.
• Parents with children 13 years of age or younger.
• People with disabilities.
• People with serious health or mental health conditions or substance use problems.
• People who were released from jail or prison within the last 90 days.
• People on Medicare Part A or Part B.
• American Indians or Alaska Natives.
• Foster youth or former foster youth under age 26.

IMPORTANT TO KNOW:

• Members must do one or more of the following:
  • Work at a job and get paid.
    • Earn at least $580 a month from working.
    • Be a seasonal worker (someone who only works during certain times of the year) and make an average of $580 a month over the last six months.
  • Be in a job training program (that helps you learn skills to get a job) for at least 80 hours per month.
  • Volunteer or do community service for at least 80 hours per month. This should be organized and something you can prove you did with a letter or form.
  • Go to school at least half-time. This usually means taking two or three classes or about six to eight credits each semester.
  • Do a mix of the things listed above for a total of at least 80 hours per month.
• If you are required to work or volunteer under these new rules and do not meet the rules, you could lose your Medi-Cal.
• When you get a letter from Medi-Cal, open it right away and respond quickly to show how you are meeting the work rules.
• Medi-Cal will send more information before this rule starts, including ways to help you meet the rules.

Starting January 1, 2027, some Medi-Cal members will have their eligibility checked twice a year instead of once.

WHO THIS APPLIES TO:

Medi-Cal members and people applying for Medi-Cal who are:

• Ages 19 to 64 years old, and
• Don’t have children younger than age 19

If this applies to you, Medi-Cal will send you a letter.

IMPORTANT TO KNOW:

• You will be asked to renew your Medi-Cal every six months.
• You could lose your coverage if you don’t fill out forms completely or turn them in on time.
• Always read your mail from Medi-Cal and respond quickly.

Starting January 1, 2027, Medi-Cal will pay for fewer months of medical bills from before you applied.

WHO THIS APPLIES TO:

Medi-Cal members who enroll January 1, 2027, or after.

• Ages 19 to 64 years old, and
• Don’t have children younger than age 19

If this applies to you, Medi-Cal will send you a letter.

IMPORTANT TO KNOW:

• Right now, Medi-Cal can help pay for bills from up to three months before you applied.
• Under the new rule:
  • If you are 19 to 64 years old without children younger than age 19, or a higher-income parent of children younger than age 19, Medi-Cal will only pay for one month of past bills.
  • For everyone else, Medi-Cal will pay up to two months of past bills.

Starting October 1, 2028, some adults on Medi-Cal may have to pay a small fee (called a copayment) for certain health care services. The Department of Health Care Services will provide more information as it becomes available.

WHO THIS APPLIES TO:

Medi-Cal members who:

• Are 19 to 64 years old, and
• Are not pregnant, and
• Are not on Medicare, and
• Make more than $15,560 a year.

IMPORTANT TO KNOW:

• You might have to pay a small fee for some health care, like seeing a special doctor (like a cardiologist or dermatologist) and getting certain treatments or tests.
• You will not pay more than 5 percent of your household income in copayments each year.
• You won’t have to pay for:
  • Services at community health centers or rural health clinics.
  • Emergency care.
  • Regular checkups.
  • Prenatal care (care during pregnancy) and pediatric care (care for children).
  • Mental health and substance use disorder treatment.