Cambios en Medi-Cal

Límites de activos

As of January 1, 2026, Medi-Cal has changed the amount of certain assets (things you own that have value) you can own when you apply or renew. Income rules have not changed.

A quién se aplica esto

Puede verse afectado si:

• Are age 65 or older
• Tener una discapacidad (física, mental o del desarrollo)
• Vivir en un ancianato
• Perteneces a una familia que gana demasiado dinero para cumplir los requisitos bajo las normas fiscales federales

Importante saberlo

Through June 30, 2027:

• The most you can own (asset limit) is $130,000 for one person
• Add $65,000 for every extra person in your house (up to 10 people)

Starting July 1, 2027, the asset limit is:

• $21,000 for one person
• $31,000 for two people
• Add $1,550 for every extra person in your house (up to 10 people)

Los activos que se consideran incluyen:

• cuentas bancarias
• efectivo
• Más de una vivienda o vehículo

Los activos que no cuentan incluyen:

• El hogar en el que vives
• One vehicle
• Artículos del hogar
• Algunos ahorros, como cuentas de jubilación

Consulte el Centro de ayuda para obtener más información.

Pausa de inscripción

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

A quién se aplica esto

• Please see the Immigration Status Categories Chart

Importante saberlo

• Si ya tienes Medi-Cal de alcance completo, puedes seguir cubierto independientemente de tu estatus migratorio.
• You must renew on time and continue to meet Medi-Cal rules.
• If your Medi-Cal ends, you have a three-month grace period to re-enroll in full-scope Medi-Cal.
• If you miss the grace period, you must reapply for Medi-Cal. You will be eligible only for restricted-scope Medi-Cal, which covers:
  • Atención de emergencia
  • Atención relacionada con el embarazo
  • Atención en hogares de ancianos

Que aún pueden obtener Medi-Cal de alcance completo, independientemente de su estatus migratorio

• Children (0-18)
• Pregnant people (through pregnancy and up to one year after)
• People under age 26 who were in foster care on their 18th birthday

Cambios de estatus migratorio

Starting in October 2026, the federal government will change how it classifies some immigration statuses. These changes affect whether certain adults can continue getting federally funded full-scope Medi-Cal. If you are affected, you will continue receiving state-funded full-scope Medi-Cal through June 30, 2027.

A quién se aplica esto

• Refugee and asylees: People who left their home country for safety and don’t yet have a Green Card
• Humanitarian parolees: People allowed into the U.S. for urgent reasons for at least one year
• Survivors of domestic violence or human trafficking: and have with a pending status

Please see the Immigration Status Categories chart for details.

Importante saberlo

Starting July 1, 2027, people in this group will only be eligible for pregnancy-related services and emergency services.

Fee-for-Service Transition

Starting January 1, 2027, some members will get their Medi-Cal care through Fee-for-Service (FFS) Medi-Cal instead of a health plan. This change affects how you get care, not whether you stay eligible for and covered by Medi-Cal.

A quién se aplica esto

• People who are undocumented.
• Some people with green cards who are in the five-year waiting period before they can get full-scope federal Medicaid.
• People considered Permanently Residing in the U.S. Under Color of Law (PRUCOL), meaning they are allowed to stay in the U.S. even without formal immigration status.

Please see the Immigration Status Categories chart for details.

Importante saberlo

• You will stay covered if you renew on time.
• You will no longer be in a health plan. You can choose any doctor or clinic that accepts FFS Medi-Cal.
• “Fee-for-Service” does not mean you pay. Medi-Cal will still pay for your care.
• Specialty mental health and substance use treatment will continue through County Behavioral Health Plans.
• Your medicines will still be covered by Medi-Cal Rx.
• Dental care is not changing for most members. The way dental care is delivered depends on the county
• Enhanced Care Management and Community Supports (services only available in managed care) will not continue in FFS Medi-Cal.
• Other kinds of help are still available for eligible members such as Community Health Worker services, chronic care management, doula services, and county mental health programs.
• DHCS will offer new care coordination and navigation support to help members during this change. This includes a nurse advice line with trained staff and community-based navigators to help you understand the change and what you need to do.
• You will get more information before this change happens.

Cobertura dental

A partir del 1de julio de 2027, algunos afiliados a Medi-Cal dejarán de recibir servicios dentales integrales como parte de su cobertura de Medi-Cal.

A quién se aplica esto

• Please see the Immigration Status Categories chart

Importante saberlo

You can still get care dental emergencies, including: 

• Dolor dental severo
• Infecciones
• Tooth extractions

Some people in this group will still get full-scope dental. You are eligible if you are:

• A child (0-18)
• Pregnant (through pregnancy and up to one year after)
• Under age 26 and were in foster care on your 18th birthday

Pagos mensuales

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

A quién se aplica esto

• Please see the Immigration Status Categories chart

Importante saberlo

If you don’t pay, your Medi-Cal will change to restricted-scope, which covers:

• Atención de emergencia
• Atención relacionada con el embarazo
• Atención en hogares de ancianos

No tendrás que pagar un Pagos si estás:

• A child (0-18)
• Pregnant (through pregnancy and up to one year after)
• Under age 26 and were in foster care on your 18th birthday

Requisitos Laborales

Starting January 1, 2027, some adults will need to work, volunteer, go to school, or participate in training to get to keep Medi-Cal. You will receive a letter if this applies to you.

A quién se aplica esto

• Adults (19-64) who are eligible for Medi-Cal because of the Affordable Care Act expansions. including members subject to the changes for immigrants listed above.

Who this does not apply to

Estas nuevas reglas de trabajo o voluntariado no se aplican a:

• Hijos (0–18)
• Older adults (65 and older)
• Pregnant people (through pregnancy and up to one year after)
• Parents of children age 0-13
• Personas con discapacidad
• Personas con problemas graves de salud o salud mental, o problemas de consumo de sustancias
• Personas que fueron liberadas de prisión en los últimos 90 días
• Personas en Medicare Part A o Parte B
• Indios americanos o nativos de Alaska
• People under age 26 who were in foster care on their 18th birthday

La oficina de Medi-Cal de tu condado te enviará una carta para informarte si debes cumplir con los requisitos laborales o si necesitas otra información para demostrar que cumples alguna de estas exenciones.

Importante saberlo

Los miembros deben cumplir uno o más de los siguientes requisitos:

• Work at a job and get paid at least $580 a month
• Be a seasonal worker 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
• 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, or at least $580 per month

Si se le requiere trabajar u ofrecerse como voluntario según estas nuevas normas y no las cumple, podría perder su cobertura de Medi-Cal.

When you get a letter from Medi-Cal or your county office, open it right away and respond quickly.

Medi-Cal enviará más información antes de que esta norma sea efectiva, incluidas las formas en las que puede ayudarle a cumplir con las normas.

Menos tiempo para obtener ayuda con el pago de facturas médicas anteriores

A partir del 1de enero de 2027, Medi-Cal pagará menos meses de facturas médicas anteriores a que aplicar.

A quién se aplica esto

• Adultos (19-64 años) sin hijos (0-18)

Si esto se aplica a usted, Medi-Cal le enviará una carta.

Importante saberlo

Nuevas normas:

• Adultos sin hijos: Medi-Cal solo pagará un mes de facturas pasadas
• Todos los demás: Medi-Cal pagará dos meses de facturas pasadas

Verificaciones de elegibilidad semestrales

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

A quién se aplica esto

• Adults (19-64) who are eligible for Medi-Cal because of the Affordable Care Act expansions, including members subject to the changes for immigrants listed above.

Who this does not apply to

Estos miembros continuarán con renovaciones anuales:

• Members not in the Affordable Care Act new adult group
• Personas embarazadas o posparto
• Miembros nativos o indígenas americanos de Alaska
• People under age 26 who were in foster care on their 18th birthday

Importante saberlo

• Missing deadlines could cause loss of coverage

Copagos

Starting October 1, 2028, some adults on Medi-Cal may have to pay a fee (called a copayment) for certain services.

A quién se aplica esto

Adults (19-64) who:

• A las mujeres que no están embarazadas
• Are not on Medicare
• Make more than $15,560 a year

Importante saberlo

• You might have to pay a fee for some health care, like seeing a specialist doctor (like a cardiologist or dermatologist) and getting certain treatments or tests.
• You will not pay more than 5 percent of your household income each year.
• There will not be copayments for:
  • Community health centers or rural health clinics
  • Atención de emergencia
  • Regular revisiones
  • Care during pregnancy
  • Pediatric care (care for children)
  • Tratamiento de la salud mental y los trastornos por consumo de sustancias