加州醫療補助健康保健計劃變更事項

資產限制

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.

適用對象

若符合以下條件，您可能會受到影響：

• Are age 65 or older
• 有殘障（身體、精神或發展障礙）
• 住在療養院
• 根據聯邦稅務規定，您的家庭賺錢太多而不符合資格

重要 資訊

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:

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

計入的資產包括：

• 銀行帳戶
• 現金
• 多於一棟房屋或一輛車

不算在內的資產包括

• 現居住宅
• One vehicle
• 家庭用品
• 某些儲蓄，例如退休帳戶

參閱幫助中心以獲取更多資訊。

暫停受理投保

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. 

適用對象

• Please see the Immigration Status Categories Chart

重要資訊

• 如果您已經擁有 Medi-Cal 全保，則無論您的移民身份如何，您都可以繼續獲得承保。
• 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:
  • 緊急醫療服務
  • 懷孕相關醫療服務
  • 療養院護理

不論移民身份為何，哪些人仍可獲得 Medi-Cal 的全面照顧

• 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

移民身份變更

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.

適用對象

• 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.

重要資訊

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.

適用對象

• 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.

重要資訊

• 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.

牙科保障

自7 月起， 1 ，2027 ，部分 Medi-Cal 會員將不再享有 Medi-Cal 承保範圍內的全面牙科服務。

適用對象

• Please see the Immigration Status Categories chart

重要資訊

You can still get care dental emergencies, including: 

• 嚴重牙痛
• 感染
• 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

每月保險費

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.

適用對象

• Please see the Immigration Status Categories chart

重要資訊

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

• 緊急醫療服務
• 懷孕相關醫療服務
• 療養院護理

如果您是，則無需支付保費：

• 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

工作規範

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.

適用對象

• 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

這些新的工作或志工規則不適用於：

• 兒童 (0-18)
• Older adults (65 and older)
• Pregnant people (through pregnancy and up to one year after)
• Parents of children age 0-13
• 身心障礙者
• 有嚴重健康或心理健康問題或藥物使用問題的人
• 在過去 90 天內從監獄或懲教所釋放出來的人
• 參加聯邦醫療保險 A 部分或 B 部分的人
• 美國印第安人或阿拉斯加原住民
• People under age 26 who were in foster care on their 18th birthday

您所在縣的 Medi-Cal 辦公室會寄信給您，讓您知道您是否必須遵守工作要求，或是否需要您提供其他資 料，以證明您符合這些豁免條件之一。

重要資訊

會員必須完成以下一項或多項：

• 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

若依新規須工作或從事志工服務卻未達標準者，可能喪失加州醫療補助健康保健計劃投保資格。

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

加州醫療補助健康保健計劃將於本規則生效前提供進一步說明，內容包含協助符合規範之具體措施。

縮短舊有醫療費用補助申請時效

自1 月起 1 ， 2027 ，加州醫療保險將支付您申請前較少月份的過往醫療帳單。

適用對象

• 沒有子女（0-18 歲）的成人（19-64 歲）

若您符合此類情況，加州醫療補助健康保健計劃會寄信給您。

重要資訊

新規定：

• 沒有子女的成年人： Medi-Cal 只會支付過去一個月的醫療費用。
• 所有其他人：Medi-Cal 將支付過去兩個月的帳單

六個月資格檢查

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

適用對象

• 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

這些會員將繼續每年續會一次：

• Members not in the Affordable Care Act new adult group
• 懷孕或產後個人
• 阿拉斯加原住民或美洲印第安人成員
• People under age 26 who were in foster care on their 18th birthday

重要資訊

• Missing deadlines could cause loss of coverage

共付額

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

適用對象

Adults (19-64) who:

• 未懷孕
• Are not on Medicare
• Make more than $15,560 a year

重要資訊

• 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
  • 緊急醫療服務
  • 定期體檢
  • Care during pregnancy
  • Pediatric care (care for children)
  • 心理健康和藥物使用障礙治療