Medi-Cal Eligibility Changes

Reinstatement of Asset Limits

Starting January 1, 2026, the State of California started requiring that we check for assets when you apply or renew your Medi-Cal. Assets are things of value that you own.

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  • Who does this rule apply to?

    You may be impacted if you get Medi-Cal and:

    • Are age 65 years or older
    • Have a disability
    • Are in a family that makes too much money to qualify for Medi-Cal under federal tax rules

     

  • Who is exempt from the asset test?

    The new rules do not apply if you:

    • Are in a family that qualifies for Medi-Cal under federal tax rules

     

  • How do I meet the asset limit?

    The most you can own is $130,000 for one person. You can add $65,000 for every extra person in your family (up to 10 people).

    Assets that are counted include:

    • Bank accounts
    • Cash
    • More than one house or vehicle

     

    Assets that are not counted included:

    • The home you live in
    • One vehicle
    • Some savings accounts like retirement accounts

     

    If you have Medi-Cal that requires a review of your assets, we will look at what you own every year when you renew.

     

  • Additional Resources

    Keep your benefits by responding to all Medi-Cal requests in a timely manner. If you need assistance, contact the Access Customer Service Center at 1-866-262-9881.

Enrollment Freeze for Adult Immigrants

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 due to state budget changes in 2025. 

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  • Who does this apply to?

    You may be impacted if you get Medi-Cal and do not have satisfactory immigration status. You may check to see if your immigration status is affected on the Immigration Status Categories chart.

     

  • Who is exempt from the enrollment freeze for adult immigrants?

    The new rules do not apply if you:

    • Already had full scope Medi-Cal before January 1, 2026
    • Are a child between the ages of 0 to 18
    • Are pregnant or up to one year has passed since your pregnancy ended
    • Are a former foster youth under the age of 26 and were in foster care on your 18th birthday

     

  • How do I keep my full scope Medi-Cal?

    To keep your full scope Medi-Cal, you must:

    • Fill out your renewal form as required
    • Meet Medi-Cal eligibility rules such as income and living in California
    • Use your benefits and renew on time

     

    If your Medi-Cal ends, you will have a three-month grace period to re-enroll in full scope Medi-Cal from the last date you were eligible as indicated on your Notice of Action. If you do not re-enroll by the end of the three-month grace period, you must reapply for Medi-Cal and will only be eligible for restricted scope benefits. Restricted scope Medi-Cal covers emergency care, pregnancy-related care, or nursing home care.

     

  • Additional Resources

    Keep your benefits by responding to all Medi-Cal requests in a timely manner. If you need assistance, contact the Access Customer Service Center at 1-866-262-9881.

Dental Coverage for Adult Immigrants

Starting July 1, 2026, some adults will stop getting full scope dental services as part of their Medi-Cal coverage. 

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Restrictions on Lawful Immigrant Eligibility

Starting October 1, 2026, the federal government will change how some immigration statuses are classified for federally funded full scope Medi-Cal benefits.

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  • Who does this rule apply to?

    You may be impacted if you get Medi-Cal and are:

    • A refugee or asylee
    • A humanitarian parolee
    • A survivor of domestic violence or human trafficking whose immigration status is pending

     

  • Who is exempt from lawful immigrant eligibility restrictions?

    The new rules do not apply if you are a:

    • U.S. Citizen
    • Lawful Permanent Resident after a 5-year waiting period
    • Cuban or Haitian entrant
    • Citizen from the member sovereign states of the Compact of Free Association (COFA) including Federated States of Micronesia and the Republic of the Marshall Islands

     

  • How do I verify my citizenship or lawful immigrant status?

    You must submit one of the following if requested by the County:

    • A document that shows a U.S. place of birth or that you are a U.S. citizen or national
      • Examples include a U.S. Passport or a birth certificate from one of the states or territories
    • A document that shows you are a Lawful Permanent Resident and have met the 5-year waiting period
    • A document confirming you are a Cuban or Haitian entrant or from one of the Compact of Free Association member states

     

    Individuals who do not verify their citizenship or lawful immigrant status may be limited to restricted scope Medi-Cal. Restricted scope Medi-Cal only covers emergency and pregnancy related services.

     

  • Additional Resources

    Keep your benefits by responding to all Medi-Cal requests in a timely manner. This is important. If you need assistance, contact the Access Customer Service Center at 1-866-262-9881.

Work and Community Engagement Requirements

Starting January 1, 2027, the federal government will require that some adults meet the new Work and Community Engagement rules to get or keep Medi-Cal.

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  • Who does this rule apply to?

    Current Medi-Cal customers and individuals applying for Medi-Cal who are:

    • Adults (age 19-64)
    • Eligible for Medi-Cal due to the Affordable Care Act expansion

     

  • Who is exempt from Medi-Cal work requirements?

    The new rules do not apply if you are:

    • Children (0-18)
    • Older Adults (65 and older)
    • Meeting CalFresh or CalWORKs work requirements
    • Pregnant and for one year after the pregnancy ends
    • Are a parent with children ages 13 and younger
    • Have a federally established disability
    • Have a serious health or mental health condition or substance use disorder
    • Are in jail/prison or have been released within the last 90 days
    • Are receiving Medicare Part A or Part B
    • Are an American Indian or Alaska Native
    • Foster youth or former foster youth aged 0-26
    • Meeting CalFresh or CalWORKs work requirements
    • Parent, guardians, caretaker of a disabled individual
    • Disabled veteran
    • Participating in a drug/alcohol treatment program
    • Medically frail or otherwise have special medical needs
    • Living in a county impacted by a federally declared emergency or disaster

     

    Individuals will be notified if they must meet these requirements or if more information is needed to verify that they meet an exemption. 

     

  • How to meet work requirements?

    Individuals must do one or more of the following:

    • Work at least 80 hours a month and earn at least $580 monthly
      • Seasonal workers must average $580 monthly over the last six months
    • Participate in a job training program for at least 80 hours per month
    • Volunteer or do community service for at least 80 hours per month
    • Attend school, college or a career/technical education program at least half-time
    • Complete any mix of activities listed above for a total of at least 80 hours per month

    Individuals who are required to meet these rules and do not meet them could lose their Medi-Cal benefits.

     

  • Additional Resources

    Keep your benefits by responding to all Medi-Cal requests in a timely manner. If you need assistance, contact the Access Customer Service Center at 1-866-262-9881.

Six-Month Eligibility Checks

Starting January 1, 2027, the federal government will require that adults have their eligibility checked twice a year instead of once.

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  • Who does this rule apply to?
    • Adults age 19-64

     

  • Who is exempt from six-month eligibility checks?

    The new rules do not apply if you are:

    • A child between the ages 0 to 18
    • Pregnant or up to one year after pregnancy ends
    • Former foster youth under the age of 26 who was in foster care on their 18th birthday
    • Age 65 or older
    • Disabled

    If you are in one of the categories listed above, you will continue to have your eligibility checked every 12 months. 

     

  • How do I stay covered?
    • Complete your renewal form
    • Turn in documents or verifications requested by the County
    • Update your contact information such as your phone number or address

     

  • Additional Resources

    Keep your benefits by responding to all Medi-Cal requests in a timely manner. If you need assistance, contact the Access Customer Service Center at 1-866-262-9881.

Less Time to Get Help Paying Old Medical Bills

Starting January 1, 2027, the federal government will change how Medi-Cal covers old medical bills. Medi-Cal will pay for one month of past bills before you apply for adults without children. For all others, Medi-Cal will pay for up to two months of past bills. 

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  • Who does this rule apply to:
    • Adults (age 19-64) without children (age 0-18)

     

  • Additional Resources

    Keep your benefits by responding to all Medi-Cal requests in a timely manner. If you need assistance, contact the Access Customer Service Center at 1-866-262-9881.

Monthly Premiums for Adult Immigrants

Starting July 1, 2027, due to California state budget changes, some adults will need to pay a small monthly premium to keep their full scope Medi-Cal. 

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  • Who does this rule apply to?

    You may be impacted if you get Medi-Cal and do not have satisfactory immigration status. You may check to see if your immigration status is affected on the Immigration Status Categories chart.

    • If this change applies to you, you will be notified in a letter

     

  • Who is exempt from having a monthly premium?

    The new rules do not apply if you are:

    • A child between the ages 0 to 18
    • Pregnant or up to one year after pregnancy ends
    • Age 60 or older
    • Former foster youth under the age of 26 who was in foster care on their 18th birthday

     

  • What happens if I don't pay my premium?

    If you don’t pay your premium, your Medi-Cal coverage will change to restricted scope which is limited to:

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

     

  • Additional Resources

    Keep your benefits by responding to all Medi-Cal requests in a timely manner. If you need assistance, contact the Access Customer Service Center at 1-866-262-9881.

Copayments for Medi-Cal

Starting October 1, 2028, the federal government will require that some adults on Medi-Cal pay a small fee (called a co-payment) for certain services.

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  • Who does this rule apply to?

    Medi-Cal members who are:

    • Adults (age 19-64), and
    • Not pregnant or within a year after pregnancy ends, and
    • Not on Medicare, and make more than $15,560 per year

     

  • What services will require a small fee?

    You may have to pay a small fee for some health care services like seeing a specialist (like a cardiologist or a dermatologist) and getting certain treatments or tests.

     

  • What is the most I will pay in copayments for services?

    You will not pay more than 5 percent of your income each year in copayments. 

     

  • What services will be exempt from copayments?

    There will be no copays 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

     

  • Additional Resources

    Keep your benefits by responding to all Medi-Cal requests in a timely manner. If you need assistance, contact the Access Customer Service Center at 1-866-262-9881.

 

Keep your benefits by responding to all Medi-Cal requests timely. If you need assistance, contact Access Customer Service at 1-866-262-9881.