What is Changing for Medi-Cal?

What’s in this post:

New Rules for Adults (19–64): Upcoming federal work requirements, a shift to six-month eligibility checks, reduced retroactive coverage, and new copayments.

Changes for Older Adults & People with Disabilities: Reinstatement of the asset limit test starting in 2026.

Adult Immigrant Coverage Updates:Details on enrollment freezes, dental coverage reductions, and new monthly premiums.

How to Prepare: Actionable steps to keep your Medi-Cal information current and avoid losing coverage.

Medi-Cal Updates 2026: California state policy changes reinstated asset checks for seniors and people with disabilities and enrollment freezes for immigrants without satisfactory immigration status. Additionally, later this year, certain Medi-Cal members will lose dental coverage.

Medi-Cal (California’s Version of Medicaid)

Medi-Cal provides free or low-cost health coverage to Californians with low income. Between 2026 through 2028, federal and state policy changes will introduce new requirements for adults, older adults, and certain immigrant groups.

New Rules for Adults (19–64)

Effective January 1, 2027, new federal law (H.R. 1) requires some adults to meet work rules to keep their Medi-Cal coverage. This will apply to adults age 19-64 who are eligible for Medi-Cal because of the Affordable Care Act expansions (known as Modified Adjusted Gross Income [MAGI]).

Work, School, or Volunteer Requirements

Some adults may need to work, go to school, or volunteer to keep Medi-Cal.

Who this applies to:

Adults ages 19–64
People who qualify under the Affordable Care Act (ACA) Medi-Cal program
People who do not qualify for an exemption

You do NOT have to meet this requirement if you are:

Under age 19 or age 65+
Pregnant, or up to one year postpartum, regardless of birth outcome
A parent or caretaker of a child age 0–13
A person with a disability
Experiencing serious physical, mental health, or substance use conditions
Recently released from jail or prison (within 90 days)
Enrolled in Medicare (Part A or B)
American Indian or Alaska Native
A former foster youth under age 26

If required, you must do one of the following:

Work and earn at least $580/month
Participate in job training (80 hours/month)
Volunteer (80 hours/month)
Attend school at least half-time
Combine activities to meet 80 hours/month or $580/month

If you do not meet the requirement, you could lose Medi-Cal coverage.

When you receive 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.

More Frequent Renewals

Starting January 1, 2027, Medi-Cal members age 19-64, who are eligible under expanded* Medi-Cal, will have their eligibility checked twice a year instead of once.

You will still renew once a year if you are:

Not in the Expanded Medi-Cal population
Pregnant or postpartum
American Indian or Alaska Native
A former foster youth under age 26

*Expanded Medi-Cal provides medical coverage to adults ages 19-64 with income below 138% of the Federal Poverty Level, regardless of disability or family status.

What to do next

Watch your mail—your county will send you a letter if these rules apply to you.
Respond quickly and provide any requested information.
Missing deadlines could cause you to lose coverage.

Reduced Retroactive Coverage

Starting January 1, 2027, Medi-Cal will only pay for 1 month of past medical bills (previously 3 months) for new applicants.

Who This Applies To:

Adults ages 19–64 who receive expanded Medi-Cal

Who This Does Not Apply To:

Children
Seniors
Persons with disabilities

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

For all others, Medi-Cal will pay for two months of past bills.

What This Means for You

Apply for Medi-Cal as soon as possible if you need help with medical bills.
The sooner you apply, the more coverage you may receive.
Watch your mail for important updates from Medi-Cal.

Copayments

Starting October 1, 2028, some adults on Medi-Cal with income above 100% of the Federal Poverty Level may be required to pay a small fee (called a copayment) for certain services. Essential services, such as emergency, prenatal, pediatric, and mental health care, remain exempt.

Who This Applies To

This may apply to Medi-Cal members who:

Are adults ages 19–64
Are not pregnant (coverage includes pregnancy and up to one year postpartum)
Are not enrolled in Medicare

Important Information

You may have to pay a small fee for some services, such as:
- Specialist visits (like heart or skin doctors)
- Certain treatments or medical tests
You will not pay more than 5% of your household income per year in copayments

Changes for Older Adults & People with Disabilities

Asset requirements for Medi-Cal

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

Who This Applies To

Adults age 65 or older and meet Medi-Cal income limits
Have a disability (physical, mental, or developmental)
Live in a nursing home
Are in a household that does not qualify under federal tax (MAGI) rules

Important Information

Asset Limit

$130,000 for one person
Add $65,000 for each additional household member
Applies up to a household of 10 people

Assets That Count

Bank accounts
Cash
Additional homes or vehicles

Assets That Do NOT Count

The home you live in
One vehicle
Household and personal items
Some savings, such as retirement accounts

What This Means for You

Medi-Cal may review your assets when you apply and at each yearly renewal
You must stay within the asset limit to qualify (if your program requires it)
Income rules for Medi-Cal have not changed

Adult Immigrant Coverage Updates

Federal and state policy shifts have introduced new restrictions and costs for certain non-citizens and individuals without satisfactory immigration status (SIS) who are ages 19 and older.

Enrollment Freeze

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.

If you already have full-scope Medi-Cal, you can stay covered no matter your immigration status.
To keep your Medi-Cal, you must:
- Fill out your renewal form as required
- Meet Medi-Cal eligibility rules (like income and living in California)
Renew your benefits on time.
If your Medi-Cal ends, you will have a three-month grace period from the last date of eligibility provided on your Notice of Action, to reenroll into full scope Medi-Cal.

If you do not re-enroll by the end of the three-month grace period, you must reapply for Medi-Cal. You will be eligible only for restricted scope Medi-Cal, which covers:

Emergency care
Pregnancy-related care
Nursing home care

Who can still get full-scope Medi-Cal, regardless of immigration status:

Children (age 0-18)
Pregnant people through the whole pregnancy and up to one year after it ends
Former foster youth under age 26, who were in foster care on their 18th birthday

Dental Coverage

Starting July 1, 2026, some Medi-Cal members will stop getting full-scope dental services as part of their Medi-Cal coverage. Please see these Frequently Asked Questions for more information. See Immigration Status Categories chart to see if you are subject to changes to Dental Coverage.

You can still get care for emergency dental needs, including:
- Serious tooth pain
- Infections
- Tooth extractions
You will also get full-scope dental if:
- You are a former foster youth under age 26 who was in foster care on your 18th birthday, or
- You are pregnant (and you will get it for one year after your pregnancy ends)

Immigration Status Changes

Starting October 1, 2026, the federal government will change how it classifies some immigration statuses (your legal standing in the U.S. based on how and why you came here). These new classifications will change the type of Medi-Cal certain populations will be eligible for. Details on how this policy will be implemented in California will be available soon.

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

A refugee or asylee – someone who left their home country for safety and don’t yet have a Green Card
A humanitarian parolee – someone allowed into the U.S. for urgent reasons for at least one year
A survivor of domestic violence or human trafficking, and you have a pending status

Monthly Premiums

Starting July 1, 2027, Medi-Cal Members without satisfactory immigration status (SIS) receiving full-scope Medi-Cal will need to pay a small monthly fee (called a premium) to keep their full-scope Medi-Cal. See Immigration Status Categories chart to see if you must pay Monthly Premiums.

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 be changed to restricted scope Medi-Cal.
You will only get restricted Medi-Cal, which covers:
- Emergency care
- Pregnancy-related care
- Nursing home care

You will not have to pay a premium if you are:

A former foster youth under age 26 and were in foster care on your 18th birthday, or
Pregnant, and for one year after your pregnancy ends.

How to Prepare

More Frequent Renewals

Starting in 2027, many adults will need to renew their Medi-Cal twice a year. Missing a renewal letter is the #1 reason people lose coverage.

Update your contact info at BenefitsCal.com today.

Keep Your Information Current:

Affected members will get letters by mail, text, or email. Make sure to keep your Medi-Cal information updated so you don’t miss important notices.

Check Your Mail:

Be sure to read any notifications you receive from the County. Watch your mail and respond quickly to Medi-Cal renewal packets or letters from your health plan or local county Medi-Cal office. Missing one letter could end your health and food benefits.

Know Your Renewal Date:

Know your renewal date so you can renew your Medi-Cal online or work with your local county Medi-Cal office if you do not receive notifications.

Report Changes Quickly:

If you become pregnant, get a new job, or experience a health change, tell the County immediately because this may exempt you from work requirements.

Apply Early:

Because the time frame to apply for "Retroactive" coverage is being cut, waiting to apply after an injury could leave you with thousands in unpaid bills.

Continue to Seek Care:

Keep going to the doctor and other medical appointments, and ask about available telehealth services.