Medi-Cal Benefit and Rule Changes

Renewing your Medi-Cal each year is important. It helps you keep the doctors, services and care you depend on. This year, it’s more important than ever because state budget changes and new federal laws affect who is eligible for full‑scope Medi‑Cal, which services are covered, and what some adult members may have to pay. Here’s what’s new and what you need to know to stay covered.

✓ Dental services

Full dental coverage for some adults with unsatisfactory immigration status (UIS) ends.   

Emergency dental services will remain covered.

✓ Work and community engagement requirements

To keep full‑scope coverage, adults subject to this rule must complete and report at least 80 hours per month of qualifying activities. Children, pregnant people, and other exempt adults will not be subject to these rules. If this rule applies to you, the county Medi-Cal office will send you a letter.

✓ Shorter renewal timeline

Adults subject to the work requirement will move from an annual renewal to a six‑month eligibility renewal cycle. This means you will need to renew your Medi-Cal twice a year to maintain your coverage. Missing a renewal or failing to report hours may cause a lapse in coverage.

✓ Retroactive coverage

Adults age 19-64 who do not have children or a qualifying disability are limited to one month prior to application. All other groups are limited to two months prior to application.

✓  Premiums

Some adults with unsatisfactory immigration status (UIS) will require a monthly fee (called a premium) to keep their full-scope Medi-Cal benefits.

✓  Medi-Cal copayments

Some adults without children may need to pay a small fee (called a copayment) to receive certain healthcare services. These fees can be as low as one cent for nonemergency services and won’t exceed $35 per service. Providers may have the option to waive these payments. Essential services like preventive care, ER visits and others are exempt.