Medi-Cal Eligibility and Benefit Changes

Below are the changes happening in 2027. This information will be updated as necessary.

Starting January 1, 2027, some Medi-Cal enrollees must do one or more of the following: 

• Work at a job and get paid.
• Earn at least $580 a month from working.
• Be a seasonal worker (someone who only works during certain times of the year) 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. This should be organized and something you can prove you did with a letter or form.
• 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.

These new work or volunteer rules do not apply to:

• Children (0–18).
• Older adults (65 and older).
• Pregnant people, including one year postpartum, regardless of birth outcome.
• Parents with children age 0-13.
• People with disabilities.
• People with serious health or mental health conditions or substance use problems.
• People who were released from jail or prison within the last 90 days.
• People on Medicare Part A or Part B.
• American Indians or Alaska Natives.
• Former foster youth under age 26, who were in foster care on their 18th birthday.

Important to know:

• If you are required to meet the rules and if you do not, you could lose your Medi-Cal.
• When you get a letter from Medi-Cal or your county office, open it right away and respond quickly.
• Medi-Cal will send more information before this rule starts, including ways to help you meet the rules.

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

Who will continue to renew once-a-year?

• Members in a Medi-Cal program that is not under the Affordable Care Act new adult group.
• Pregnant or postpartum individuals.
• Alaska Native or American Indian members.
• Former foster youth under age 26, who were in foster care on their 18th birthday.

Important to know:

• If you are required to meet the rules but do not, you could lose your Medi-Cal.
• When you get a letter from Medi-Cal or your county office, open it right away and respond quickly.
• Medi-Cal will send more information before this rule starts, including ways to help you meet the rules.

These members will continue to renew once a year:

• People not in the ACA new adult group
• The ACA new adult group includes adults aged 19-64 who do not have children and have an income below 138% of the Federal Poverty Level.
• Pregnant or postpartum people
• Alaska Native or American Indian members
• People under age 26 who were in foster care on their 18th birthday

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.

Who this applies to:

You may be affected if you:

• Are age 65 or older
• Have a disability (physical, mental, or developmental)
• Live in a nursing home
• Are in a family that makes too much money to qualify under federal tax rules

Important to know:

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)

Assets that count include:

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

Assets that don’t count include:

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

Starting January 1, 2027, some members will get their care through Fee-for-Service (FFS) Medi-Cal instead of a health plan. This changes how you get care, not whether you can keep Medi-Cal.

Who this applies to:

• 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.

Important to know:

• You will stay covered if you renew on time.
• “Fee-for-Service” does not mean you pay. Medi-Cal still pays for your care.
• You will not be in a health plan anymore. Instead, you can go to any doctor or clinic that accepts FFS Medi-Cal.
• 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. How dental care works depends on your county.
• Enhanced Care Management and Community Supports (services only available in health plans) will not continue in FFS Medi-Cal.
• Other help is still available, like Community Health Workers, chronic care management, doula services, and county mental health programs.
• DHCS will offer new help during this change, including a nurse advice line and community navigators to guide you and answer questions.
• You will get more information before the change begins.

Starting July 1, 2027, some Medi-Cal dental benefits will change for certain adult members based on immigration status. However, emergency dental services will still be covered by Medi-Cal.

Important to know:

If this change affects you, you can use your Medi-Cal dental benefits until June 30, 2027. Starting July 1, 2027, you will no longer have full-scope dental benefits and may be disenrolled from your Medi-Cal Dental Plan (Dental Managed Care Plan). If you have a dental emergency, you can go to a Medi-Cal dental provider for care.

To learn more about Medi-Cal Dental services, you can call the Medi-Cal Dental Customer Service Center Monday-Friday, 8 a.m.-5 p.m. (except state holidays), at 1-800-322-6384. You can also visit smilecalifornia.org/benefitchanges/.

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

Who this applies to:

• 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 who have with a pending immigration case.

Important to know:

Starting July 1, 2027, people in this group will only be able to get pregnancy-related care and emergency services.

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.

Who this applies to:

• Please visit https://www.dhcs.ca.gov/immigration-status-and-changes-to-medi-cal-eligibility/

A Medi-Cal member will not have to pay a premium if they 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

Important to know:

If a Medi-Cal member doesn’t pay, their Medi-Cal will change to restricted-scope, which covers:

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