California Medi-Cal eligibility comes down to three things: you live in California, you fit into one of the program’s covered categories (adults 19–64, children, pregnant individuals, seniors, or people with disabilities), and your income falls at or below the limit for your category. For most single adults in 2026, that limit is roughly $22,025 a year; for a family of four, about $45,540.1California Department of Health Care Services. 2026 Federal Poverty Levels Immigration status no longer disqualifies anyone, and the asset rules that once shut out many seniors have been loosened dramatically.
Income Limits by Category
Medi-Cal measures income against the Federal Poverty Level. The 2026 guideline is $15,960 a year for a single person and $33,000 for a family of four.2ASPE. 2026 Poverty Guidelines Most adults qualify at 138% of that number, which is where the $22,025 single-person figure comes from.1California Department of Health Care Services. 2026 Federal Poverty Levels
Some groups qualify at higher income levels. Pregnant individuals are eligible for full-scope coverage up to 213% of the Federal Poverty Level. Children and teens can qualify up to 266% of poverty, so a family that earns too much for adult Medi-Cal may still get their kids covered.3California Department of Health Care Services. 2025 Federal Poverty Levels – Section: Enclosure 3
The program looks at gross income before most deductions: wages, Social Security, unemployment, and similar sources. Self-employment income is reduced by legitimate business expenses. For most applicants, Medi-Cal uses Modified Adjusted Gross Income rules, essentially the same rules used on federal tax returns. That means what you currently earn matters, not what you’ve saved over time.
Do Your Savings and Property Count?
For most adults under 65, children, and pregnant individuals, no. These are the MAGI groups, and only income matters. Assets are federally excluded from the calculation.
For people 65 and older, those with disabilities, nursing home residents, and families whose income exceeds MAGI thresholds, California does count assets, but the ceiling is now $130,000 for one person and $65,000 for each additional household member up to ten people.4Department of Health Care Services. Asset Limit Frequently Asked Questions Under the old rules, a single person was capped at $2,000, so many seniors and people with disabilities who were previously denied now qualify.
Your primary home and one vehicle don’t count. Bank accounts, cash, stocks, bonds, and additional real estate do. If you’re over the limit, you can spend down by paying medical bills, buying household necessities, or paying rent or mortgage.4Department of Health Care Services. Asset Limit Frequently Asked Questions
Who Fits Into an Eligible Category
Income alone isn’t the whole test. You also need to fit into one of the program’s categories, which in practice cover most low-income Californians.5Department of Health Care Services. Medi-Cal Overview
- Adults ages 19–64 at or below 138% of the Federal Poverty Level who don’t qualify in another category.
- Children and teens, with income thresholds extending up to 266% of poverty depending on age and program.
- Pregnant individuals up to 213% of poverty, with coverage continuing through the end of the month 12 months after delivery.
- Seniors 65 and older, through the Aged, Blind, and Disabled Federal Poverty Level program (asset limits apply).
- People with disabilities, through the same Aged, Blind, and Disabled pathway, with disability confirmed through a medical determination.
- Former foster youth up to age 26, regardless of income, if they were in foster care and enrolled in Medicaid at age 18 or older.
Residency and Immigration Status
You must live in California and intend to stay. There’s no minimum time requirement. A lease, utility bill, or piece of mail showing your California address is enough to prove it.
Immigration status is no longer a barrier to full-scope Medi-Cal. As of January 1, 2024, adults ages 26–49 became the final group added, completing the expansion.6Medi-Cal. Ages 26 Through 49 Adult Full Scope Medi-Cal Expansion All low-income California residents can now receive full Medi-Cal benefits regardless of immigration status, as long as they meet the income and category rules.
Provide a Social Security Number if you have one. If you don’t and aren’t eligible for one, you can provide an Individual Taxpayer Identification Number or sign a statement that you don’t have an SSN. It won’t stop your enrollment.
If Your Income Is Slightly Too High
The Medically Needy pathway can still get you covered if your income is over the limit but you have significant medical expenses. You pay a monthly “share of cost” — the gap between your income and the state’s maintenance need level — and once you’ve hit that amount in medical costs for the month, Medi-Cal pays the rest. Unpaid provider bills can count toward the share of cost, not just what you’ve actually paid. This pathway is most relevant for seniors and people with disabilities whose income puts them just above the standard threshold. Your county office calculates the exact figure.
How to Apply
What to Gather First
You’ll need proof of income (a recent pay stub or your most recent federal tax return), proof of your California address (a lease, utility bill, or piece of mail), and identification for each household member applying (driver’s license, birth certificate, or passport).7Department of Health Care Services. Medi-Cal Request for Information MC 355 Immigration documents help if you have them but aren’t required for eligibility.
Report monthly gross income before taxes. If your earnings vary, report what you’re currently making rather than an average of past months.
Where to Submit
The fastest option is BenefitsCal, the state’s online benefits portal, where you can fill out the application and upload documents in a single session.8BenefitsCal. BenefitsCal Covered California also accepts Medi-Cal applications and will route you to subsidized private coverage if your income turns out to be too high.9Department of Health Care Services. Apply for Medi-Cal You can also mail or hand-deliver a paper application to your county social services office.
Standard applications must be processed within 45 days. Disability-related applications get up to 90 days because a medical determination is involved.10California Department of Health Care Services. Medi-Cal Eligibility Division Information Letter No. I 23-55 You’ll receive a Notice of Action with the decision. Keep copies of everything you submit.
Coverage for Bills You Already Have
Medi-Cal can pay medical expenses you incurred up to three months before you applied, if you would have been eligible during those months.11Department of Health Care Services. Medi-Cal Reimbursement for Medical Expenses The services must have been medically necessary and the kind Medi-Cal covers. If you paid out of pocket, you can request reimbursement through your county office. If you delayed applying because of a health crisis, those earlier bills may not be yours alone to carry.
After You’re Approved
Most enrollees join a managed care health plan that coordinates care through a network of doctors, hospitals, and pharmacies. The state sends you information about the plans available in your county and gives you time to choose. If you don’t pick one, you’ll be auto-assigned, typically to a plan that includes doctors you’ve seen before. You can switch to another available plan within 90 days of enrollment.12eCFR. 42 CFR 438.54 – Managed Care Enrollment The DHCS Health Care Options program handles selections and changes.
Renewals
Eligibility is reviewed once every 12 months. The county first tries to confirm your eligibility automatically using wage records, tax filings, and other electronic data — an ex parte renewal. If it works, your coverage continues and you get a notice saying so.13Medicaid.gov. Basic Requirements for Conducting Ex Parte Renewals of Medicaid and CHIP Eligibility If the automatic check falls short, you’ll get a renewal form in the mail and at least 30 days to send it back with any requested documents. Ignoring the form is the most common way people lose coverage they still qualify for. Keep your address current with your county office so notices reach you.
A change takes effect January 1, 2027: adults enrolled through the 19–64 expansion group will renew every six months instead of every 12. This new federal requirement doesn’t apply to children, pregnant individuals, seniors, or people with disabilities, who remain on the annual cycle.14Medicaid.gov. Implementation of Eligibility Redeterminations, Section 71107 of the Working Families Tax Cut Legislation
If You’re Denied
Your Notice of Action will explain why and how to appeal. You can request a State Fair Hearing within 90 days of the notice.15eCFR. 42 CFR Part 431 Subpart E – Fair Hearings for Applicants and Beneficiaries If you’re already enrolled and you request a hearing within 10 days of a termination or reduction notice, your benefits continue at the same level until the hearing is decided. This is called aid paid pending. Miss that 10-day window and your coverage may stop while you wait. Requests can be filed by phone, mail, or online through BenefitsCal.
A Note for Seniors: Estate Recovery
Medi-Cal is free while you’re alive, but the state can seek reimbursement from your estate after you die for certain services if you were 55 or older when you received them: nursing facility care, home and community-based services, and related hospital and prescription costs.16ASPE. Medicaid Estate Recovery California does not pursue recovery for basic outpatient care like doctor visits or standard prescriptions. Recovery is also limited to assets that pass through probate, so property held in joint tenancy, living trusts, or other arrangements that avoid probate is generally out of reach.
Recovery is barred entirely while a surviving spouse or registered domestic partner is alive, and it’s barred if the deceased is survived by a child under 21 or a child of any age who is blind or disabled.16ASPE. Medicaid Estate Recovery Hardship waivers are also required when recovery would force a family out of a home of modest value, defined in California as a home worth 50% or less of the average home price in the county. If you’re a senior with property, this is worth reviewing with a qualified elder law attorney before you enroll.