Yes, Medi-Cal does cover long-term care in California, including nursing home stays, in-home caregiver help, and assisted living for a limited number of enrollees. Coverage depends on two separate tests: a medical determination that you need this level of care, and financial rules that in 2026 once again include asset limits alongside income rules. What you pay toward your own care, and whether you qualify at all, comes down to how you fit those two tests.
What Medi-Cal Pays For
Long-term care under Medi-Cal splits into three programs, each aimed at a different living situation.
Skilled nursing facilities provide round-the-clock care for people who can no longer manage daily life at home. Coverage includes both medical care and custodial help with eating, bathing, dressing, and moving around. Medi-Cal will pay indefinitely as long as you keep meeting the medical and financial requirements. This is different from the short-term rehab stays Medicare covers after a hospitalization.
In-Home Supportive Services pays a caregiver to come to your home and help with housekeeping, meals, laundry, bathing, and rides to medical appointments. The caregiver can be a family member or a friend, and the county sets hours based on an assessment of what you can safely do alone.1CDSS.ca.gov. In Home Supportive Services
The Assisted Living Waiver covers care in licensed residential care facilities for people who need a nursing-home level of care but would do better in a smaller setting. Space is tight. As of December 2025, roughly 14,800 people were enrolled while more than 18,300 sat on the waitlist.2DHCS – CA.gov. ALW Enrollment and Waitlist The waiver is also limited to applicants with no share of cost, which effectively means lower incomes.3DHCS – CA.gov. Assisted Living Waiver
The Medical Standard You Have to Meet
Before any of these programs pays a dollar, an evaluator has to confirm you need the care. For nursing facility placement and the Assisted Living Waiver, the standard is a “nursing facility level of care”: your physical or cognitive limitations are serious enough that you would otherwise need to live in a nursing home. A licensed nurse or physician documents how much help you need with the Activities of Daily Living, which are bathing, dressing, eating, toileting, and moving from a bed to a chair.
The bar is real. Occasional help with errands is not enough. The assessor is looking for people whose safety would be at risk without consistent, hands-on assistance. IHSS uses a somewhat lower threshold because it is designed to keep people at home who need daily help but can still live in their own residence with support.
Income Rules and Share of Cost
For nursing home care, there is no income cap for eligibility itself. Instead, nearly all of your monthly income goes straight to the facility, and Medi-Cal covers the rest. You keep a personal needs allowance of $35 per month, or $62 if you receive SSI. Some of your income may also be redirected to a spouse at home under the rules described further down.
For IHSS and the Assisted Living Waiver, the income limit is $1,801 per month. If you earn more than that, you may still qualify with a share of cost, which works like a monthly deductible. You pay a set amount toward your medical bills each month and Medi-Cal covers everything above it. The share of cost is your income minus a maintenance need allowance, which in 2026 is $600 for an individual and $934 for a couple.4CA.gov. Share of Cost – Medi-Cal Manual
Asset Limits Are Back in 2026
This is the biggest recent change, and it matters most for anyone who joined Medi-Cal in the last two years. California eliminated all Medi-Cal asset limits on January 1, 2024. That policy is over. Effective January 1, 2026, asset limits are back for every non-MAGI Medi-Cal program, including long-term care.5DHCS – CA.gov. DHCS Asset Limit Fact Sheet
Countable assets can total up to $130,000 for one person, with another $65,000 for each additional household member, up to ten people.6DHCS – CA.gov. Asset Limit Frequently Asked Questions Bank accounts, investments, and property beyond your primary home count. Your main residence, one vehicle, and certain other categories remain exempt. If you enrolled during the no-asset-limit window and now hold more than these thresholds, you could lose coverage at your next redetermination.
The 30-Month Look-Back on Transfers
Alongside the reinstated asset limits, California brought back a look-back period for anyone entering a nursing home on or after January 1, 2026. The state will review any assets you gave away or sold below fair market value in the 30 months before you entered the facility. Transfers made before January 1, 2026, do not count.6DHCS – CA.gov. Asset Limit Frequently Asked Questions
If the state finds you gave away assets to qualify, it can impose a penalty period during which Medi-Cal will not pay for nursing facility care. The penalty length depends on the value of what was transferred relative to nursing home costs. Gifting money to children or signing a house over to a family member during that window can leave you without coverage exactly when you need it. Any planning around these rules should happen well before a health crisis, and usually with an elder law attorney.
Protections When a Spouse Stays Home
When one spouse enters a nursing home and the other stays home, federal law keeps the at-home spouse from being wiped out. The protections cover both assets and income.
On the asset side, the at-home spouse can keep a Community Spouse Resource Allowance. In 2026, this runs from $32,532 to $162,660, depending on the couple’s total countable resources.7Centers for Medicare and Medicaid Services. 2026 SSI and Spousal Impoverishment Standards The home and one vehicle are typically exempt on top of that.
On the income side, the at-home spouse can draw a Monthly Maintenance Needs Allowance from the institutionalized spouse’s income. In 2026, that runs from $2,643.75 to $4,066.50 per month, depending on the at-home spouse’s own income and housing costs.7Centers for Medicare and Medicaid Services. 2026 SSI and Spousal Impoverishment Standards These protections are automatic, but you have to document both spouses’ income and assets during the application.
How to Apply
You will need proof of identity, California residency, income, and assets, plus medical records or a physician’s statement documenting your functional limitations.8Department of Health Care Services. Medi-Cal Help Center Income documentation includes Social Security statements, pension records, and any other payment sources. With asset limits back in effect, expect to provide statements for bank accounts and other holdings, and be ready for questions about recent transfers if you are applying for nursing home coverage.
You can apply through the BenefitsCal online portal, by mail to your county social services office, or in person. Federal rules give the county 45 days to decide most applications, and 90 days when eligibility rests on a disability determination.9GovInfo. 42 CFR 435.911 Timely Determination of Eligibility You will receive a Notice of Action stating whether you were approved, when coverage starts, and what your share of cost is.
If You Are Denied
You can request a state fair hearing within 90 days of the Notice of Action.10DHCS – CA.gov. Medi-Cal Fair Hearing If you already have Medi-Cal and file before the effective date on the notice, your benefits continue during the appeal under a rule called “aid paid pending.”11eCFR. 42 CFR Part 431 Subpart E – Fair Hearings for Applicants and Beneficiaries One caution: if the hearing goes against you, the state can seek repayment for services provided while the appeal was pending.
What the State Can Recover After Death
After a Medi-Cal recipient dies, the Department of Health Care Services can file a claim against the estate for the value of long-term care services it paid. California limits recovery to what federal law requires: nursing facility care, home and community-based services, and related hospital and prescription costs for recipients who received the services at age 55 or older. Nursing facility services can be recovered regardless of the recipient’s age.12California Legislative Information. California Welfare and Institutions Code 14009.5
Recovery reaches only assets that pass through probate. Property held in a living trust or in joint tenancy is generally out of reach. The state also cannot recover when the deceased leaves behind a spouse or registered domestic partner, a child under 21, or a child of any age who is blind or permanently disabled.13Medicaid.gov. Estate Recovery California also waives its claim when the estate is a modest homestead and recovery would cause substantial hardship.12California Legislative Information. California Welfare and Institutions Code 14009.5 You can ask DHCS once per calendar year for an estimate of what could be recovered from your estate.