Social Security does count as income for Medi-Cal in California, with one clear exception. Retirement benefits, Social Security Disability Insurance (SSDI), and survivors benefits are all treated as unearned income and counted at their gross amount. Supplemental Security Income (SSI) is not counted at all, and SSI recipients qualify for Medi-Cal automatically. How much of your Social Security ends up in the eligibility math after that depends on your age, disability status, and which Medi-Cal track you fall under.
Which Social Security Payments Count
Three types of Social Security payments count toward your Medi-Cal income total: retirement, SSDI, and survivors benefits. All three are unearned income, and Medi-Cal uses the gross benefit, not what lands in your account.
That distinction matters. If your Social Security statement shows a gross benefit of $1,600 but your deposit is $1,430 after the Medicare Part B premium is withheld, the number you report is $1,600. Applicants routinely enter the deposit amount instead, and the county catches the mismatch when it cross-checks federal records. The result is a slower application, sometimes a denial letter that has to be appealed.
Use the figure from your Social Security benefit verification letter. You can download it from your account at ssa.gov, and the annual COLA notice mailed in December works as documentation for the following year.
Why SSI Is the Exception
Supplemental Security Income runs on separate rules. Medi-Cal does not count SSI as income, and receiving SSI in California qualifies you for Medi-Cal automatically without a separate income test.1California Health and Human Services. SSI Benefits and Medi-Cal California’s State Supplementary Payment, added on top of federal SSI, is also excluded.
If you receive both a small Social Security retirement check and an SSI payment, only the retirement portion counts. The SSI portion is invisible to the eligibility process.
How Your Age and Category Change the Math
California runs two parallel eligibility systems, and the same Social Security check can be counted differently depending on which one applies to you.
- MAGI (Modified Adjusted Gross Income) covers most adults ages 19 through 64, children, parents, caretaker relatives, and pregnant individuals. Income follows federal tax rules, and your full gross Social Security benefit goes into the household total.
- Non-MAGI covers adults 65 and older, people who are blind or have a disability, individuals in long-term care, and Medicare recipients. It uses older Medicaid rules that allow certain deductions before income is compared to the limit.2Department of Health Care Services. Medi-Cal Help Center – Coverage for All
Most people collecting Social Security retirement are 65 or older and fall under Non-MAGI. Someone under 65 collecting SSDI is usually evaluated under MAGI unless they qualify for a disability-based Non-MAGI category. The difference is not trivial, because Non-MAGI applicants get income disregards that MAGI applicants don’t.
Non-MAGI Disregards That Reduce Countable Income
Under Non-MAGI, the state subtracts specific amounts from your gross Social Security before comparing it to the limit. The first $20 of unearned income each month is disregarded.3Social Security Administration. Code of Federal Regulations 416.1124 – Unearned Income We Do Not Count If you also work, $90 per month comes off for work-related expenses.4Department of Health Care Services. Non-MAGI Medi-Cal Out-of-pocket health insurance premiums are also deductible.
These sound small, but they can move you across the line. A gross benefit of $1,850 drops to $1,830 after the $20 disregard alone.
MAGI Includes the Full Gross Amount
MAGI has no equivalent disregards for Social Security. The framework starts with adjusted gross income, then adds back tax-exempt interest and the non-taxable portion of Social Security benefits, so the entire gross amount ends up in the calculation regardless of what would be taxable on a federal return.5DHCS. Updated ACA Coverage Brief MAGI Coverage Group Hierarchy
2026 Income Limits
The 2026 Federal Poverty Level for a single individual in the 48 contiguous states is $15,960 per year, or $1,330 per month.6ASPE. 2026 Poverty Guidelines – 48 Contiguous States Both MAGI and Non-MAGI programs for adults use 138% of the FPL as their primary income threshold, which works out to roughly $1,835 per month for an individual.
For the Non-MAGI Aged, Blind, and Disabled Federal Poverty Level program, the 138% limit is applied after the disregards are subtracted. So a Non-MAGI applicant with a gross Social Security check of $1,850 can still qualify once the $20 general disregard and any other applicable deductions bring countable income under the threshold.
Going over the 138% limit does not end the conversation. California has additional pathways for higher-income applicants, including the Share of Cost program.
When Social Security Puts You Over the Limit
If your Social Security income pushes you above 138% of the FPL, California’s Medically Needy program offers a backup. Instead of a denial, you’re assigned a monthly Share of Cost that works like a deductible. Each month you must incur medical expenses equal to that amount before Medi-Cal starts paying.
The calculation subtracts a Maintenance Need Allowance from your countable monthly income. For 2026, the individual allowance is $600, and everything above it becomes your Share of Cost. Countable income of $1,900 produces a Share of Cost of $1,300, meaning you would need $1,300 in medical bills each month before Medi-Cal covers the rest.7Medi-Cal. Share of Cost (SOC) – Medi-Cal Providers
Any medically necessary service or supply counts toward the Share of Cost, whether or not Medi-Cal would normally cover it: prescriptions, doctor visits, dental work, medical equipment, out-of-pocket insurance premiums. Once your bills hit the amount, Medi-Cal pays the rest of your covered services that month. The counter resets on the first of the next month.
Medicare Savings Programs
If you receive both Social Security and Medicare, California’s Medicare Savings Programs can help with premiums, deductibles, and copays even when your income is too high for full Medi-Cal. Each program has its own income limit, and Social Security counts toward it.
- Qualified Medicare Beneficiary (QMB) pays Part A and Part B premiums, deductibles, and copays. The 2026 individual income limit is $1,350 per month.8Social Security Administration (SSA) Program Operations Manual System (POMS). Medicare Savings Programs Income and Resource Limits
- Specified Low-Income Medicare Beneficiary (SLMB) pays the Part B premium. Individual limit: $1,616 per month.
- Qualifying Individual (QI) also pays the Part B premium with a slightly higher ceiling. Individual limit: $1,816 per month.
QMB has real teeth: Medicare providers are legally prohibited from billing QMB enrollees for cost-sharing.9Centers for Medicare & Medicaid Services (CMS). Beneficiaries Dually Eligible for Medicare and Medicaid If your Social Security disqualifies you from regular Medi-Cal, one of these programs may still cut your healthcare costs substantially. You apply through your county social services office using the same Medi-Cal application.
The COLA Timing Problem
Social Security payments typically increase every January through a cost-of-living adjustment. The Federal Poverty Level guidelines that set Medi-Cal’s income limits are usually updated a few weeks later. During the gap, a COLA raise can push your income past the old threshold even though the new, higher threshold hasn’t been published.
Some county offices have terminated or reduced coverage in January or February by comparing the new Social Security amount against the previous year’s FPL. If you get a reduction or termination notice during that window, check whether the county used updated FPL figures. If they didn’t, file an appeal immediately and ask that your benefits continue during the review.
Even after the FPL catches up, a large enough COLA can still push you over the new limit. If you were sitting just below 138% in December, you may be above it in January. Share of Cost is the fallback in that situation; you keep access to Medi-Cal, but with a monthly deductible.
Reporting Your Benefit Amount
California requires Medi-Cal beneficiaries to report any change in income within 10 days.10Department of Health Care Services. Update Information – Medi-Cal A COLA increase, a new SSDI award, or the start of survivors benefits all qualify. Missing the deadline can create an overpayment the state will later try to recover.
When you apply or report a change, use the gross benefit shown on your Social Security benefit verification letter.11Social Security Administration. Get Benefit Verification Letter Whether you’re using the Single Streamlined Application or form MC 210, enter that number, not the deposit amount. The county will verify it against federal records, and any mismatch slows the process.
If your Medi-Cal is denied or reduced because the county counted your Social Security incorrectly, such as by treating SSI as income, skipping the $20 disregard, or using outdated FPL figures, you have 90 days from the Notice of Action to request a state fair hearing.12Department of Health Care Services. Medi-Cal Fair Hearing Requesting the hearing before the effective date on the notice keeps your coverage in place while the appeal is decided.