Yes. Medi-Cal counts SSDI as income when deciding whether you qualify, and it counts the gross benefit shown on your award letter rather than the smaller amount that lands in your bank account after Medicare premiums come out. For a single adult in 2026, the standard Medi-Cal income limit sits around $1,836 per month, so an SSDI check above that figure can push you past the main eligibility threshold. California runs several alternative programs with different counting rules, and one of them will likely still cover you.
Gross SSDI Is the Number That Counts
Medi-Cal treats SSDI as countable income under both the MAGI (Modified Adjusted Gross Income) methodology used for most adults and the non-MAGI rules used for people with disabilities. Under MAGI, the state counts your gross Social Security benefit, not the net deposit that hits your bank account after Medicare premiums are withheld.1Department of Health Care Services. MAGI Income and Deduction Types That distinction matters. The standard Medicare Part B premium in 2026 is $202.90 per month, so the gross figure on your award letter can be meaningfully higher than what you actually receive.2Centers for Medicare & Medicaid Services. 2026 Medicare Parts A and B Premiums and Deductibles
Federal tax rules are more forgiving. The IRS only starts taxing Social Security benefits when your combined income exceeds $25,000 for a single filer.3Internal Revenue Service. Regular and Disability Benefits Medi-Cal doesn’t use that threshold. It counts your full gross benefit from the first dollar.
A quick boundary: none of this applies to Supplemental Security Income. SSI recipients in California automatically get free Medi-Cal without any separate income test.4Social Security Administration. Supplemental Security Income (SSI) in California SSDI is different. Because it’s earned through your work history and paid regardless of your current assets, it triggers a real eligibility calculation.
The MAGI Income Limits for 2026
Most adults under 65 are first evaluated under the MAGI methodology, which sets the income ceiling at 138% of the Federal Poverty Level. For 2026, the monthly limits are:5Covered California. Program Eligibility by Federal Poverty Level for 2026
- One person: approximately $1,836 per month
- Two people: approximately $2,489 per month6HHS ASPE. 2026 Poverty Guidelines: 48 Contiguous States, Alaska, and Hawaii
Household size drives the limit up, so a couple where one person receives SSDI has more room than a single applicant. If your gross SSDI check alone falls under the limit for your household size, you should qualify under MAGI. If it pushes you over, even by a small amount, the county isn’t supposed to simply deny you. California requires eligibility workers to screen you for every program you might fit, including the non-MAGI pathways below.7Department of Health Care Services. Aged, Blind and Disabled Federal Poverty Level Expansion Program
The ABD FPL Pathway Uses Deductions That Help SSDI Recipients
SSDI recipients with a recognized disability typically qualify for evaluation under the Aged, Blind, and Disabled Federal Poverty Level program instead of MAGI. ABD FPL comes with income disregards that can pull your countable income below the threshold.
Two deductions apply before the county compares your income to the limit. A $20 general income disregard is subtracted from unearned income like SSDI. Your Medicare Part B premium of $202.90 in 2026 is also deducted from gross income before the comparison.2Centers for Medicare & Medicaid Services. 2026 Medicare Parts A and B Premiums and Deductibles Together, those two knock more than $220 off your countable income each month.
For 2025, the ABD FPL income limit was $1,801 per month for an individual and $2,433 for a couple. The 2026 limits had not been officially published at the time of writing but typically increase in line with updated poverty guidelines. If your countable income after the disregards comes in under the ABD FPL limit, you get full-scope Medi-Cal at no cost.
What Happens If You’re Over Both Limits
If your income exceeds both the MAGI and ABD FPL limits, you don’t lose Medi-Cal entirely. The county may place you in the Aged, Blind, and Disabled Medically Needy program with a monthly Share of Cost. It works like a deductible: the county takes your net countable income, subtracts a maintenance need allowance for basic living expenses, and whatever remains is your Share of Cost. In months where your medical expenses exceed that amount, Medi-Cal pays the rest. In months with light expenses, you may cover everything out of pocket.
This matters most for SSDI recipients whose benefits sit a few hundred dollars over the ABD FPL limit. Coverage for expensive care like hospitalizations and surgeries stays intact. You just carry a predictable share each month before Medi-Cal starts paying.
The 250% Working Disabled Program
SSDI recipients who work at all, even part-time, should look at the 250% Working Disabled Program. It lets people with disabilities who are employed qualify with household income up to 250% of the Federal Poverty Level, roughly $3,260 per month for an individual in 2026.5Covered California. Program Eligibility by Federal Poverty Level for 2026 That’s well above the 138% FPL threshold used for standard MAGI.
To qualify, you must meet the federal definition of disability and be currently working in some capacity. There’s no minimum number of hours or earnings requirement. You also need to show that you’d be eligible for SSI if not for your earned income.8DHCS. Working Disabled Program The program used to charge a small monthly premium on a sliding scale, but as of July 2022, California eliminated it. Participants pay $0.
Many SSDI recipients who do some work assume the combined income disqualifies them from Medi-Cal, when the 250% WDP threshold is generous enough to cover most situations where someone collects SSDI and earns modest wages.
Impairment-Related Work Expenses Lower Your Countable Income
SSDI recipients who work can claim Impairment-Related Work Expenses to reduce countable income further. These are out-of-pocket costs you pay because of your disability that enable you to work. The full cost of the item or service comes off your income as long as it isn’t reimbursed by insurance or another source.9Department of Health Care Services. Treatment of Impairment-Related Work Expenses (IRWEs) and Blind Work Expenses (BWEs) for Medi-Cal Beneficiaries with Disability Linkage
Qualifying expenses include:
- Wheelchairs, braces, inhalers, catheters, and similar medical devices, plus their maintenance and repair
- Attendant care at home or help getting to and from work
- Bus fare, cab fare, or carpool costs for commuting
- Vehicle modifications needed because of your disability
- Medications and treatments essential for you to keep working
- The cost of a service animal, along with food and veterinary care
Document these expenses through the year and bring the records to eligibility reviews. Small monthly costs add up. Around $150 in qualifying expenses each month could be enough to bring your countable income below the ABD FPL threshold.
SSDI Back Pay Only Counts Once
Many people approved for SSDI receive a lump-sum back payment covering months or years of benefits. Under MAGI-based Medi-Cal, that lump sum counts as income only in the month you receive it.10Department of Health Care Services. Lump Sum Payments – Results So if a $15,000 retroactive payment lands in March, you’re over the limit for March alone. Starting in April, only your regular monthly SSDI benefit counts. A single month of ineligibility is far better than losing coverage permanently, but it can happen, so plan medical appointments accordingly if you know a lump sum is coming.
Report Your COLA Every January
Once you’re enrolled in Medi-Cal, you must report any change in income within 10 days.11DHCS. Update Information – Medi-Cal The one that catches people off guard is the annual Social Security cost-of-living adjustment. Each January, the SSA typically raises benefit amounts to keep pace with inflation. If that increase pushes your gross SSDI above the limit for your current Medi-Cal program, the county has to reassess your eligibility, potentially moving you to a different program or adding a Share of Cost.
Not reporting a COLA increase doesn’t make the problem go away. The county will discover the change at your annual renewal and may determine you owe an overpayment. Reporting proactively lets the county screen you for ABD FPL or the 250% Working Disabled Program before any gap in coverage develops.