What’s changing with Medi-Cal (Medicaid) in California?

Changes are coming to Medi-Cal, California’s version of Medicaid, including rules that will affect who qualifies, who needs to meet work requirements, and what you need to do to keep your health coverage active.

Not all of the new Medicaid rules will start at once, so it’s important to stay on top of the changes in California. The best way to stay up-to-date is to make sure that the California benefits office has your current mailing address and contact information.

California is required to send a notice in the mail whenever there are changes with your case.

If you are a Medi-Cal member, here’s what you need to know about changes coming soon to your health coverage.

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What changes are coming to Medi-Cal in California?#what-changes-are-coming-to-medi-cal-in-california

Several Medicaid rule changes are coming to Medi-Cal, including:

• New community engagement requirements for some adults: Also called, “work rules” or “work requirements,” this new rule requires some adults, considered “able-bodied adults without dependents” to complete qualifying activities each month to keep their benefits.
• More frequent Medi-Cal renewals for some members: This new rule requires some people with Medi-Cal to renew every six months instead of once per year.
• Changes to eligibility rules: These new rules impact Medi-Cal eligibility requirements including immigration status and asset limits.
• Changes to coverage: These new rules impact retroactive coverage (coverage for care you received before you applied for Medi-Cal), cost of services, and types of services for some Medi-Cal members.

Rule changes do not apply to everyone who has Medi-Cal. Be sure to reach out to your case manager or local benefits office if you have questions about how upcoming changes might affect you.

Who will be affected by the Medi-Cal changes in California?#who-will-be-affected-by-the-medi-cal-changes-in-california

Not every change applies to every Medi-Cal member.

Many of the biggest changes affect adults ages 19 to 64 who qualify through the Affordable Care Act (ACA) expansion group.#many-of-the-biggest-changes-affect-adults-ages-19-to-64-who-qualify-through-the-affordable-care-act-aca-expansion-group

This generally includes adults with low incomes who qualify for Medi-Cal based on their income rather than because they are pregnant, have a disability, are an older adult, or qualify through another special eligibility group.

These adults may be affected by new community engagement requirements, six-month renewals, shorter retroactive coverage, and new copayments.

How do the changes affect Medi-Cal members with certain immigration statuses?#how-do-the-changes-affect-medi-cal-members-with-certain-immigration-statuses

Depending on your immigration status, changes may affect whether you can newly enroll in full-scope Medi-Cal, whether you can keep full-scope coverage, whether you receive care through a Medi-Cal health plan or Fee-for-Service, your dental benefits, and whether you have to pay a monthly premium.

Immigration rules are different depending on your status. You can check the California Department of Health Care Services' Immigration Status and Changes to Medi-Cal Eligibility page to see which changes apply to your immigration category.

Who is exempt from Medi-Cal changes?#who-is-exempt-from-medi-cal-changes

Whether a new rule applies to you depends on why you qualify for Medi-Cal and, for some changes, your age, pregnancy status, disability status, immigration status, income, or other circumstances.

For many rule changes, children, pregnant and postpartum people, older adults, people with disabilities, American Indians and Alaska Natives, certain former foster youth, and people with Medicare are excluded from some of the new requirements. The exact exceptions depend on the rule.

Your county Medi-Cal office may reach out and request additional information to prove you qualify for an exemption. If you have questions about whether you qualify for an exemption, reach out to your case manager or local benefits office.

What are the new community engagement requirements for Medi-Cal in California?#what-are-the-new-community-engagement-requirements-for-medi-cal-in-california

Starting January 1, 2027, some adults enrolled in Medi-Cal will need to meet new community engagement requirements, also called work requirements, to qualify for or keep their Medi-Cal health coverage.

Generally, affected adults will need to prove that they earn $580 per month of income or complete at least 80 hours per month of qualifying activities.

Community engagement can include activities such as:

• Working at a job for 80 hours per month or earning at least $580 a month
• Being a seasonal worker and earning an average of $580 a month over the last six months
• Staying enrolled in a job training program (that helps you learn skills to get a job) for at least 80 hours a month
• Volunteering or doing community service for at least 80 hours a month
• Going to school at least half-time (usually two or three classes, or about six to eight credits each semester)
• Doing a mix of the activities above so the total is at least 80 hours a month or at least $580 of earned income a month

When the new community engagement rules take effect you may receive a letter in the mail from Medi-Cal. This letter will explain if you are required to meet the work rules, what types of activities qualify, and how to provide proof. If you do not need to follow the new work rules, Medi-Call may request additional information to prove you are exempt.

If you are required to meet the community engagement rules and do not, you could lose your Medi-Cal health coverage benefits.

How are Medi-Cal renewals changing in California?#how-are-medi-cal-renewals-changing-in-california

Starting January 1, 2027, some adults enrolled in Medi-Cal will need to renew their eligibility for Medi-Cal twice per year to keep their health coverage instead of once.

The timing of the new rules depends on when you applied or last renewed:

• If you newly enroll in Medi-Cal after January 1, 2027, you will have your first eligibility check 6 months after you’re approved and continue completing renewals every 6 months.
• If you already had Medi-Cal before January 1, 2027, you will have your next renewal at 12 months, and then your renewals after March 2027 will be every 6 months. For example if you renew your benefits in October 2026, your next renewal will be in October 2027 and your first 6-month renewal will be April 2028.

This change affects Medi-Cal members who are adults ages 19-64 and get Medi-Cal as part of the Affordable Care Act (ACA) expansion group.

Some people are exempt and do not need to follow these rules including people who are not in the ACA expansion group, people who are pregnant or postpartum, Alaska Natives and American Indians, and people under age 26 who were in foster care on their 18th birthday.

How is Medi-Cal eligibility changing in California?#how-is-medi-cal-eligibility-changing-in-california

Several Medi-Cal eligibility rules are changing in California, some based on new federal Medicaid rules, while others are California-specific changes.

The biggest changes to Medi-Cal eligibility affect how immigration status and assets impact who qualifies.

• New enrollment limits based on immigration status: As of January 1, 2026, some adults can no longer newly enroll in full-scope Medi-Cal because of their immigration status. If you already had full-scope Medi-Cal before the change, you can keep your coverage as long as you continue to qualify and renew on time.
  • If your Medi-Cal ends, you only have three months to sign up again. If you miss the three-month period, you must apply again, but will only be able to get restricted-scope Medi-Cal, which covers emergency care, pregnancy care, and nursing home care.
• Full-scope Medi-Cal ending for certain immigrants: Starting July 1, 2027, some immigrants will lose full-scope Medi-Cal and will only be able to get pregnancy-related care and emergency services. Groups that will lose full-scope Medi-Cal include refugees, asylees, humanitarian parolees, and survivors of domestic violence or human trafficking who have a pending immigration case.
• Fee-for-Service Medi-Cal for certain immigrants: Starting January 1, 2027, some immigrants, including undocumented people, certain green card holders in the five-year waiting period, and some people with PRUCOL status, will get their care through Fee-for-Service (FFS) Medi-Cal instead of a Medi-Cal health plan. This changes how you get care, not whether you can keep Medi-Cal. You can see providers that accept FFS Medi-Cal, and Medi-Cal will still pay for covered care.
• New asset limits for some Medi-Cal members: As of January 1, 2026, Medi-Cal limits how much some people can have in certain assets, like cash and bank accounts. The rules generally affect people who are 65 or older, have a disability, live in a nursing home, or qualify through certain other pathways that consider assets. The limit is $130,000 for one person through June 30, 2027, but drops to $21,000 for one person starting July 1, 2027. The home you live in, one vehicle, household items, and some retirement savings do not count towards your assets.

How is Medi-Cal coverage changing in California?#how-is-medi-cal-coverage-changing-in-california

Several changes are coming to what Medi-Cal covers and what some members may have to pay for their healthcare. Here’s what’s changing and when:

• Less retroactive coverage for past medical bills: Starting January 1, 2027, Medi-Cal will cover fewer months of eligible medical bills from before you applied. Adults ages 19 to 64 without children ages 18 and under will be able to get one month of retroactive coverage, while everyone else will be able to get two months. This means it’s even more important to stay on top of renewals.
• Reduced dental coverage for some immigrants: Starting July 1, 2027, some Medi-Cal members will no longer receive full-scope dental benefits based on their immigration status. People who lose full-scope dental benefits will still be able to get emergency dental care for problems like severe tooth pain, infections, and tooth removal. Children, pregnant people and people up to one year postpartum, and certain former foster youth under age 26 will continue to receive full dental benefits regardless of immigration status.
• New monthly premiums for some adults: Starting July 1, 2027, some Medi-Cal members will have to pay a monthly premium to keep full-scope Medi-Cal based on their immigration status. If you are required to pay a premium and don't pay it, your coverage will change to restricted-scope Medi-Cal, which covers emergency care, pregnancy-related care, and nursing home care. Children, pregnant and postpartum people, and certain former foster youth under age 26 will not have to pay the premium regardless of immigration status.
• New copayments for some adults: Starting October 1, 2028, some adults ages 19 to 64 who are not pregnant, are not enrolled in Medicare (see who is eligible for both Medicaid and Medicare), and make more than $15,560 per year may have to pay copays for certain services, such as specialist visits, treatments, or tests. Total copays cannot exceed 5% of your household's income in a year. There will be no copays for certain services, including emergency care, regular checkups, pregnancy care, mental health and substance use treatment, or care for children.

When do the Medi-Cal changes start in California?#when-do-the-medi-cal-changes-start-in-california

Some of the changes are already in effect as of 2026, others begin in 2027.

What if I lose Medi-Cal because of the new rules?#what-if-i-lose-medi-cal-because-of-the-new-rules

If you lose Medi-Cal because of the new rules, you may have other options for health coverage. What you should do next depends on why your coverage ended and whether you qualify for another program.

Depending on your situation, you may be able to:

• Get restricted-scope Medi-Cal for certain services if you lose full-scope coverage because of your immigration status
• Reapply for Medi-Cal if you become eligible again or can share any missing information that affected your renewal
• Appeal the Medi-Cal decision if you believe your coverage ending is a mistake
• Get coverage through Covered California, California's Health Insurance Marketplace, and see if you qualify for financial help that lowers your monthly premium or other costs
• Enroll in Medicare if you qualify based on your age, disability, or other status

Be sure to read any notices you receive from Medi-Cal or your county Medi-Cal office. Your notice should explain why your coverage is changing, when the change takes effect, and what options you have to keep or replace your health coverage.