Medi-Cal Program Changes (2026-2027)

Medi-Cal Program Changes (2026-2027)

What Medi-Cal members need to know

For most Medi-Cal members, eligibility and benefits will stay the same.

January 2026 – ASSET LIMIT

Starting January 1, 2026, Medi-Cal will once again consider assets (what you own) when reviewing eligibility for older adults and people with disabilities as part of the application and renewal process.

Who: Medi-Cal members and applicants whose eligibility is based on age (65+), disability (physical, mental, or developmental), or long-term care needs.

Key information:

The asset limit is $130,000 for one person. Each additional household member adds $65,000 to the asset limit, up to 10 members per household.
Assets include bank accounts, cash, and anything over one home and one vehicle.
Some assets don’t count, like the home you live in, one vehicle, household items, and certain savings, like retirement accounts.
Assets will be reviewed during the annual renewal. Income rules are not changing.

January 2026 – ENROLLMENT FREEZE FOR UNDOCUMENTED MEMBERS. 19+

Starting January 1, 2026, Medi-Cal will freeze new enrollments for certain adults who are undocumented and do not have a satisfactory immigration status for federal full scope Medi-Cal. This group will no longer be able to newly enroll in full scope Medi-Cal, even if they qualified before under state-funded programs.

Satisfactory Immigration Status

California uses the term Satisfactory Immigration Status (SIS) to determine the scope of benefits for which you’re eligible.

If you have SIS, you may qualify for full coverage Medi-Cal benefits, including regular doctor visits, mental health care, dental, vision, and more.

You are considered to have SIS if:

You are a U.S. citizen or national, OR
You are a non-citizen who has an immigration status that allows eligibility for federally funded full coverage Medi-Cal. Examples include:

Lawful Permanent Residents (Green Card holders) who are exempt from or who have met the 5-year waiting period.
Refugees and asylees
Unsatisfactory Immigration Status

California uses the term Unsatisfactory Immigration Status (UIS) to determine when someone does not meet eligibility for full Medi-Cal benefits.

If you have UIS, it means your current immigration situation doesn’t meet the requirements for full benefits, either because your status isn’t one of the accepted categories or because it hasn’t been verified. In that case, you may still qualify for restricted coverage Medi-Cal, which covers emergency or pregnancy-related services.

You are considered to have UIS if you do not claim or cannot verify one of the recognized immigration statuses that qualify for federally funded full coverage Medi-Cal. Examples include:

You do not have a status or do not have an immigration status recognized by Medi-Cal.
You have DACA.
You are in the U.S. on a visitor visa, student visa, or temporary work visa (unless under age 21).
You have applied for a U visa (but it hasn’t been granted yet).
You were paroled into the U.S. for less than one year.

Who: Californians aged 19 and older, who are not pregnant, who are undocumented, and who qualify for full scope Medi-Cal because of the state-funded Adult Expansions.

Key information:

If someone is already enrolled in full scope Medi-Cal, they will stay covered no matter the immigration status as long as the annual renewal is completed by the given deadline.
If the Medi-Cal beneficiary is part of this group and loses coverage, she/he won’t be able to sign up again -except for emergency and pregnancy care.
If coverage stops because of a late renewal or missing paperwork, the beneficiary will have 90 days to fix it and stay enrolled.
Income-eligible children (0-18) and pregnant people can enroll in full Medi-Cal scope, no matter the immigration status. Coverage is for the entire pregnancy and one year after the pregnancy ends.

July 2026 – DENTAL COVERAGE

Starting July 2026, dental benefits will no longer be provided to adult Medi-Cal members who do not have satisfactory immigration status.

Who: Californians aged 19 and older who do not have satisfactory immigration status, including but not limited to:

Green card holders nonexempt from the five-year waiting period, who have had their permanent resident status for less than five years.
PRUCOL (e.g., with temporary protected status or refugee status).
People with no immigration status, but who currently qualify under past Medi-Cal expansions.
People enrolled through a trafficking or crime victim assistance program.
Lawfully present immigrants who are older than age 20 and not pregnant.

Key information:

Emergency dental care (such as treatment for severe pain or infection and tooth extractions) will still be covered for everyone, no matter their immigration status.
Pregnant people without satisfactory immigration status will continue to receive full dental benefits during pregnancy and up to one year after the pregnancy ends.

July 2027 – MONTHLY PREMIUMS

Starting July 1, 2027, certain adult Medi-Cal members who do not have a satisfactory immigration status must pay $30 per month to keep full scope Medi-Cal.

Who:

Californians aged 19-59, who are not pregnant, and who do not have a satisfactory immigration status, including but not limited to:

Green card holders subject to the five-year waiting period, who have had their permanent resident status for less than five years.
PRUCOL (e.g., with temporary protected status or refugee status).
People without federal immigration status who currently qualify under past Medi-Cal expansions.
People enrolled through a trafficking or crime victim assistance program.
Lawfully present immigrants who are older than age 20 and not pregnant.

Key information:

Full scope Medi-Cal coverage for this group includes doctor visits and preventive care, hospital and emergency services, prescription drugs, mental health and substance use disorder treatment, vision care, immunizations, and reproductive health services.

If a beneficiary is part of this group and does not pay the premium, coverage will be reduced to emergency and pregnancy-related services.

“This publication is supported by the Administration for Community Living (ACL), US Department of Health and Human Services (HHS) as part of a financial assistance award totaling $328,756with 100 percent funding by ACL/HHS. The contents are those of the author and do not necessarily represent the official views of, nor an endorsement by, ACL/HHS, or the US Government.”