How to Check If You Qualify for Medi-Cal in California - and What to Do Next
What is the income limit to qualify for Medi-Cal in California in 2026?
For most adults under 65, Medi-Cal eligibility is set at 138% of the federal poverty level, which the California Department of Health Care Services updates each year when federal poverty guidelines change. As of 2026, that is roughly $20,000 annually for a single adult, but confirm the current figure for your household size at dhcs.ca.gov or by calling 1-800-541-5555.
Can undocumented immigrants get Medi-Cal in California?
Yes. California has extended full-scope Medi-Cal coverage to income-eligible adults regardless of immigration status. Undocumented adults who meet California's income and residency requirements may qualify for full benefits, not just emergency care. This expansion was completed in 2024. Income thresholds are the same as for other adults; check dhcs.ca.gov for current eligibility rules.
Does Medi-Cal have an open enrollment period like Covered California?
No. Medi-Cal has no open-enrollment window - you can apply any day of the year. If approved, coverage can start as early as the first day of the month you applied, and in some cases retroactively for the prior month if you had qualifying medical expenses during that period. Apply online at BenefitsCal.com or coveredca.com.
What happens if my Medi-Cal is terminated and I think I'm still eligible?
If your Medi-Cal coverage is terminated and you believe you still qualify, you have the right to appeal by requesting a state fair hearing. California law generally gives you 90 days from the notice of action to file. If you request the hearing before your termination date, you may be able to keep benefits during the appeal. Contact the California Department of Social Services at cdss.ca.gov or 1-800-952-5253.
Does Medi-Cal satisfy California's individual health insurance mandate?
Yes. Medi-Cal counts as qualifying health coverage under California's individual mandate, which has been in effect since 2020. Californians who go without qualifying coverage in a given year can face a state tax penalty administered by the Franchise Tax Board. Enrolling in Medi-Cal satisfies the coverage requirement and eliminates any penalty for the months you were enrolled. See ftb.ca.gov for current penalty details.
More than 14 million Californians are enrolled in Medi-Cal, the state's Medicaid program, making it one of the largest public health insurance programs in the country. Yet every year, people who are eligible either don't know it or assume the application process is too complicated to bother with. It isn't - but knowing where to start matters.
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Who Qualifies for Medi-Cal
Medi-Cal eligibility is primarily based on income, household size, immigration status, and age - though different eligibility pathways exist for different groups. For most adults under 65, the main income threshold is set at 138% of the federal poverty level. As of 2026, that works out to roughly $20,000 a year for a single adult and around $34,000 for a family of three, though the California Department of Health Care Services (DHCS) updates these figures annually when federal poverty guidelines change - check dhcs.ca.gov or call 1-800-541-5555 to confirm the current limits for your household size.
California expanded Medi-Cal under the Affordable Care Act, and the state has also extended full-scope coverage to income-eligible adults regardless of immigration status. That means undocumented adults who meet the income and residency requirements may now qualify for full benefits, not just emergency care - a significant change that took effect in stages and was completed in 2024. Children, pregnant people, and individuals who are blind, disabled, or in long-term care have their own eligibility rules and may qualify at higher income levels.
If your income is above Medi-Cal's threshold but you don't have coverage through an employer, you may qualify for a subsidized plan through Covered California instead. The two programs are directly connected - when you apply through coveredca.com, the system automatically screens you for Medi-Cal eligibility first.
How to Apply
Unlike Covered California's private plans, Medi-Cal has no open-enrollment window. You can apply any day of the year, and if you're approved, coverage can start as early as the first day of the month you applied - or in some cases, the month before, if you had eligible medical expenses during that period (this is called retroactive coverage, and it's worth asking about if you've recently had medical bills).
There are four ways to apply. Online is often the fastest: BenefitsCal.com is California's unified benefits portal for Medi-Cal and other assistance programs. You can also apply through coveredca.com, which routes Medi-Cal-eligible applicants to the right place. If you prefer paper, a county social services office can provide a mail-in application. You can also apply in person at your county's social services or human services agency - county offices vary in name (Los Angeles County uses the Department of Public Social Services; Alameda County uses the Social Services Agency, for example), so search your county's name plus "Medi-Cal application" to find the right office.
Certified enrollment counselors and Covered California-certified agents can also help you apply at no charge. Find one at coveredca.com/find-help.
What You'll Need to Gather
The application will ask for basic identifying information - name, date of birth, address, Social Security number if you have one (it's not required for all applicants), and current income. You'll need to report income for everyone in your household, including wages, self-employment income, unemployment benefits, and most other regular income sources. You don't need to document assets like a savings account or a car; California eliminated asset tests for most Medi-Cal applicants.
If you're applying based on disability or a specific medical condition, the process can involve additional documentation, and those cases sometimes take longer to process. The standard timeline for a routine application is generally 45 days, though disability-based cases can take up to 90 days, according to DHCS guidance.
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After You Apply: Renewals and What Can Go Wrong
Once you're enrolled, Medi-Cal renews annually. The state is required to send you a renewal packet when your renewal period comes up - typically by mail to the address on file. This is where a lot of people lose coverage unnecessarily: if the renewal packet goes to an old address, or if someone doesn't return the paperwork, coverage can be terminated even if the person is still eligible. Keeping your address current with your county office is one of the most practical things a Medi-Cal enrollee can do.
If your coverage is terminated and you believe you're still eligible, you have the right to appeal. California law gives you 90 days from the notice of action to file a state fair hearing request. You can request a hearing through the California Department of Social Services at cdss.ca.gov or by calling 1-800-952-5253. If you request a hearing before your termination date, you may be able to continue receiving benefits during the appeal process - this is called "aid paid pending," and it's worth asking about specifically when you call.
The California Individual Mandate and How Medi-Cal Fits In
California reinstated its own individual health insurance mandate starting in 2020, after the federal penalty was zeroed out. That means Californians who go without qualifying health coverage in a given year can face a state tax penalty when they file their California income tax return. Medi-Cal counts as qualifying coverage, so enrolling satisfies both the coverage requirement and the penalty concern. The penalty amount is calculated based on household income and family size; the California Franchise Tax Board (FTB) administers it, and current penalty details are at ftb.ca.gov.
This is general information, not legal or medical advice. Medi-Cal eligibility rules, income thresholds, and application procedures can change, and your specific situation may involve factors not covered here. Verify current eligibility limits and application requirements directly with the California Department of Health Care Services at dhcs.ca.gov, or through BenefitsCal.com or coveredca.com.