Understanding Your California Medi-Cal 2026 Eligibility Requirements

If you get a number that is 0 or less, then you have no share of cost. You only have to pay a share of cost in months when you have medical expenditures. Example You live alone and have $1,935 monthly in countable earnings and have no other insurance coverage.

You get approved for ABD-MN Medi-Cal. Your share of cost is $1,935 (your countable income) - $600 (the Upkeep Needs Level for a private living alone) = $1,335. You will need to pay the first $1,335 in medical expenses throughout the month before Medi-Cal will begin covering you. If you get Supplemental Security Earnings (SSI), an advantage for people with low earnings who are aged, blind, or disabled, you get Medi-Cal instantly.

Read DB101's SSI article for more details about whether you qualify for SSI. If your SSI benefits go to zero since you return to work, an SSI guideline called 1619(b) lets you to keep your Medi-Cal protection if you: Were eligible for SSI benefits for a minimum of 1 month Need Medi-Cal coverage to keep working Still fulfill all the other SSI requirements, such as being handicapped, having resources below $2,000, and Earn less than $66,078 in gross income each year. After he began working, his earnings increased to $2,800 per month ($33,600 annually) triggering his monthly SSI benefit to drop to zero. Even though his income is now greater than the normal income limitations for Medi-Cal, he is still qualified for Medi-Cal through 1619(b) because his yearly earnings is less than $66,078.

Local Guidance On CA Life Coverage

If you are working, handicapped, and your earnings is too expensive to certify for free Medi-Cal, Medi-Cal's Working Handicapped Program may permit you to get Medi-Cal. Medi-Cal's Working Handicapped Program used to have a monthly premium. Beginning on July 1, 2022, there is no more premium. Find out more about this change.

You don't have to fulfill the earnings and work requirements. Be a U.S. resident or meet Supplemental Security Earnings's non-citizen requirements. Be working and earning earnings. The Medi-Cal guidelines do not specify what "working" implies for this program, and you can qualify if you are working part time. You can utilize pay-stubs or other composed confirmation from a company to show that you're working.

Have countable income less than 250% of the Federal Poverty Level ($3,325 per month for individuals and $4,508 for couples). These are countable earnings limitations, which is your gross earnings minus certain deductions. Your gross earnings can be much greater than your countable earnings.

Impairment earnings does not count for the WDP program. This indicates that SSDI, Employee's Settlement, California State Disability Insurance, and any federal, state, or private impairment benefits are not considered as earnings for this program. Keep in mind: If you got SSDI before you reached retirement age and now your SSDI advantages have been converted to Social Security retirement benefits, they will not be counted as income either.

Again, disability income does not count. If you are single and live on your own, you can use the tool below to help figure out your countable income.

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How to Qualify for California Coverage

For additional information Medi-Cal's Working Disabled Program, contact your regional county social services firm. Medi-Cal Eligibility Categories Summary Low to moderate earnings 138% of FPL for grownups 19-64 years of ages. 266% of FPL for kids 18 and under. Earned and unearned income is counted based on internal revenue service guidelines for modified adjusted gross earnings (MAGI).