medicaid/california/eligibility-income-limits

Last updated: May 3, 2026 · Verified for 2026 program year · Reading time: ~22 minutes

If you are searching "Medi-Cal income limit 2026" or "Medi-Cal asset limit 2026," you are arriving at a uniquely turbulent moment. Two of the most generous Medi-Cal expansions in California history, the elimination of the non-MAGI asset test and the opening of full-scope coverage to all undocumented adults, were partially reversed on January 1, 2026 by AB 116 (Chapter 21, Statutes of 2025), the FY 2025-26 Health Omnibus Trailer Bill. The asset reinstatement alone has reshaped financial planning for hundreds of thousands of older Californians and people with disabilities who had two years to forget that asset limits existed.

This guide is your reset button. It walks through every Medi-Cal income standard in effect on May 3, 2026, every reinstated asset rule, every category-specific eligibility threshold, and every applicant-facing nuance, Spousal Impoverishment math, transfer-penalty look-back ramp-up, the 250% Working Disabled Program, Medically Needy Share-of-Cost, and the question that confuses applicants from every other income-cap state: do I need a Miller Trust in California? (Spoiler: no, you don't.)

We've cross-checked every figure against DHCS All County Welfare Director Letters (ACWDLs), the 2026 federal poverty guidelines, the SSA 2026 COLA fact sheet, the CMS December 9, 2025 Spousal Impoverishment Standards CIB, and the most current legal-aid analyses from CANHR, Justice in Aging, Disability Rights California, and the Health Consumer Alliance.

By Brevy Care Team · Last verified May 3, 2026

MAGI Medi-Cal: The Income-Only Categories

MAGI Medi-Cal, the post-ACA expansion framework, uses Modified Adjusted Gross Income only. There is no asset test for any MAGI category. This is the single most important fact to remember if you are an adult, a parent, a pregnant person, or a child.

Adult Expansion (138% FPL)

W&I Code §14005.60. Open to adults age 19-64 who are not pregnant, not Medicare-enrolled, and not categorically eligible under another non-MAGI rule. 2026 income threshold: 138% FPL ≈ $1,836/month single, $2,489/month for two. No assets considered.

A 2026 wrinkle: Undocumented adults age 26+ who applied for the first time on or after 1/1/2026 cannot enroll in the full-scope Unsatisfactory Immigration Status (UIS) program, AB 116 froze new UIS adult enrollment to close a budget shortfall. Existing UIS enrollees as of 12/31/2025 are grandfathered. Children 0-25 remain unaffected, and emergency/pregnancy-only Medi-Cal still applies regardless of immigration status. See our California Medi-Cal Programs guide for the full UIS history.

Parents and Caretaker Relatives (138% FPL)

Same 138% FPL threshold. Caretaker relatives include grandparents, aunts, uncles, and other adults caring for related children, they qualify on the basis of the child's residency in their home.

Pregnant Women (213% FPL Medi-Cal; 213-322% MCAP)

Pregnant women earning up to 213% FPL qualify for full-scope Medi-Cal. Between 213% and 322% FPL, they qualify for the Medi-Cal Access Program (MCAP), a state-funded program that mirrors Medi-Cal benefits with a small premium ($1,500-$3,000 over the program duration depending on income).

12-month postpartum coverage: Effective April 1, 2022, all women who qualified for Medi-Cal during pregnancy receive continuous Medi-Cal for 12 months postpartum regardless of income changes. The statutory authority is the 2021-22 Budget Act + AB 133 (2021) implementing ARPA §9812, not SB 65 (which is the broader "California Momnibus" maternal-health package). This distinction matters because legal aid attorneys and journalists frequently misattribute the postpartum extension. The actual implementation came through the 2021 Health Omnibus Trailer Bill.

Children (Multiple Bands)

Two layered continuous-coverage protections for kids:

1. Multi-year continuous coverage birth-to-age-5, California-specific, adopted in the 2022-23 budget. Children stay continuously enrolled through age 5 regardless of family income changes. Funded again in the 2025-26 budget; remains in effect.
2. Federal 12-month continuous eligibility for children under 19, Effective 1/1/2024 under §5112 of the Consolidated Appropriations Act of 2023. Once a child is enrolled, they keep coverage for 12 months even if family income rises.

Family PACT (Family-Planning-Only at 200% FPL)

Family PACT covers contraception, STI testing, and reproductive health services. No income documentation required at the point of service; eligibility self-attested. No asset test.

Former Foster Youth (No Income Limit, Ages 18-26)

Anyone who was in California foster care on their 18th birthday (or aged out from foster care in another state and now resides in California) qualifies for Medi-Cal up to age 26 with no income or asset test. This program parallels the ACA's coverage for adult children up to 26, but for kids who didn't have parents to keep them on family insurance.

Non-MAGI Medi-Cal: Where Assets Now Matter Again

Non-MAGI Medi-Cal applies to seniors (65+), people with disabilities, applicants needing long-term care, and a handful of historical eligibility categories. Non-MAGI uses SSI methodology for income counting, meaning some income disregards apply, and (post-1/1/2026) reinstated asset limits.

SSI-Linked Medi-Cal (Automatic for SSI Recipients)

If you receive SSI in California, you are automatically enrolled in Medi-Cal under California's "1634 agreement" with the Social Security Administration, no separate Medi-Cal application required. Income limits: $994/month single / $1,491/month couple. Asset limits: $2,000 single / $3,000 couple, the federal SSI standard, unchanged by AB 116.

Aged & Disabled FPL Program (A&D FPL)

Authority: W&I §14005.40. Designed to cover seniors and people with disabilities who lost SSI due to a small Social Security increase but still need Medi-Cal. 2026 income limits effective 4/1/2026: approximately $1,835/month single / $2,489/month couple after the $230 single / $310 couple income disregards. Asset limits (post-1/1/2026): $130,000 single / $195,000 couple.

Medically Needy / Share of Cost (No Income Limit)

If your income exceeds the A&D FPL threshold, you can still qualify for Medi-Cal under the Medically Needy / Share of Cost (SOC) pathway. There is no income limit. Instead, you pay a Share of Cost each month before Medi-Cal kicks in:

Share of Cost = Countable Monthly Income − $600 MNL (single) − $35 PNA (if institutional)
                − allowable health insurance premiums

For a community-dwelling single applicant earning $2,000/month with $200/month Medicare premium: SOC = $2,000 − $600 − $200 = $1,200/month. The applicant pays $1,200 in medical bills before Medi-Cal pays anything in that month. The MNL of $600 ($934 for two) was set by W&I §14005.7 and has not been adjusted for decades, making SOC eligibility increasingly unforgiving as costs rise.

250% Working Disabled Program (250% WDP)

Authority: W&I §14005.40. For working people with disabilities. 2026 income limit: ~$3,325/month (250% of FPL). 2026 asset limit: $130,000 single / $195,000 couple. Premium: $20-$250/month sliding scale, plus retirement-account contributions (IRA/401(k)) are treated as non-countable.

This program is one of the most generous in the country for working people with disabilities, substantially more than the federal "Medicaid Buy-In for Workers with Disabilities" baseline. CANHR maintains a detailed 250% WDP fact sheet that walks through premium calculation step-by-step.

Pickle Amendment Recipients

If you previously received SSI but lost it solely because of a Title II (Social Security) Cost-of-Living Adjustment, you remain Medi-Cal eligible under the Pickle Amendment (1976, named for Rep. J.J. Pickle). California implements via DHCS ACWDL c07-28. Pickle recipients are statutorily exempt from the 1/1/2026 asset reinstatement, they continue under the no-asset-test rules that applied 1/1/2024-12/31/2025.

Disabled Adult Children (DAC, §1634(c))

Adults with disabilities that began before age 22, who receive Social Security on a parent's record after the parent's retirement, disability, or death. DAC recipients are also statutorily exempt from the 1/1/2026 asset reinstatement.

Disabled Widow(er)s (DWW, §1634(b))

Widow(er)s with disabilities aged 50-64 receiving Social Security survivors' benefits. DWW recipients are also statutorily exempt from the 1/1/2026 asset reinstatement.

Long-Term Care Institutional Medi-Cal

Income cap: 300% SSI FBR = $2,982/month. Asset limit: $130,000 (single) / $195,000 (couple) per AB 116. If your income is above $2,982/month, you do NOT need a Miller Trust, see "Why California Is Not a Miller Trust State" below. You enroll via Medically Needy / Share of Cost, which is mathematically equivalent.

The 1/1/2026 Asset Limit Reinstatement: Everything You Need to Know

This is the single biggest 2026 Medi-Cal change. AB 116 (Chapter 21, Statutes of 2025), the FY 2025-26 Health Omnibus Trailer Bill, reversed Phase 2 of California's two-step elimination of the non-MAGI asset test. Phase 1 (7/1/2022) had raised the limit to $130K single / $195K couple. Phase 2 (1/1/2024) had eliminated all asset tests for non-MAGI Medi-Cal. Phase 2 is now over.

Effective Date and Limits

DHCS implements via ACWDL 25-18. The CalSAWS eligibility platform was reconfigured before 1/1/2026; renewals on or after that date now require non-MAGI applicants to provide bank statements, retirement account statements, vehicle registrations, and real-property deeds.

Who Is NOT Affected

• All MAGI Medi-Cal categories (Adult Expansion, parents, pregnant women, children), never had an asset test.
• SSI-linked Medi-Cal, federal $2,000/$3,000 limits unchanged.
• Pickle Amendment recipients, statutorily exempt.
• Disabled Adult Children (DAC), statutorily exempt.
• Disabled Widow(er)s (DWW), statutorily exempt.

Exempt Assets (Don't Count Toward the Limit)

• Principal residence (regardless of value, if applicant intends to return).
• One vehicle.
• Household goods and personal effects.
• Irrevocable burial trusts (any amount), prepaid burial plans, burial plot.
• Term life insurance (no cash value).
• Cash-value life insurance with face value ≤$1,500/person.
• Retirement accounts in periodic distribution mode, once you elect to take Required Minimum Distributions (RMDs), the IRA balance is treated as income, not a countable asset. Before RMD election, the full balance counts.

Transfers Between 1/1/2024 and 12/31/2025 Are Shielded

This is one of the most important practical rules for 2026 LTC applicants. Transfers made during the 24-month asset-test-elimination window are not subject to transfer-penalty review when applying after 1/1/2026. Counties cannot reach back into that period for gifting, irrevocable trust funding, real-property transfers, or other dispositions.

The 30-Month Lookback Ramp-Up

California's transfer-penalty look-back is California-specific, not the federal 60-month standard. California elected a phased ramp-up:

• Feb 2026: New LTC applicants face a 1-month lookback.
• March 2026: 2 months.
• April 2026: 3 months.
• ... (one additional month each subsequent month) ...
• July 2028: 30 months, the maximum.

The 2026 Transfer-Penalty Divisor (APPR)

The Average Private Pay Rate (APPR) is California's 2026 transfer-penalty divisor: $14,440/month. If a county finds an uncompensated transfer during the lookback, divide the transfer amount by $14,440 to calculate the months of LTC ineligibility. Example: a $50,000 gift to a child during the 30-month lookback = $50,000 ÷ $14,440 = 3.46 months of ineligibility.

HCBS Spousal Impoverishment Carve-Out (W&I §14005.41)

California applies federal Spousal Impoverishment protections to BOTH institutional Medi-Cal AND home- and community-based services (HCBA, ALW, MSSP) AND IHSS. This places California among the more generous states for HCBS spousal protection, most states apply Spousal Impoverishment only to institutional Medi-Cal. See "Spousal Impoverishment Mechanics" below.

Spousal Impoverishment Mechanics (Married LTC Applicants)

If you are married and one spouse is applying for institutional Medi-Cal or an HCBS waiver, federal Spousal Impoverishment rules (42 U.S.C. §1396r-5) protect the community spouse from being impoverished by the institutionalized spouse's care costs.

2026 Standards (CMS CIB Issued 12/9/2025)

How CSRA Works

When the institutionalized spouse applies for Medi-Cal, the couple's combined non-exempt assets are inventoried as of the date of admission ("snapshot date"). The community spouse may keep up to the CSRA maximum ($162,660 in 2026), with a minimum protection of $32,532. The institutionalized spouse must spend down their own assets to $130,000.

How MMMNA Works

The community spouse is allowed to keep enough of the institutionalized spouse's monthly income to bring their own income up to the MMMNA. Standard 2026 MMMNA range: $2,643.75 - $4,066.50/month, depending on shelter expenses (housing allowance $793.13 added to certain shelter costs above 30% of MMMNA).

The 90-Day CSRA Transfer Period

After Medi-Cal eligibility is approved, the institutionalized spouse has 90 days to transfer assets up to the CSRA to the community spouse without transfer-penalty exposure. This is a critical planning window, many applicants miss it because counties don't always send timely notices.

Spousal Refusal (W&I §14009.5)

California recognizes "spousal refusal", the community spouse can decline to use their separate property to support the institutionalized spouse. In that case, Medi-Cal pays for institutional care, and the state may seek cost recovery from the community spouse afterward. Historically, California's enforcement has been infrequent, but advocates report increased state interest in 2024-2025. The doctrine is most useful when the community spouse holds substantial pre-marital or inherited assets.

HCBS Application Per W&I §14005.41

California is one of the few states that applies Spousal Impoverishment protections to HCBS waivers (HCBA, ALW, MSSP) AND IHSS. If your spouse is applying for an HCBS service (rather than nursing home placement), you still get CSRA, MMMNA, and the 90-day Transfer Period. CANHR's Using California's Spousal Impoverishment Rule for HCBS is the authoritative guide.

Same-Sex Couples and Registered Domestic Partners

Same-sex married couples and registered domestic partners receive identical Spousal Impoverishment protections under California law.

Why California Is Not a Miller Trust / QIT State

If you have read about Texas, Florida, Arizona, or Nevada Medicaid for long-term care, you've encountered Miller Trusts (also called Qualified Income Trusts, or QITs). These trusts are required in "income-cap" states for applicants whose monthly income exceeds 300% SSI FBR ($2,982/month in 2026). Without a QIT, an over-cap applicant in TX/FL/AZ cannot qualify for institutional Medicaid at all.

California is structurally different. California is technically an income-cap state, but you do not need a QIT. Here's why:

1. California's LTC institutional Medi-Cal income cap is 300% FBR ($2,982/month), same as TX/FL/AZ.
2. But California also has the Medically Needy / Share-of-Cost pathway, which has no income limit.
3. An over-cap applicant simply enrolls via Medically Needy / SOC, the over-cap income above the MNL becomes the Share of Cost, which is paid to the facility each month.
4. Medi-Cal then pays the difference between the facility rate and the SOC, exactly as it would with a QIT.
5. The applicant's out-of-pocket cost is identical whether they use Medically Needy / SOC or a QIT: $35/month Personal Needs Allowance.

The practical upshot: California applicants save the $1,500-$3,000 in legal fees plus ongoing trustee, banking, and tax compliance costs that QIT setup imposes in other states. Some California elder-law attorneys still recommend QITs in unusual circumstances (e.g., self-settled trusts for veterans benefits coordination), but they are not a state-mandated planning tool.

Long-Term Care Eligibility Math (Worked Example)

Here is the full SOC calculation for a single LTC applicant with no spouse:

Applicant: Mary, age 82, widowed, entering a skilled nursing facility on April 15, 2026. Income: $4,500/month from Social Security and a pension. Assets: $115,000 (under the $130,000 limit after spending down a $30,000 CD). Health insurance: Medicare Part B premium $202.90/month (2026 standard); supplemental Plan G $245/month.

Step 1: Establish Medi-Cal eligibility. Income $4,500 > $2,982 LTC cap. Apply via Medically Needy / SOC.

Step 2: Calculate Share of Cost.

• Gross income: $4,500
• Less Personal Needs Allowance: −$35
• Less Medicare Part B premium: −$202.90
• Less Plan G premium: −$245
• Share of Cost: $4,017.10/month

Step 3: Mary pays $4,017.10 to the nursing home each month from her income.

Step 4: Medi-Cal pays the difference between the facility rate and the SOC. If the Medi-Cal-rate facility charge is $11,000/month, Medi-Cal pays $11,000 − $4,017.10 = $6,982.90/month.

Mary's net out-of-pocket: $35/month PNA. Same as a Miller Trust state applicant.

Estate Recovery Under SB 833 (2017)

California has the most restrictive Medicaid estate recovery program in the nation following SB 833 (Chapter 30, Statutes of 2016), effective January 1, 2017. Recovery is limited to:

1. LTC services for ages 55+ only, nursing facility care, HCBS waiver services (HCBA, ALW, MSSP), and related hospital and prescription drug services. NOT general Medi-Cal benefits, managed-care premiums, or routine office visits.
2. Probate-only assets, assets passing via revocable living trust, joint tenancy, beneficiary designation, transfer-on-death deed, or other probate-avoidance devices are NOT subject to recovery.
3. Surviving spouse exemption, no recovery on the estate of a surviving spouse or registered domestic partner, even if the Medi-Cal recipient died before 1/1/2017.
4. Homestead-of-modest-value waiver, the state waives its claim if the home's fair market value is ≤50% of the average home price in the county where it sits as of date of death.
5. Hardship waiver, available where recovery would create undue hardship for survivors.

Practical effect: A community-dwelling Medi-Cal recipient under age 55 who never receives LTC services has zero estate recovery exposure. An LTC recipient who titles their home in a revocable living trust before death generally avoids recovery as well.

CANHR's Medi-Cal Recovery Booklet (July 2025) is the most comprehensive guide.

Continuous Coverage Protections (2026)

The 90-day Reasonable Opportunity Period and 90-day Reconsideration window are particularly important post-unwinding. If you were terminated for failing to return paperwork during the 2023-2024 federal continuous-coverage unwinding, you generally had 90 days to return the MC 355 RFI and have coverage restored without reapplying. A meaningful portion of unwinding-era terminations were procedural, not substantive, meaning the affected member would have remained eligible if they had returned the paperwork.

How to Apply

Online: BenefitsCal.com

BenefitsCal is the unified self-service portal for Medi-Cal, CalFresh, and CalWORKs. It connects to CalSAWS, the single statewide eligibility platform that all 58 county welfare departments now operate on (as of late 2023, replacing legacy LRS, C-IV, and CalWIN systems).

Through BenefitsCal you can apply, upload documents, submit annual renewals, report changes, check status, and request replacement EBT cards.

Phone

• Medi-Cal Member Helpline: 1-800-541-5555
• Local County Welfare Department (look up your county at BenefitsCal)

In-Person

Local County Welfare Department offices in all 58 counties. Many require appointments post-COVID.

Paper

• SAWS 1, Statewide Automated Welfare System Application (single integrated application for Medi-Cal/CalFresh/CalWORKs). Available in 13+ languages.
• MC 210, Medi-Cal-only paper application.

Mail or hand-deliver to the county welfare department.

Documents You'll Need

Always:

• Photo ID
• Social Security Number (or proof of application)
• Proof of California residency
• Proof of income (paystubs, tax returns, SSA award letter)
• Proof of citizenship/immigration status (for full-scope; state-funded coverage doesn't require)

For non-MAGI applicants (post-1/1/2026):

• Bank statements (typically 90 days)
• Vehicle title/registration
• Real property deeds
• Life insurance policies (face value)
• IRA/pension/retirement statements with distribution schedule

For LTC applicants:

• Past 30 months of bank statements (during the lookback ramp-up window, fewer earlier in 2026)
• Marriage certificate (for spousal protection)
• Medical records establishing Nursing Facility Level of Care (NFLOC)

Decision Timelines

• Standard determinations: 45 days from application receipt
• Disability-based determinations: Up to 90 days
• Federal cap: 90 days from application, absolute deadline under federal Medicaid rules
• Retroactive coverage: Up to 3 months retroactive coverage for medical bills incurred before application, if you would have been eligible at the time of service

Phone Numbers and Resources

Bottom Line: What 2026 Means for You

1. MAGI Medi-Cal eligibility is unchanged, adults at 138% FPL, children up to 322% FPL, pregnant women with 12-month postpartum coverage. No asset test.
2. Non-MAGI Medi-Cal asset limits are back at $130K single / $195K couple. Plan accordingly if you've added assets since 1/1/2024 thinking the asset test was permanently gone.
3. The 1/1/2024-12/31/2025 transfer-shield window is one of the most important practical rules of 2026. If you transferred assets during that window, those transfers cannot be reviewed.
4. Pickle / DAC / DWW recipients are statutorily exempt from the asset reinstatement and continue under no-asset-test rules.
5. California is NOT a Miller Trust state, over-cap LTC applicants enroll via Medically Needy / Share of Cost. You save the QIT setup costs that TX/FL/AZ applicants face.
6. Spousal Impoverishment protections apply to HCBS waivers AND IHSS in California per W&I §14005.41, placing California among the most generous states for spousal protection in home- and community-based settings.

If you are a senior or person with a disability evaluating Medi-Cal eligibility for the first time, or re-evaluating after the 2026 changes, your best next steps are: (1) call the Health Consumer Alliance at 1-888-804-3536 for free legal counseling, (2) call CANHR at 1-800-474-1116 if you have an LTC question, and (3) start an application at BenefitsCal.com.

If you are doing Medi-Cal LTC planning, do not wait. The 30-month lookback is ramping up, and any new transfer made today will be reviewed when the lookback reaches 30 months in July 2028. Speak with an elder-law attorney who is familiar with California-specific rules, particularly W&I §14005.41 (HCBS spousal impoverishment) and the Medically Needy / SOC pathway.

Find personalized help with Medi-Cal eligibility in California at brevy.com.

This guide reflects Medi-Cal eligibility rules in effect on May 3, 2026. For information on Medi-Cal program structure overall, see our California Medi-Cal Programs Guide. For application walkthroughs, see How to Apply for Medi-Cal. For long-term care planning specifically, see Medi-Cal Long-Term Care. Sources: DHCS, CMS Spousal Impoverishment 2026 CIB, HHS 2026 FPL, SSA 2026 COLA, CANHR, Justice in Aging, Disability Rights California, Health Consumer Alliance.