This story was originally published by CalMatters. Sign up for their newsletters.
It’s a tumultuous time for healthcare. Federal and state budget cuts are changing the rules for public benefits. Most people with Medi-Cal won’t be affected, but it may be confusing to figure out whether your benefits will change.
The two most important things to do: Update your contact information with your county benefits office, and keep an eye out for any letters mailed from the county or state.
You can update your information by calling your local county office or online with a BenefitsCal account.
Here are the key changes, what they mean, and where to get help.
Changes for immigrants
Non-citizens — undocumented immigrants, refugees, asylum seekers, and people with pending immigration cases — are the group most affected, even those with a green card. The state has an immigration status chart to help you check whether these changes apply to you. If they do, you’ll get a letter.
Undocumented immigrants
- As of Jan. 1, immigrants over age 19 without legal status can no longer apply for Medi-Cal (children remain eligible).
- Those already enrolled keep benefits if they renew on time. If they miss the renewal deadline and coverage ends, they have three months to reapply. After that window, they cannot sign up again.
- Anyone who loses Medi-Cal may apply for emergency services. Those are limited to pregnancy, emergency visits and nursing home care.
- Starting Jan. 1, 2027, this group moves to “fee-for-service” Medi-Cal that limits some coverage. Doctors visits, prescriptions, and mental health treatment won’t be affected. Confirm your doctor accepts this Medi-Cal type, or find a new doctor by calling 1-800-541-5555.
- Adults ages 19-64 must also prove they are working or volunteering at least 80 hours a month. Students, people with disabilities and parents with young children are exempt from the work requirement. Starting July 1, 2027, adults lose dental coverage. Those 19-59 will also pay a $30 monthly fee.
- Children and pregnant individuals will remain eligible for Medi-Cal.
Refugees, asylum seekers, some green card holders
- Starting Jan. 1, 2027, refugees, asylum seekers, humanitarian parolees, and survivors of domestic violence or trafficking move to “fee-for-service” Medi-Cal. They will still be able to see the doctor, pick up prescriptions and see the dentist, but they will no longer have a health insurance plan. Call 1-800-541-5555 to find a new doctor if your current one does not accept it.
- Six months later, this group will lose full-scope Medi-Cal and dental benefits, keeping only pregnancy and emergency care.
Promotoras, community health workers and legal aid groups can help answer questions about this.
Adults without children
About 5 million Californians gained Medi-Cal coverage when the Obama administration expanded eligibility to childless adults and those earning slightly above the federal poverty level. Now this group faces stricter requirements in order to keep their health coverage.
Work requirements
- Beginning Jan. 1, adults 19-64 and many immigrants must prove at least 80 hours each month of working or volunteering, or half-time schooling.
- Who’s exempt: children, seniors, pregnant people, those who are disabled or have serious health conditions or addictions, people on Medicare, those recently released from prison, American Indians and Alaska Natives populations and some former foster youth.
- The state will mail a letter if this applies to you. Most renewal packets come in a bright yellow envelope, but notices may look different. Respond quickly.
More frequent renewals
Beginning next March, the state will check Medi-Cal eligibility every six months for adults ages 19-64 and many immigrants, verifying income, work status, and other requirements. Renewal may happen automatically; if it doesn’t you will receive a letter asking for more information.
Seniors (65+) and people with disabilities
Starting July 1, 2027, seniors (65+) and people with disabilities cannot own more than $21,000 in assets, including savings accounts, cash and property other than a home and a car. For couples it’s $31,000 total. This limit also applies to non-citizens. Your county benefits office or a local legal aid group can clarify what counts; the state also has an FAQ about the new limits.
If you’re afraid of losing coverage, do these things right now
Not everyone will be affected, and some people won’t need to do anything. If you’re required to report work hours or other information, you’ll receive a notice in the mail or through the BenefitsCal online portal if you have an online account: Check both regularly.
The state doesn’t yet have a timeline for initial notices, but advocates say the best move now is simply keeping your information current. This is especially important because the rules keep changing.
“It’s so vital they watch the mail, look out for communications from the county, and are responsive to requests for information,” said Jack Dailey, director of health policy at the Legal Aid Society of San Diego.
If you get a notice: You should have plenty of warning before benefits are terminated – respond promptly to any notice of action.
If you get a notice that your benefits will be cancelled and you disagree with that decision, you can appeal and request a state hearing, which “allows you to temporarily freeze an adverse action and keep your benefits while your appeal is being reviewed,” says Alicia Emanuel, a staff attorney with the National Health Law Program.
If you’ve already lost coverage: You have 90 days to restore benefits without filing a new application. Submit the requested information in that window and, if you still qualify, you shouldn’t see a coverage gap. After 90 days, you’ll need to reapply from scratch.
Where to get free help
Promotoras — community health workers trained through groups like Vision y Compromiso — can meet you in your neighborhood, explain benefits in plain language, and help with Medi-Cal applications. Rosa Lopez, a promotora in Long Beach, said many immigrants worry about losing coverage: “I tell them you don’t have status, don’t worry. The first thing is your health.”
Community clinics often have benefits counselors on staff, and legal aid groups offer free advice for confusing letters — call the Health Consumer Alliance at 1-888-804-3536, or check its website. The state also runs a helpline at 1-800-541-5555 and keeps its website up-to-date.
One more thing worth knowing: Medi-Cal eligibility isn’t just one door — there are several ways to qualify, based on conditions such as income, age, disability, or pregnancy. Before the state can terminate your benefits under one category, it must check whether you still qualify through any of the others. “It’s a really critical protection because sometimes an individual is in fact eligible through a different pathway,” Emanuel said. And by law, Medi-Cal must provide free language assistance for people with limited English proficiency.
