by Kristen Hwang and Ana B. Ibarra
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.
Are you on Medi-Cal, or is someone in your family worried about the cuts?
Tell us about your health coverage, and we’ll share advice, information and updates.
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
The CUT
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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.
