California Medicaid is a joint federal and state program that pays for health care for people with low income

In California, Medicaid is called Medi-Cal. It covers doctor visits, hospital stays, prescription drugs, mental health care, and other medical services for people who meet income and other requirements. The program is funded partly by the federal government and partly by California, but it is run by the state.

Medi-Cal is not the same as Medicare, which is a federal program for people over 65 or with certain disabilities. Medi-Cal is for people under 65 with low income, regardless of disability status. You can have both programs at the same time.

California expanded Medi-Cal may be able to access over time, so more people may have access to now than in other states. The income limits are higher, and California covers some groups that other states do not — including undocumented immigrants in certain age ranges and people who are homeless or at risk of homelessness.

Key Takeaways

  • Medi-Cal covers medical, dental, vision, and mental health services for people with low income in California.
  • Income limits vary by family size and by which group you fall into — for example, parents, children, pregnant people, or seniors.
  • You can enroll in Medi-Cal year-round; there is no open enrollment period like there is for other health insurance.
  • California covers some groups that other states do not, including undocumented immigrants ages 26 to 49 and people experiencing homelessness.
  • The state uses your tax return, pay stubs, and other documents to verify your income; you do not have to be a U.S. citizen to enroll.

Income limits and who qualifies

Medi-Cal income limits depend on your family size and which group you belong to. A single adult with no children has a different limit than a parent with two children. The limits also differ by category — for example, pregnant people and children have higher income limits than working-age adults without dependents.

As of 2024, a single adult can earn up to about 138% of the federal poverty level and still may have access to. For a family of three, the limit is higher in absolute dollars. These numbers change each year, so you should check the current limits on the California Department of Health Care Services website or through a local enrollment helper.

You do not have to be a U.S. citizen to enroll in Medi-Cal. Undocumented immigrants can enroll if they meet the income and residency requirements. California also covers some groups with higher income limits or no income limit at all — for example, people over 65, people who are blind, and people with disabilities.

What Medi-Cal covers

Medi-Cal covers a broad range of services. This includes doctor visits, hospital stays, emergency care, prescription drugs, mental health and substance use treatment, dental care, vision care, and hearing aids. It also covers preventive care like cancer screenings and vaccinations at no cost to you.

Some services may require a copay — usually a small amount like $1 to $3 per visit or prescription. Pregnant people and children under 21 have no copays. If you are on Medi-Cal because you are over 65 or have a disability, your copays may be different.

Medi-Cal also covers long-term care services for people who need help with daily activities. This can include nursing home care, in-home care, and adult day programs. These services are available only if you meet medical and financial requirements.

How to enroll in Medi-Cal

You can enroll in Medi-Cal at any time of year through several routes. The easiest is to go online to the California Department of Social Services website and create an account. You can also call the Medi-Cal hotline, visit your county social services office in person, or work with a community organization that helps people enroll.

When you enroll, you will need to provide proof of income (like a recent pay stub or tax return), proof of California residency (like a utility bill or lease), and your Social Security number if you have one. If you are undocumented, you do not need a Social Security number. You will also need to list anyone in your household who wants coverage.

The state will review your information and tell you whether you may have access to. This usually takes 30 days, but can be faster if you enroll online. Once you are approved, your coverage starts on the first day of the month after you enroll, or sometimes the same month if you enroll early in the month.

Medi-Cal managed care versus fee-for-service

Most people on Medi-Cal in California are enrolled in a managed care plan. This means you choose a health plan (or one is assigned to you), and that plan coordinates your care. You pick a primary care doctor, and that doctor refers you to specialists. The plan pays the doctors and hospitals.

Some people are in fee-for-service Medi-Cal instead. This means the state pays doctors and hospitals directly for each service you use. You do not have to pick a primary care doctor, but you may have fewer choices of providers. Fee-for-service is less common in California and is usually only for people with special needs or who live in areas where managed care plans are not available.

When you enroll, you will be told which managed care plans are available in your county. You can pick one, or the state will assign you to one if you do not choose. You can change plans once a year or if you have a may have access to life event like moving to a new county.

Renewing your Medi-Cal coverage

Medi-Cal coverage lasts 12 months. Before your coverage ends, the state will send you a notice asking you to renew. You can renew online, by phone, by mail, or in person at your county office. You will need to provide updated information about your income and household.

If you do not renew by the deadline, your coverage will end. You can still enroll again later, but there may be a gap in your coverage. Some people are exempt from renewal requirements — for example, people over 65 and people who are blind or have a disability may have continuous coverage.

California has also paused some renewal requirements during certain periods. Check the state website or call your county office to find out whether any exemptions apply to you.

Medi-Cal for specific groups

California covers several groups with special rules. Pregnant people can enroll regardless of immigration status and keep coverage for 60 days after the pregnancy ends. Children under 19 are covered up to 266% of the federal poverty level — much higher than adults. Seniors over 65 can enroll with higher income limits and get additional benefits like dental and vision care.

People experiencing homelessness can enroll without proof of an address. Undocumented immigrants ages 26 to 49 became newly may be able to access in 2024 under California's expansion. People with disabilities can enroll through the Supplemental Security Income (SSI) program or through other disability pathways, and they may may have access to even if their income is higher than the standard limit.

Each group has different income limits, different renewal rules, and sometimes access to different services. If you are in one of these groups, ask an enrollment helper or your county office what rules apply to you.

Frequently Asked Questions

Can I have Medi-Cal and private insurance at the same time?

Yes. If you have employer insurance or buy insurance on your own, you can still enroll in Medi-Cal if you meet the income limit. Medi-Cal will be your secondary insurance and will cover costs that your private insurance does not. This is called coordination of benefits.

What happens to my Medi-Cal if I move out of California?

Your Medi-Cal coverage ends when you move. You will need to enroll in Medicaid in your new state. Each state has different income limits, covered services, and enrollment rules, so contact your new state's Medicaid office to learn what is available.

Do I have to pay back Medi-Cal if my income goes up?

No. Medi-Cal is not a loan. If your income increases after you enroll, you do not have to repay the cost of your coverage. However, you may no longer may have access to for Medi-Cal, so you should report the income change during your next renewal or when you are asked.

Can I use Medi-Cal at any doctor or hospital?

If you are in a managed care plan, you must use doctors and hospitals in your plan's network. If you are in fee-for-service, you can see any doctor or hospital that accepts Medi-Cal. Ask your doctor's office whether they take Medi-Cal before you schedule an appointment.

What if I am undocumented and afraid to enroll?

Enrolling in Medi-Cal does not put you at risk of deportation. The state does not share your immigration status with immigration authorities. You do not need a Social Security number or a green card to enroll. Many community organizations can help you enroll confidentially.