Eligibility

If you are a California resident with low or no income, you may be eligible for Medi-Cal. This includes the following:

  • Low-income individuals
  • Families with Children
  • Seniors
  • Persons with disabilities
  • Foster care
  • Pregnant women
  • Individuals with diseases such as tuberculosis, breast cancer or HIV

 

The Medi-Cal program has different eligibility requirements that fall under two categories: MAGI and Non-MAGI.

 
MAGI
NON-MAGI
Overview

Modified Adjusted Gross Income (MAGI) Medi-Cal provides free or low-cost health care for those that meet the income requirements.

The following groups may be eligible:

  • Adults (aged 19-64)
  • Parents/Caregiver Relatives
  • Children (up to age 19)
  • Pregnant Women

Non-MAGI Medi-Cal provides health care to all individuals/groups who were eligible for Medi-Cal before the Affordable Care Act. This includes:

  • Aged or disabled
  • Blind
  • Long term care (LTC)
  • Refugee
  • Youth who need confidential medical services
  • Families with children
  • Pregnant women
  • Children
Residency

California Residency is a requirement.

California Residency is a requirement.

Income

Income is limited to 138% of the Federal Poverty Level (FPL) for adults, 266% for children, and 213% for pregnant women. Generally, income eligibility is based on the tax filling household’s adjusted income that is reported to the IRS on Form 1040.


Children with parents whose income is between 160% and 266% will have a monthly premium for MAGI Medi-Cal.

The income limits vary according to family size and program category. Income is used to determine if an individual/family is eligible for free Medi-Cal or Medi-Cal with a Share of Cost (SOC). Income over the limit becomes the monthly SOC, which is similar to a monthly deductible. It is the amount of medical expenses that a Medi-Cal beneficiary must pay before Medi-Cal will cover any medical expenses. If Medi-Cal is not used in a given month, no SOC will need to be paid that month.

Age
  • Adults age 19-64
  • Parents/Caretaker relatives
  • Children up to age 19
  • Pregnant Women
  • Children age 0-19 and their parent/caretaker relatives
  • Adults age 19-64 who are aged, disabled, blind, in long term care, or are a refugee
  • Adults over age 65
Property

There is no property limit.

Two categories of property are counted:

  • Personal Property: includes bank accounts, stocks, bonds, cash on hand, etc.
  • Real Property: land, houses, buildings, etc.

MAGI and Non-MAGI Medi-Cal benefits are split into two categories of eligibility: Full Scope and Restricted. The table below applies to both.

Medi-Cal
Full Scope
Restricted Scope
Who is eligible?
  • U.S. Citizens
  • Eligible Immigrants
  • Children up to age 19 regardless of immigration status
  • Adults aged 19-25 regardless of immigration status
  • Adults aged 50 and older regardless of immigration status*
  • Adults over the age of 25 and under the age of 50 without satisfactory immigration status
What is covered?
  • Doctor Visits
  • Hospital Care
  • Vision
  • Mental Health
  • Pregnancy and 365-day postpartum services
  • Family Planning
  • Laboratory Services
  • Tuberculosis
  • Renal Dialysis
  • Substance Use Disorder Services
  • Prescription Drugs
  • Dental
  • Rehabilitative & Habilitative Services
  • Children's (Pediatric) Services
  • Long-Term Care
  • Emergency Care
  • Pregnancy and 365-day postpartum services
  • Tuberculosis
  • Renal Dialysis
  • Long-Term Care

*Effective May 1, 2022, older adults ages 50 and older will qualify for full scope Medi-Cal regardless of immigration status, if they meet all other eligibility requirements.


You can use this tool to see if you are potentially eligible for Medi-Cal: Am I eligible?