California Medi-Cal changes: what to prepare for in 2027 and 2028
DHCS, the California department that runs Medi-Cal, has announced changes that start on different dates in 2027 and 2028. They affect different groups. Receiving an initial notice does not mean that you will lose Medi-Cal or that every change applies to you.
Start with these 3 steps
- Read your county's letters and check that your address, phone number and preferred language are correct.
- Ask your county: Which eligibility group am I in? Does an exemption apply? Do you need anything from me, and by what date?
- Keep copies of notices and anything you submit. Continue following the deadlines in your own notices. Do not wait for a future rule to resolve an existing bill or renewal.
This guide covers announced California changes. It does not decide eligibility, an exemption or a personal renewal date. The county must check your situation. Different rules may apply outside California.
Our estimator does not evaluate these future requirements or their exemptions. They are not used to calculate your result. Additional instructions and a full implementation review are needed before we can add any of them to an automatic calculation.
January 1, 2027: check your doctor and card if you move to Fee-for-Service
Some members will receive care through Fee-for-Service (FFS) instead of a Medi-Cal health plan. This transition alone does not end Medi-Cal eligibility, and FFS does not mean you must pay for each visit. Keep renewing on time and ask your county whether you are in the affected group.
- Before January 1, ask your doctor or clinic: Do you accept Medi-Cal Fee-for-Service, and can you continue my care? If not, ask for help finding an accepting provider and arranging the handoff. The Medi-Cal Helpline is (800) 541-5555.
- Keep your Medi-Cal Benefits Identification Card (BIC). If you transition to FFS, bring it to medical, dental and pharmacy visits; your former Medi-Cal health-plan card will no longer be the card for that coverage. Ask your county for a replacement BIC if needed.
- Open each notice and ask about upcoming visits, prescriptions, referrals and care coordination. If you receive Enhanced Care Management or Community Supports, ask your current plan what help can replace services that are not offered through FFS.
PACE and Medicare: check your own arrangement
DHCS says people enrolled in PACE (Program of All-Inclusive Care for the Elderly) stay in PACE and do not move to FFS under this transition. If you receive PACE care, check your notice with your PACE team.
For affected members in an integrated Medi-Medi plan, DHCS describes leaving that plan on January 1, 2027 while keeping Medicare. Ask the plan to explain your Medicare options and continuity of care. This is not a claim that everyone with Medicare must change plans.
Medi-Cal Rx medicines and county specialty mental-health or substance-use services continue through those systems. A statement that dental care is unchanged by the January FFS transition does not resolve the separate dental changes announced for July.
January 1, 2027: work or other qualifying activities for certain adults
This requirement concerns certain adults ages 19–64 in the Affordable Care Act (ACA) expansion group. It is not a rule for everyone who has Medi-Cal. The $580 figure refers to earnings from work; it is not a payment from Medi-Cal or a general income limit for coverage.
DHCS lists several ways to meet the requirement. Your county must determine which activities, earnings periods and exemptions count in your case. Do not assume that everyone must submit documents every month: the county may be able to verify information it already has.
- Work and earn at least $580 a month, or meet an accepted 80-hour monthly work requirement. DHCS also describes seasonal work with average monthly earnings of at least $580 over six months.
- Complete 80 hours a month of qualifying job training, volunteering or community service, or use an accepted combination of activities.
- Study at least half-time, subject to the applicable education rules.
- DHCS identifies exemptions or groups outside this requirement: people under 19 or over 64; pregnancy and the year afterward; parents or caregivers of a dependent child age 13 or younger; and caregivers of a person with a disability under the applicable rules.
- Other listed exemptions include disability, serious health conditions or substance use disorders; release from incarceration within the last 90 days; Medicare Part A or Part B; American Indian or Alaska Native status; and former foster youth under 26 who were in foster care when they turned 18. The county verifies the conditions for each exemption.
- One DHCS summary describes the child-age cutoff differently. The main changes page and federal rule include children age 13 or younger. If you care for a child age 13, ask your county to check the exemption; do not assume you are excluded.
January 1, 2027: a shorter period for bills from before you apply
For applications submitted on or after January 1, 2027, preliminary DHCS instructions reduce retroactive coverage to up to one month before the application month for the MAGI New Adult Group, and up to two months for other groups. These are calendar months before the application month, not rolling periods of 30 or 60 days.
Your eligibility group determines the period. Having or not having children is not enough to identify that group. You must have been eligible during each requested month, and the medical service must be covered. Payment is not automatic.
Applications submitted before January 1, 2027 keep the earlier rules allowing up to three months. DHCS letter ACWDL 26-07, dated March 12, 2026, already gives preliminary instructions and says they may change.
- Tell the county about unpaid bills from before your application and ask for retroactive coverage.
- If you do not know your eligibility group, the letter instructs counties to allow a request for up to two months under the new rules and not discourage the request. The county will determine the applicable period.
- Keep the bill and service date. Ask which months and services can be reviewed before assuming Medi-Cal will pay.
March 1, 2027: renewals every six months for certain adults
DHCS announces six-month eligibility reviews for certain adults ages 19–64 in the ACA expansion group, starting March 1, 2027. This does not give you a personal renewal deadline: follow the notice your county sends.
DHCS says annual renewals continue for people outside the ACA adult group, people who are pregnant or postpartum, American Indians and Alaska Natives, and former foster youth under 26 who were in foster care when they turned 18. An exemption from the work requirement does not necessarily exempt someone from six-month renewals.
- Ask whether your renewal schedule is changing and whether the county can renew your coverage using information it already has.
- Open each notice. If the county requests information, respond by the deadline in that notice.
- Ask for language assistance if you cannot understand the letter. Keep a copy and a record of your response.
July 1, 2027: lower asset limits for groups with an asset test
This change affects groups that have an asset test, including some older adults and people with disabilities. It does not introduce an asset test for everyone in MAGI Medi-Cal.
DHCS lists future limits of $21,000 for one person, $31,000 for two people and $1,550 for each additional person, up to ten people. These amounts start July 1, 2027; do not treat them as the current limits.
The number of people counted for this rule is not necessarily everyone living in the home. For example, the DHCS FAQ excludes adult children who live with you. Spousal protections may allow higher amounts. Ask the county which people, assets and protections it will count.
- The main home, main vehicle and household belongings are generally excluded under the rules described by DHCS.
- Retirement funds have conditions. The DHCS FAQ mentions receiving regular payments; do not assume every retirement account is excluded.
- Ask for an individual review if you are married or need long-term care. Do not give away or transfer assets simply to meet a limit without checking the rules: transfers can affect long-term care coverage.
October 1, 2028: copayments for some adults, with limits and exemptions
DHCS announces copayments for some adults ages 19–64 who are not pregnant and are not enrolled in Medicare. Its summary currently mentions annual income above $15,560. That is the figure shown in the summary checked on September 12, 2026, not a confirmed income threshold for 2028 or a general Medi-Cal eligibility limit.
DHCS describes an annual cap of 5% of family income and exempt services. We are not using the summary to estimate a personal copayment. The applicable amounts and operational details need further verification before the change takes effect.
- DHCS lists exemptions for emergency care, checkups, pregnancy-related services, children, mental health and substance use treatment, and care at community or rural health centers.
- Before paying a future copayment, ask your plan or provider whether the service is exempt and how the family limit is tracked.
- A future copayment announcement is not an instruction to stop treatment or pay a new charge now.
Other changes: ask which date and rule applies to you
DHCS separately describes immigration-related funding changes from October 2026 and dental coverage or premiums for some members from July 1, 2027. These are different from the January FFS transition and from the work rules above. This guide does not determine a personal loss of coverage or premium.
The official summaries need clarification
The general changes page and the immigration-status table do not describe every group consistently. Examples include dental benefits during pregnancy/postpartum and later coverage for some humanitarian-status groups. The table itself says its information is current as of August 2026 and valid through June 30, 2027, despite showing July columns. We cannot resolve those differences for your case.
Ask your county: Which eligibility group applies to me? What changes, on what date, and under which written rule? Do pregnancy, age, foster-care history or another exception change the answer? Ask for an explanation in your language and keep the notice.
For help understanding a coverage problem, DHCS lists the Health Consumer Alliance at (888) 804-3536. Ask whether they can assist with your case.
These transitions, disputed details and possible charges are not added to the estimator. This guide is not a decision on immigration consequences, eligibility or an appeal deadline.
What you can do now
The DHCS bulletin dated September 8, 2026 describes initial letters sent to potentially affected adults. An initial letter is not a decision that your coverage will end. Counties may ask for information later if they cannot verify eligibility, activities or an exemption from available records.
Use the official county contact listed in your notice or on the DHCS website. Send personal documents only through the official channel the county confirms. You do not need to send GetBenefits your medical records, immigration documents or Social Security number.
- Say: “I received a Medi-Cal notice. Which eligibility group am I in, and which changes apply to me?”
- Then ask: “Could I qualify for an exemption? Can you verify it from existing records? If not, what documents do you need and when?”
- If you have older medical bills, ask which calendar months can be considered. If your renewal schedule changes, ask for your actual deadline.
- Write down the date, the office you contacted and the answer. Keep confirmation of anything you submit.
Official sources and review dates
- DHCS: Medi-Cal changes. No publication or update date visible; checked September 12, 2026.
- DHCS ACWDL 26-07: preliminary retroactive coverage instructions, March 12, 2026.
- DHCS: federal changes affecting eligibility, updated August 18, 2026.
- DHCS: asset limit frequently asked questions, checked September 12, 2026.
- CMS: federal bulletin on work and qualifying activities, December 8, 2025.
- CMS: federal rule on qualifying activities, June 3, 2026.
- DHCS stakeholder news archive: September 8, 2026 bulletin about initial letters.
The four language versions explain the same dates and conditions. They do not guarantee that a county or provider offers assistance in a particular spoken language. Ask the official service for the language assistance you need.