Medicaid Eligibility & Requirements in California

Medi-Cal, California’s Medicaid program. Medi-Cal allows low-income seniors, adults and children to gain access to health care and medical services, among other programs.

You may qualify for health and medical insurance coverage at little or no cost if you meet the Medicaid eligibility requirements and guidelines below.

Who Is Eligible for Medicaid in California?

To receive Medi-Cal benefits in California, you must be a U.S. citizen, a state resident of California, a permanent U.S. resident, a legal alien or a U.S. national. You are eligible to receive benefits if you are:

  • Over the age of 65
  • Blind or disabled
  • Pregnant
  • In a nursing or intermediate care home
  • Under the age of 21
  • A refugee living in the U.S. temporarily

As a parent or guardian relative of a child who is under the age of 21, you may be eligible for Medicaid assistance if you’re taking care of the child because the parents:

  • Have died
  • Do not live with the child
  • Are incapacitated
  • Are not employed

You may also qualify for Medi-Cal benefits if you are already enrolled and receiving benefits from one or more of the following programs:

  • CalFresh — also known as the Supplemental Nutrition Assistance Program (SNAP)
  • Supplemental Security Income (SSI) / State Supplementary Payment (SSP)
  • CalWorks (AFDC) — also known as Temporary Assistance to Needy Families (TANF)
  • Refugee Assistance
  • Foster Care or Adoption Assistance Program

Medicaid Income Eligibility Requirements

If you meet the qualifications above, you must also show you have financial hardship by meeting the income eligibility requirements. To see if you meet the Medicaid requirements for income, you must examine your family size — the number of people living in your household — and your modified adjusted gross income (MAGI) — your total income from all sources.

Your household income must not exceed more than 138 percent of the federal poverty level (FPL) based on your household size. For example, if you live alone, your income cannot be more than $16,395 a year. If you live with a spouse or another adult, your combined income cannot be more than $22,108 a year.

To qualify based on your family size, your household income cannot exceed:

  • One: $16,395
  • Two: $22,108
  • Three: $27,821
  • Four: $ 33,534
  • Five: $39,248

Visit the California Department of Health Care Services to view additional income levels.

What Benefits Are Covered Under Medicaid in California?

When you enroll in Medi-Cal, you no longer have to worry about whether you can afford to visit your doctor or dentist for regular checkups or when you’re sick. You now have access to a variety of services thanks to the Affordable Care Act, which mandates every Medi-Care health plan to offer 10 services under Essential Health Benefits, which include:

  • Outpatient (ambulatory services)
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance abuse treatment services
  • Prescription medications
  • Physical and occupational therapy (or rehabilitative and habilitative services)
  • Preventive and wellness services and chronic disease management
  • Dental and vision care

How Do I Know If I Quality for Medicaid Services?

If you’re unsure whether you meet the Medicaid qualifications and income requirements, you can use a Medicaid calculator. Simply enter your information, including your state/zip code, income, household size and the number of adults and children you want to enroll.

Health For California is here to help you determine your Medi-Cal eligibility. Our free agents are always available to answer your question. If you want to enroll yourself or your family in Medi-Cal, get your free quote today.