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https://ssa.ocgov.com/health-care-services/medi-cal-program-services/children-and-adults

CHILDREN AND ADULTS

Which low-income children and non-disabled adults may be eligible for Medi-Cal?

  • Adults ages 26-64
  • Children and young adults under 26
  • Former foster youth under 21
  • Pregnant individuals

See also the Seniors and Persons with Disabilities section regarding Medi-Cal programs for these populations.

What are the eligibility requirements?

  • California residence.
  • Countable income below established limits. Those with income below these limits may qualify for Modified Adjusted Gross Income (MAGI) Medi-Cal. People with higher incomes may qualify for other Medi-Cal programs, possibly with a Share of Cost.
  • Medi-Cal disregards property for individuals whose eligibility is determined using Modified Adjusted Gross Income (MAGI). Property limits still apply to certain other Medi-Cal programs. For an overview of Medi-Cal property rules, click here:  Medi-Cal General Property Limitations (MC 007).
  • Children and young adults (under the age of 26) are eligible for Medi-Cal regardless of citizenship or immigration status, if they meet all the other eligibility requirements.
  • Adults may be eligible for restricted Medi-Cal coverage of emergency and pregnancy related medical care regardless of citizenship or immigration status, if they meet all the other eligibility requirements.
  • Beginning April 2022, pregnant individuals will be eligible to full-scope Medi-Cal benefits during both the pregnancy and postpartum periods. Additionally,  Medi-Cal postpartum care coverage will be extended for a period of 365 days regardless of changes in income, citizenship and immigration status, if they meet all the other eligibility requirements.
  • Beginning May 2022, adults ages 50 and older will be eligible for full scope Medi-Cal coverage regardless of immigration status, if they meet all the other eligibility requirements.

Other Programs

  • Individuals with incomes above the MAGI Medi-Cal income limits:
    • may qualify for subsidies to reduce monthly health insurance premium costs or reduce out-of-pocket costs (such as co-pays and deductibles).
    • may qualify for Non-MAGI Medi-Cal with or without a Share of Cost.
  • The Medi-Cal Access Program (MCAP) provides low cost comprehensive health insurance coverage to eligible pregnant women.  MCAP is for middle-income families who do not have health insurance and whose income is too high for no-cost Medi-Cal. The program is also available to women who have other health insurance plans that do not cover maternity services or with a maternity-only deductible or copayment greater than $500. For additional information regarding the MCAP program, please visit the website, http://mcap.dhcs.ca.gov/ or call 1-800-433-2611.
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