Medicaid Eligibility in California: Income Limits & How to Apply
Medicaid Eligibility in California
Under the ACA's Medicaid expansion, California residents earning up to 138% FPL can enroll in Medi-Cal. For a single adult, that's roughly $21,597 annually; for a four-person household, the cutoff is about $44,367 in 2026.
Key threshold: If your income is below $21,597 (individual) or $44,367 (family of 4), you likely qualify for Medi-Cal with free or very low-cost coverage. No premiums, no deductibles.
Medicaid expansion in California covers:
- Adults aged 19-64 with income up to 138% FPL
- Children in families with income up to 200-300% FPL (varies by age)
- Pregnant women with income up to 185-200% FPL
- Seniors and people with disabilities who meet income and asset requirements
About Medi-Cal
In California, Medi-Cal is the state's Medicaid program, providing free or low-cost health coverage to millions. As of July 2024, nearly 15 million Californians were enrolled in Medi-Cal, demonstrating its widespread use. You generally qualify for Medi-Cal if your household income is at or below 138% of the Federal Poverty Level (FPL). For a single adult, this means a monthly income of about $1,732 or less. A family of four would qualify with a monthly income below roughly $3,588. Income limits are higher for children (up to 266% FPL) and pregnant individuals (up to 213% FPL). If you are 65 or older, have a disability, or need long-term care, both your income and assets will be considered. As of January 1, 2026, the asset limit for these groups is $130,000 for one person and $195,000 for a couple, with some exceptions for your home and one vehicle.
If your income is slightly above the Medi-Cal threshold, you might qualify for subsidized coverage through Covered California, the state's health insurance marketplace. For example, a single adult with a monthly income greater than $1,732 may be eligible for subsidies. The benchmark Silver plan in California costs around $573 per month, which is moderate compared to the national average. With subsidies, your actual payment would be significantly lower, based on your income. Be aware that changes in your income can shift your eligibility between Medi-Cal and Covered California. During the recent "unwinding" period, nearly 2 million people lost Medi-Cal coverage, often due to procedural reasons like not returning renewal forms. If this happened to you, you can reapply at any time.
Medi-Cal provides comprehensive benefits, including doctor visits, hospital care, mental health and substance use disorder services, prescription drugs, and maternity care, with little to no cost-sharing for most enrollees. California also offers unique programs and waivers. For instance, the Home and Community Based Alternatives (HCBA) Waiver helps medically fragile or technology-dependent individuals of any age receive care at home instead of a nursing facility. The state has also expanded full-scope Medi-Cal to all income-eligible residents regardless of immigration status. Additionally, Medi-Cal offers In-Home Supportive Services (IHSS) to assist eligible individuals with daily living activities at home.
When applying for or renewing Medi-Cal, be prepared for potential processing delays, as counties have been managing a large volume of applications. You will need to submit various documents, including proof of identity, income, and immigration status if applicable. If you live in a county with multiple Medi-Cal health plan choices, you typically have 30 days to select a managed care plan; otherwise, one will be chosen for you. Recent policy changes mean that as of January 1, 2026, asset limits have been reinstated for older adults and people with disabilities, so you will need to verify your assets at your annual renewal. To ensure continuous coverage, respond promptly to all requests for information from your county Medi-Cal office.
California Medicaid Income Limits 2026
The following table shows the key income thresholds for California in 2026:
| Household Size | 100% FPL | 138% FPL (Medicaid Limit) | 400% FPL (Subsidy Limit) |
|---|---|---|---|
| 1 | $15,650 | $21,597 | $62,600 |
| 2 | $21,150 | $29,187 | $84,600 |
| 3 | $26,650 | $36,777 | $106,600 |
| 4 | $32,150 | $44,367 | $128,600 |
| 5 | $37,650 | $51,957 | $150,600 |
| 6 | $43,150 | $59,547 | $172,600 |
If your household income falls below the 138% FPL column, you qualify for Medi-Cal. If your income is between 138% and 400% FPL, you qualify for ACA marketplace subsidies to help pay for private insurance.
The benchmark Silver plan in California costs about $573/month before subsidies, which is in line with the national average. Subsidies can significantly reduce this cost for qualifying households.
Marketplace Insurance in California
California residents who do not qualify for Medicaid can purchase private health insurance through Covered California. The average benchmark (second-lowest cost Silver) plan in California costs approximately $573/month for a 40-year-old in 2026.
Premium tax credits (subsidies) are available for households with income between 100% and 400% FPL. Here is what a 40-year-old individual in California might pay after subsidies:
| Income Level | Annual Income | Expected Contribution | Estimated Monthly Premium |
|---|---|---|---|
| 150% FPL | $23,475 | 4.01% of income | ~$78/mo |
| 200% FPL | $31,300 | 6.52% of income | ~$170/mo |
| 250% FPL | $39,125 | 8.33% of income | ~$272/mo |
| 300% FPL | $46,950 | 9.83% of income | ~$385/mo |
| 400% FPL | $62,600 | 9.83% of income | ~$513/mo |
These are estimates for an individual. Actual premiums depend on your age, household size, tobacco use, and the specific plan you choose. Households with income between 100-250% FPL also qualify for cost-sharing reductions (CSR) on Silver plans, which lower deductibles and copays.
Unlike most states, California runs its own insurance marketplace through Covered California. Residents shop for plans and apply for subsidies through this state-run platform rather than HealthCare.gov.
California's Medicaid program goes beyond the ACA's minimum requirements. Medi-Cal includes comprehensive benefits, and the state's investment in its own marketplace reflects a broader commitment to accessible healthcare coverage.
How to Apply for Medi-Cal
- Apply online through Covered California. The system will automatically check your Medicaid eligibility based on your income and household size.
- Apply directly through your state's Medicaid agency. You can apply year-round — there is no enrollment period for Medicaid.
- Call the Medicaid hotline for California to get help with your application or check your eligibility over the phone.
- Visit in person at your local Department of Social Services or county human services office.
To complete your application, you'll need income documentation (pay stubs, tax returns), a California address for residency verification, Social Security numbers for household members, and information about existing coverage.
Calculate Your Subsidy in California
Enter your income, age, and household size to see if you qualify for Medicaid or marketplace subsidies in California.
Check Your Eligibility →Frequently Asked Questions
How much can I earn and still qualify for Medi-Cal?
In 2026, the Medicaid income limit in California is 138% of the federal poverty level: $21,597 per year for an individual, $29,187 for a household of 2, $36,777 for 3, and $44,367 for a family of 4.
Has California expanded Medicaid under the ACA?
Yes, California has expanded Medicaid under the ACA. Adults aged 19-64 earning up to 138% of the federal poverty level qualify for Medi-Cal.
Can I get ACA subsidies in California?
Yes. California residents with household income between 100% and 400% FPL ($15,650 to $62,600 for an individual in 2026) qualify for premium tax credits that reduce the cost of marketplace health insurance. Apply through Covered California.
What is the California Medicaid program called?
California's Medicaid program is known as Medi-Cal. It provides health coverage for eligible low-income residents including children, pregnant women, seniors, and adults up to 138% FPL.
What happens if I lose Medicaid coverage in California?
If your Medi-Cal coverage ends due to income changes or redetermination, you qualify for a Special Enrollment Period on the marketplace. This gives you 60 days to sign up for a private plan through Covered California. If your income is between 100-400% FPL, you'll likely qualify for subsidies to help cover the cost.
Does working disqualify me from Medicaid in California?
Yes. Medicaid eligibility in California is based on your Modified Adjusted Gross Income (MAGI), not your employment status. If your household income is at or below 138% FPL ($21,597 for an individual), you qualify for Medi-Cal even if you work full-time. Many Medi-Cal enrollees are working adults.
What's the difference between Medicaid and marketplace insurance in California?
Medicaid (Medi-Cal) is free or near-free with no premiums or deductibles. Marketplace plans in California average $573/month before subsidies. If you qualify for Medicaid, it's the more affordable option. If your income puts you just above the cutoff, subsidized Silver plans with cost-sharing reductions are the next best thing.
Medicaid Eligibility in Nearby States
- Arizona Medicaid Eligibility — Expansion state
- Nevada Medicaid Eligibility — Expansion state
- Oregon Medicaid Eligibility — Expansion state