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Eligibility Requirements for the Medicaid Program in California

Medi-Cal, the California state Medicaid program, is available to assist a wide variety of low-income individuals in accessing health care. To determine eligibility, a four-page application that covers all types of applicants is filled out and submitted to the Department of Health Care Services. The state considers household income and other assets, such as bank accounts, cars and houses, along with expenses, to determine eligibility.

  1. Age-based Programs

    • Elderly residents of California who are over the age of 65 and who meet the requirements for income and assets are eligible for Medi-Cal. Adults under the age of 65 may also qualify for assistance if they have minor children living with them and meet the other requirements. A minor child is defined as a child under the age of 21 who is living at home or living away from home at school.

    Disabled and Medically Needy Individuals

    • Those California citizens who are low-income and who are also blind or disabled may qualify for Medi-Cal. Anyone living in a nursing home or assisted living facility and who has limited income and assets may also be eligible for health care assistance from the state. Medically needy individuals with exceptionally high medical costs may also be able to have their income reduced based on their medical costs to qualify for Medi-Cal assistance.

    Pregnant Women, Children and Caretakers

    • Pregnant women may access Medi-Cal assistance, as may children living in families with limited resources. Anyone who is a caretaker of a child under 21, whether they are related or not, may also qualify. For caretakers to be eligible for Medi-Cal, the child's parent must be deceased, incapacitated or unemployed.

    Non-U.S. Residents

    • Some non-U.S. residents are eligible for Medi-Cal in California based on their income and other resources. Documentation is not required, although not all services are available to all applicants. Some undocumented aliens may qualify for emergency and pregnancy-related services only.

    Patient Programs

    • Individuals diagnosed with tuberculosis, breast cancer, cervical cancer or HIV/AIDS may be eligible for assistance with health costs under Medi-Cal if their income and asset level is below the limit set by the state.

    Enrollment in Other Programs

    • Participation in certain state programs not related to health care may automatically render those individuals eligible for Medi-Cal. Those receiving Supplemental Security Income, which provides cash assistance for low-income elderly and disabled citizens, are eligible to receive Medi-Cal, as are residents who get refugee assistance, who are in the Foster Care or Adoption Assistance Program, those receiving In-Home Supportive Services, and those participating in CalWORKS.

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