Medicare and Medi-Cal in California

If you're new to this, start with how Medicare and Medicaid work together.

Medi-Cal is California's Medicaid. With Medicare and full Medi-Cal, the state pays the $202.90 a month Medicare costs you and most of your copays. Medi-Cal also covers care Medicare does not, like help at home. That matters if copays keep adding up, or you need more help at home than family can give. Your county Medi-Cal office decides, and you can apply online at BenefitsCal.com.

You may qualify if

• You're 65 or older, or have a disability, and live in California.
• Your countable income is under $1,836 a month, or $2,490 for a couple. Medi-Cal takes off $20 and the $202.90 Medicare costs you before it compares.
• Your savings are under $130,000, or $195,000 for a couple. Your home and main car don't count.

Not sure you qualify? Apply anyway, because the county makes the call and some of your income may not count. If you would rather not do it alone, a Pair Team advocate can check with you in one call.

Ways to get Medi-Cal when you have Medicare

The income limits are from California Advocates for Nursing Home Reform (CANHR), a nonprofit, and change each April. The savings limits are from California's Department of Health Care Services (DHCS).

How does share of cost work?

Share of cost works like a monthly deductible. If you live alone, Medi-Cal lets you keep $600 a month for living costs. The rest of your countable income is your share of cost. Once your medical bills for the month reach that amount, Medi-Cal pays the rest.

Say your countable income is $2,100, so your share of cost is $1,500. You only owe it in months when you get care.

What changed in 2026

• January 1: savings count again. Medi-Cal looks at savings for people 65 and older for the first time since 2023. The limit is $130,000 for one person, plus $65,000 for each extra person in the home. Your main home, main car, furniture and clothes don't count. If you already have Medi-Cal, you report your savings at your next renewal.
• January 1: a look-back for nursing home care. If you move into a nursing home, Medi-Cal looks at gifts you made in the 30 months before. Gifts made before 2026 do not count.
• January 1: Medi-Medi Plans in 29 more counties. They're now in 41 counties, and new ones include Alameda, San Francisco and Kern.
• April 1: new income limits. The A&D limit went up to $1,836 a month for one person.
• Coming next: a lower limit. The savings limit drops to $21,000 for one person and $31,000 for two on July 1, 2027, DHCS says.

What are Medi-Medi Plans?

A Medi-Medi Plan is California's name for a plan that gives you your Medicare and Medi-Cal together, with one care team. It's a kind of Medicare Advantage plan. To join, you need Medicare Parts A and B, Medi-Cal, and to be 21 or older. Call your Medi-Cal plan, 1-800-MEDICARE, or Health Care Options at 1-800-430-4263.

You don't have to join one, because you can keep Original Medicare with Medi-Cal. In some areas, the Program of All-Inclusive Care for the Elderly (PACE) is another choice. The Health Insurance Counseling and Advocacy Program (HICAP), California's free Medicare counseling, can help you compare.

How to apply

1. Get your papers together. The county will want your Medicare card, your Social Security letter, a photo ID, and your latest bank statements.
2. Apply one of three ways, whichever is easiest.
   • Apply online at BenefitsCal.com.
   • In person or by phone at your county social services office.
   • By mail, with a paper application from your county.
3. Get free help if you want it. HICAP counselors (1-800-434-0222) know both Medicare and Medi-Cal, and the Medi-Cal helpline is 1-800-541-5555.
4. Wait for the answer. The county has 45 days to decide, or 90 if it has to decide whether you have a disability.
5. Check your Social Security statement, because with full Medi-Cal, the state pays the $202.90. If it still comes out a few months after approval, call your county.

If you are turned down

You have 90 days from the notice to ask for a state hearing. Call the State Hearings Division at 1-800-743-8525, or ask online through the California Department of Social Services (CDSS). For problems with a Medi-Cal plan, call the Ombudsman at 1-888-452-8609.

What a Pair Team advocate does

When someone calls us about Medi-Cal, there's often a second problem behind it. Usually it's help at home, or a ride to dialysis or the specialist. This is what we do:

• Figure out which Medi-Cal program you can likely get, in one phone call.
• Help you apply on BenefitsCal, gather the bank statements the county now asks for, and follow up until you have an answer.
• Help you set up paid help at home through In-Home Supportive Services (IHSS) and Medi-Cal rides.
• Help with what usually comes with it: food, utilities and housing.

An advocate is covered by Medicare if you qualify. It takes two minutes to find out.

Check if you qualify for a Pair Team advocate

Frequently asked questions

My countable income is just over $1,836. What can I do?

Check your health insurance premiums, because Medi-Cal subtracts the ones you pay. A dental or vision plan can bring you under the limit, so you have no share of cost, CANHR says.

Can I have Medi-Cal and a Medicare Advantage plan?

Yes, you can have Medi-Cal and a Medicare Advantage plan, or you can pick Original Medicare. Either way, Medi-Cal still pays the costs it covers.

Do I get Extra Help with prescriptions?

Yes, with full Medi-Cal you get Extra Help with prescriptions automatically. Your drugs are covered by a Medicare drug plan.

I gave money to my children. Will that hurt my Medi-Cal?

For most people, gifts to your children won't hurt your Medi-Cal. Gifts only matter if you need long-term care, like a nursing home, DHCS says. Only gifts made on or after January 1, 2026 count.

Does my house count toward the $130,000?

The home you live in does not count toward the $130,000, but a second home does.

Sources

• Asset Limit Frequently Asked Questions, DHCS
• Medi-Medi Plans, DHCS
• Where to Get Help, DHCS
• Hearing Requests, California Department of Social Services
• Medicaid, Medicare.gov
• Medicare Counseling (HICAP), California Department of Aging
• Aged, Blind and Disabled Federal Poverty Level Program, Los Angeles County DPSS
• Aged and Disabled and Medically Needy Medi-Cal Programs, CANHR
• Medi-Cal Categories, DB101 California