Medi-Cal Update 2026-4 Retroactive Medi-Cal

Policy Changes to Retroactive Medi-Cal Coverage Periods

Date	References	Clerical	Implementation
8/10/2026	ACWDL 26-07	N/A	January 1, 2027

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Background

Under current policy, individuals may be eligible for up to three months of retroactive Medi-Cal coverage prior to the month of application, if all eligibility requirements are met for each retroactive month.

Changes

Effective January 1, 2027, the maximum allowable retroactive Medi-Cal coverage period for all eligibility groups will be reduced. Under the revised policy, individuals in the Modified Adjusted Gross Income (MAGI) New Adult Group may be eligible for up to one month of retroactive coverage. Aid codes in this population include M1, M2, 1C, 1J, and 1M. All other Medi-Cal coverage groups may be eligible for up to two months of retroactive coverage if all other eligibility criteria are met.  

The Retroactive MC topic in Chapter 4 of the Medi-Cal Handbook has been revised to reflect this change.

Implementation

This policy applies to applications submitted on or after January 1, 2027.

 

Data Systems

Because applicants may not know which coverage group they qualify for, applicants who apply after January 1, 2027, may request up to two months of retroactive coverage. Any months requested by the applicant must be entered into the system. CalSAWS will automatically limit eligibility determinations to the allowable months based on the individual's coverage group. 

Forms

The Supplement to Statement of Facts For Retroactive Coverage/Restoration (MC 210A) will be revised based on this policy change. The older version of the MC 210A must still be accepted when submitted.

Other Programs

This change only affects the Medi-Cal program. 

 

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Department of Employment & Benefits Services

Contact Person(s): Megan Turney and Manuel Garcia, SSA BPIS, 408-755-7540