PD 25-17: Upcoming Changes to Medi-Cal Policy
| Date: | 11/3/25 |
| To: | DEBS |
| From: | Megan Turney, Manuel Garcia |
| Reference: | N/A |
Background
As a result of recent state and federal policy decisions, significant changes are expected to impact the Medi-Cal program in the coming years. The following timeline outlines these changes. This document is intended to provide a basic overview of the changes. As these policies are implemented, additional guidance will be provided in corresponding Medi-Cal Handbook updates.
Timeline of Changes
2026
|
January 1 |
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Reinstatement of the Asset Limits The asset limits will be reinstated to $130,000 per individual and $65,000 for each additional household member for seniors and people with disabilities. |
|
Expansion Freeze The Medical expansion freeze for adults 19 and older who do not have satisfactory immigration status and apply on or after January 1, 2026, will pause enrollments into full scope Medi-Cal. Recipients already receiving full-scope Medi-Cal through one of the prior expansions in CA will continue on full-scope with no change to their benefits until July 2026. |
|
July 1 |
|
Dental Benefits Non-emergency dental services will no longer be covered for adult members who do not have a satisfactory immigration status. |
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October 1 |
|
Definition of Qualified Non-Citizen The federal definition of a qualified non-citizen will change, resulting in some categories no longer being considered a satisfactory immigration status for full-scope through federal funding. However, in California, these individuals will still be eligible for full-scope Medi-Cal with no dental coverage. |
2027
|
January 1 |
|
Work Requirements Community engagement and work requirements will be imposed on individuals in the New Adult Group (MAGI M1 aid code). |
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Six-Month Renewals Eligibility renewals must be conducted once every six months for individuals in the New Adult Group (MAGI M1 aid code). |
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Retroactive Timeframes The allowable timeframe for Retroactive Medi-Cal coverage will be reduced from three months to one month for ACA expansion members and two months for all other Medi-Cal members. |
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July 1 |
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Monthly Premiums Certain adult members who do not have a satisfactory immigration status must pay $30 per month to retain full-scope Medi-Cal with no dental coverage. |
2028
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October 1 |
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Cost Sharing for Services Individuals in the New Adult Group (MAGI M1 aid code) with income above 100% of the Federal Poverty Level (FPL) will be charged cost-sharing amounts ranging from $1 to $35 dollars for certain services. |
Resources
For additional information and resources, impacted applicants and members can be referred to the Medi-Cal Changes page on the Department of Health Care Services (DHCS) website.