Last Updated: September 15, 2026
What to Do If Your Medi-Cal Application Is Denied: California 2026 Guide
If your Medi-Cal application is denied, the first thing to do is find out exactly why the County made the decision.
A denial does not always mean the issue cannot be corrected. Depending on the reason, you may be able to provide missing information, ask the County to review the case, request a State Fair Hearing, or submit a new application.
If you are new to Medi-Cal and want to understand how the program works, see our Medi-Cal Beginner’s Guide .
Read your Notice of Action first. If something is missing or incorrect, contact your County Medi-Cal Office as soon as possible. If you disagree with an eligibility denial, you generally have 90 days from the date on the Notice of Action to request a State Fair Hearing.
Step 1: Read Your Notice of Action
After your Medi-Cal application is processed, your County or Covered California sends an eligibility decision called a Notice of Action (NOA).
If your application was denied, the notice should explain:
- Why you were denied
- What information was used to make the decision
- The effective date of the decision
- Your State Fair Hearing rights
- The deadline for requesting a hearing
Keep the Notice of Action and the envelope it came in. They may be important if you later dispute the decision or the hearing deadline.
Step 2: Find Out Why Your Medi-Cal Was Denied
Medi-Cal applications can be denied for different reasons.
Examples may include:
- Income above the limit for the Medi-Cal category being reviewed
- Missing income verification
- Missing requested documents
- Incomplete application information
- California residency could not be verified
- Identity or other required information could not be verified
- Immigration-related eligibility requirements for the applicable Medi-Cal category were not met
- The County determined that you qualify for a different program or coverage category
Do not assume that “income too high” means you have no health coverage options. Different Medi-Cal categories use different rules, and people who do not qualify for Medi-Cal may be eligible for financial assistance through Covered California.
Step 3: Contact Your County Medi-Cal Office
Your County Medi-Cal Office generally handles your individual Medi-Cal application and eligibility determination.
When you call, ask:
- Why exactly was my application denied?
- Which income amount did you use?
- Which household members did you include?
- Is any verification or document missing?
- Can I submit additional information?
- Can the County review or correct the decision?
In some cases, an issue may be corrected without immediately filing another application.
Write down the date and time of your call, the name of the County worker you spoke with, and what you were told. Keep copies of any documents you submit.
Step 4: Submit Missing or Corrected Information
If your application was denied because information was missing or could not be verified, ask the County whether additional documents can still be submitted.
Depending on your case, the County may request items such as:
- Recent pay stubs
- Federal tax information
- Employer income statements
- Self-employment income records
- Proof of California residency
- Identity documents
- Immigration documents, when applicable
- Other documents needed for your specific Medi-Cal category
Only submit documents that the County requests or that are relevant to correcting the problem.
Keep confirmation that your documents were submitted, especially if you upload them online, fax them, mail them, or deliver them in person.
Step 5: Check Whether the County Used the Correct Income
Income calculations are a common source of Medi-Cal questions.
For many adults evaluated under MAGI Medi-Cal rules, eligibility is based on Modified Adjusted Gross Income and tax-household rules rather than simply the amount of money deposited into a bank account.
If you think the County used the wrong income, ask which amount and income source were included in the calculation.
You should also check whether:
- Old employment income was used
- Your current income changed
- Self-employment income was calculated correctly
- Your tax household was determined correctly
- An income source was counted that should not have been included
Different Medi-Cal programs use different financial rules, so the correct calculation depends on the eligibility category.
You can also compare the applicable limits with our 2026 Medi-Cal Income Limits by Household Size .
Step 6: Request a State Fair Hearing If You Disagree
If you believe the County's Medi-Cal eligibility decision is wrong, you have the right to request a State Fair Hearing.
For a denial involving a new Medi-Cal application, the normal deadline is generally 90 days from the date on the Notice of Action.
The California Department of Social Services (CDSS) administers the State Hearing process.
Phone: 1-800-743-8525
TTY: 1-800-952-8349
You may also request a hearing online or by mail. Follow the hearing instructions on your Notice of Action or use the official CDSS State Hearing website.
Talking with the County about the problem does not necessarily replace your State Hearing rights. If you are approaching the hearing deadline and the issue has not been resolved, carefully review the hearing instructions on your Notice of Action.
What Happens at a State Fair Hearing?
A State Fair Hearing gives you an opportunity to explain why you believe the Medi-Cal decision was incorrect.
An Administrative Law Judge reviews the dispute. The County may explain how it reached its decision, and you can provide documents or other information supporting your position.
Before the hearing, organize documents that may be relevant, such as:
- Your Notice of Action
- Your original application
- Income documents
- Documents you previously submitted to the County
- Upload or fax confirmations
- Letters or messages from the County
- Notes from telephone conversations
What If the County Has Not Decided My Application?
A denial is not the only situation in which State Hearing rights may apply.
DHCS states that processing a Medi-Cal application may take up to 45 days. An application based on disability may take up to 90 days.
If you do not receive an eligibility decision within the applicable processing period, you may also have the right to request a State Fair Hearing.
Can I Apply for Medi-Cal Again After Being Denied?
Yes. A previous denial does not permanently prevent you from applying for Medi-Cal.
A new application may make sense if:
- Your income has decreased
- Your household size has changed
- Your pregnancy status has changed
- Your immigration or eligibility circumstances have changed
- You now have the documents needed to establish eligibility
- Enough time has passed that the County tells you a new application is required
Submitting a new application and appealing an incorrect old decision are not necessarily the same thing. If the original decision was wrong and past months of coverage matter, ask about your State Fair Hearing rights rather than assuming a new application will solve the earlier period.
What If My Medi-Cal Ended Because I Missed My Renewal?
This situation is different from having a new Medi-Cal application denied.
If your existing Medi-Cal ended because you did not return your renewal form or requested information, DHCS says that if it has been less than 90 days from the date on the termination letter, you can submit the renewal form or missing information to your County.
The County will review whether you are still eligible, and you generally do not need to submit a completely new Medi-Cal application during that 90-day period.
If more than 90 days have passed, a new Medi-Cal application may be required.
CDSS currently states that certain Medi-Cal redetermination and renewal-related eligibility hearing requests have a temporary extended hearing period of 120 days from the mailing date of the Notice of Action. This extension does not apply to new Medi-Cal applications. Always check the current instructions on your notice.
What If I Am Denied Because My Income Is Too High?
First, confirm that the County used the correct income, household size, and Medi-Cal category.
Review the 2026 Medi-Cal Income Limits to better understand how income limits vary by household size and eligibility category.
If the calculation is correct and you truly do not qualify for Medi-Cal because of income, you may be eligible to purchase coverage through Covered California and may qualify for financial assistance depending on your household income and other circumstances.
Do not remain uninsured simply because you received a Medi-Cal denial. Review the other coverage options available to you.
Medi-Cal Denial Checklist
- ✓ Read your Notice of Action carefully.
- ✓ Check the reason for denial.
- ✓ Check the income and household information used.
- ✓ Contact your County Medi-Cal Office.
- ✓ Submit missing or corrected information promptly.
- ✓ Keep copies and submission confirmations.
- ✓ Write down who you speak with and when.
- ✓ Review your State Fair Hearing deadline.
- ✓ Request a hearing if you disagree with the decision.
- ✓ Consider reapplying if your circumstances have changed.
- ✓ Check Covered California if you are not eligible for Medi-Cal.
Frequently Asked Questions
Can I appeal a Medi-Cal application denial?
Yes. If you disagree with a Medi-Cal eligibility denial, you can request a State Fair Hearing. For a new application denial, the normal deadline is generally 90 days from the date on the Notice of Action.
Can I apply again after Medi-Cal denies me?
Yes. A denial does not prevent you from applying again. However, if you believe the original decision was incorrect, also review your hearing rights instead of relying only on a new application.
What if I already submitted the document the County says is missing?
Contact the County and provide proof of submission, such as an online confirmation, fax receipt, mailing receipt, or copy of the document. If the problem is not corrected and you disagree with the denial, review your State Fair Hearing rights.
Do I have to talk to the County before requesting a hearing?
You can try to resolve an eligibility issue with your County, but do not allow the State Hearing deadline to expire while waiting for the County to correct the problem.
Who conducts the Medi-Cal State Fair Hearing?
The California Department of Social Services State Hearings Division administers the hearing process. An Administrative Law Judge reviews the dispute.
Official Resources
- DHCS — Medi-Cal Help
- DHCS — Medi-Cal Fair Hearing
- California Department of Social Services — State Hearing Requests
- BenefitsCal
- Covered California
- California Medi-Cal County Office Contact Guide
California Benefits Guide is an independent informational website and is not affiliated with or endorsed by the State of California, the California Department of Health Care Services (DHCS), the California Department of Social Services (CDSS), Medi-Cal, Covered California, or any county agency. This guide is for general educational and informational purposes only and is not legal or official Medi-Cal eligibility advice. Hearing deadlines and Medi-Cal procedures can depend on the type of decision and may change. Always follow the instructions and deadlines on your official Notice of Action and verify current information with your County Medi-Cal Office, DHCS, or CDSS.