What is Medi-Cal? A Beginner's Guide

Last Updated: October 17, 2026

If you live in California and need affordable health coverage, you may have heard about Medi-Cal. But what exactly is Medi-Cal, who can qualify, and what does it cover?

This beginner's guide explains the basics of Medi-Cal, including eligibility, benefits, Managed Care, Fee-for-Service, the Medi-Cal BIC card, how to apply, and what happens after you are approved.

Quick Answer:

Medi-Cal is California's Medicaid program. It provides free or low-cost health coverage to eligible California residents. Your eligibility and coverage depend on the rules of the specific Medi-Cal program.

1. What Is Medi-Cal?

Medi-Cal is California's Medicaid program.

It is a public health coverage program that helps eligible California residents receive medical care at little or no cost.

Medi-Cal is administered by the California Department of Health Care Services (DHCS), while local county offices handle many eligibility and enrollment functions.

Medi-Cal is different from Medicare. Medi-Cal eligibility generally depends on income and other eligibility requirements, while Medicare is a federal health insurance program primarily for people age 65 or older and certain younger people with disabilities or qualifying medical conditions.

2. Who Can Qualify for Medi-Cal?

Medi-Cal has several eligibility categories. Whether you qualify depends on your individual circumstances.

Factors that may affect eligibility include:

California residency
Household income
Age
Household size and tax filing information
Pregnancy
Disability
Whether you receive Medicare
Assets for certain Non-MAGI Medi-Cal programs
Immigration status for certain types of coverage

Different Medi-Cal programs have different eligibility rules. Two people living in the same household may qualify for different types of health coverage.

Important for 2026:

Medi-Cal eligibility rules changed in 2026. Some changes affect new full-scope enrollment based on immigration status, while asset limits returned for certain Medi-Cal programs. Always check the eligibility rules that apply to your individual situation.

For a detailed explanation of current income guidelines, read: 2026 Medi-Cal Income Limits by Household Size .

3. What Is MAGI Medi-Cal?

Many children, parents, caretakers, pregnant individuals, and adults under age 65 are evaluated under rules known as Modified Adjusted Gross Income (MAGI).

MAGI Medi-Cal generally uses federal tax-based household and income rules to determine eligibility.

For many applicants, income is therefore one of the most important factors in determining Medi-Cal eligibility.

For example, a household's eligibility may depend on countable income, household size, and the relationship between family members for tax purposes.

However, not everyone is evaluated under MAGI rules.

4. What Is Non-MAGI Medi-Cal?

Medi-Cal also has programs that do not use the standard MAGI income rules. These are commonly referred to as Non-MAGI Medi-Cal.

Non-MAGI programs may apply to certain people such as:

Adults age 65 or older
People with disabilities
People who need long-term care
Certain Medicare beneficiaries
Other individuals who qualify under special Medi-Cal programs

For some Non-MAGI Medi-Cal programs, both income and assets may be considered when determining eligibility.

2026 Asset Rules:

Beginning January 1, 2026, asset limits returned for certain Medi-Cal eligibility categories. The general countable asset limit is $130,000 for one person, with additional amounts for qualifying household members through June 30, 2027. Special rules and exclusions may apply.

An asset test does not automatically apply to everyone receiving Medi-Cal.

5. What Does Medi-Cal Cover?

Medi-Cal provides a broad range of health care benefits. The exact services available depend on eligibility, the type of Medi-Cal coverage, medical necessity, and other program rules.

Covered benefits may include:

Doctor visits
Hospital and clinic services
Emergency medical care
Prescription medications
Preventive care and checkups
Laboratory tests and imaging
Maternity and newborn care
Mental health services
Substance use disorder treatment
Physical and occupational therapy
Dental services
Vision services
Medical equipment and supplies
Transportation for certain covered medical services
Long-term care and certain in-home services for eligible members

Remember:

Not every service is automatically covered in every situation. Some services may require a referral, prior authorization, or a determination that the service is medically necessary.

For a more detailed breakdown, read: What Services Does Medi-Cal Cover?

6. How Much Does Medi-Cal Cost?

For many eligible Medi-Cal members, health coverage is available at no cost or low cost.

Many members do not pay a monthly premium for their Medi-Cal coverage, and many covered medical services are provided without out-of-pocket charges.

However, costs and requirements vary depending on the Medi-Cal program and the individual's circumstances.

Some people may have a Share of Cost or other program-specific payment requirements.

Upcoming Change:

Starting July 1, 2027, monthly premiums are scheduled to apply to certain Medi-Cal members based on immigration-related eligibility rules. This requirement will not apply to all members. Check DHCS guidance for the applicable categories and exemptions.

7. Is Medi-Cal the Same as Covered California?

No. Medi-Cal and Covered California are related to health coverage in California, but they are not the same program.

Medi-Cal is California's Medicaid program for eligible residents.

Covered California is California's health insurance marketplace, where individuals and families can purchase private health insurance and may qualify for financial assistance to reduce their costs.

When you complete a health coverage application through Covered California, the information can also be used to determine whether you qualify for Medi-Cal.

Example:

Members of the same family do not necessarily receive the same type of coverage. A child may qualify for Medi-Cal while the parents may qualify for a Covered California health plan with financial assistance.

8. Is Medi-Cal the Same as Medicare?

No. Medi-Cal and Medicare are different programs.

Medicare is a federal health insurance program primarily for people age 65 or older and certain younger people who qualify because of disabilities or qualifying medical conditions.

Medi-Cal is California's Medicaid program and is based on Medi-Cal eligibility requirements.

Some people qualify for both Medicare and Medi-Cal. These individuals are often called dual eligible members.

For people who have both programs, Medicare generally pays first for Medicare-covered services, while Medi-Cal may help with certain remaining costs and additional covered services, depending on eligibility.

A person who turns 65 should check Medicare enrollment requirements separately, even if they already receive Medi-Cal.

9. What Is Medi-Cal Managed Care?

Most Medi-Cal members receive health care through a Medi-Cal Managed Care health plan.

A Medi-Cal health plan has a network of doctors, clinics, specialists, hospitals, and other health care providers.

Members generally choose or are assigned a Primary Care Provider (PCP), who helps provide routine care and coordinate other medical services.

The Medi-Cal health plans available to you depend on the California county where you live.

You may need to confirm that both your doctor and medical group accept your specific Medi-Cal health plan before scheduling care.

If you need help finding a provider, read: How Can I Find a Doctor Who Accepts Medi-Cal?

10. What Is Fee-for-Service Medi-Cal?

Some Medi-Cal members receive services through Fee-for-Service (FFS) Medi-Cal, sometimes called Regular Medi-Cal.

With Fee-for-Service Medi-Cal, members can receive covered services from enrolled Medi-Cal providers who accept Fee-for-Service.

Instead of a Managed Care health plan arranging most medical services, California generally pays eligible providers directly for covered services.

Fee-for-Service does not mean that members must personally pay for all their medical care.

Some people may also have Fee-for-Service Medi-Cal temporarily before enrolling in a Managed Care health plan.

Important Change for 2027:

Starting January 1, 2027, certain Medi-Cal members affected by federal immigration-related requirements are scheduled to move from Managed Care to Fee-for-Service.

This changes how they receive medical care. It does not automatically mean that they are losing Medi-Cal eligibility.

Members who may be affected should ask their doctors whether they accept Medi-Cal Fee-for-Service and review any notices from DHCS.

For official details, visit: DHCS – Fee-for-Service Transition .

11. What Is the Medi-Cal BIC Card?

After you are approved for Medi-Cal, you generally receive a Benefits Identification Card (BIC).

The BIC identifies you as a Medi-Cal member and helps health care providers access the information needed to verify and bill for Medi-Cal-covered services.

If you enroll in a Medi-Cal Managed Care plan, you may also receive a separate membership card from your health plan.

Keep Both Cards:

If you have a Medi-Cal Managed Care plan, keep both your Medi-Cal BIC card and your health plan membership card. Your medical office may ask to see one or both cards.

For affected members moving to Fee-for-Service in 2027, the Medi-Cal BIC card will be especially important when receiving medical services.

12. How Do You Apply for Medi-Cal?

You can apply for Medi-Cal at any time during the year. Unlike many private health insurance plans, Medi-Cal generally does not require you to wait for an annual open enrollment period to submit an application.

You can apply through several methods:

Online through BenefitsCal
Online through Covered California
By contacting your local county office
By phone
By mail
In person

Your application will be reviewed to determine the health coverage program for which you qualify.

You may apply online through: BenefitsCal or Covered California .

For official application instructions, visit: DHCS – Apply for Medi-Cal .

13. What Happens After You Are Approved?

After Medi-Cal approval, you will generally receive information about your eligibility and coverage.

New Medi-Cal beneficiaries receive a Benefits Identification Card (BIC). Depending on where you live and your eligibility category, you may also need to enroll in or be assigned to a Medi-Cal Managed Care health plan.

Once enrolled in a health plan, you can choose or be assigned a Primary Care Provider and begin using your plan's network for covered services.

Before scheduling your first appointment, confirm which health plan, medical group, and doctor are assigned to you.

For more information, read: What Happens After I Am Approved for Medi-Cal?

14. Do You Have to Renew Medi-Cal?

Yes. Medi-Cal eligibility generally must be renewed periodically.

Sometimes your county can renew your Medi-Cal automatically using information already available. In other cases, you may receive a renewal form requesting additional information.

To help keep your Medi-Cal coverage:

Keep your address and contact information current.
Open and read all notices from your county.
Provide requested documents by the deadline.
Complete your renewal when required.
Contact your county if you believe a decision was incorrect.

Important:

Do not ignore Medi-Cal renewal notices. Missing a required renewal or failing to provide requested information can cause coverage to end even if you might otherwise remain eligible.

Renewal is especially important for certain members affected by the immigration-related enrollment restrictions that began in January 2026.

15. Important Medi-Cal Changes for 2026 and 2027

Medi-Cal rules change over time. Some changes affect eligibility, immigration-related coverage, asset limits, dental benefits, health plan enrollment, or program costs.

Important developments include:

January 2026: New full-scope enrollment restrictions for certain adults based on immigration status.
January 2026: Asset limits returned for certain Medi-Cal eligibility categories.
October 2026: Federal immigration status classification changes affecting some Medi-Cal members.
January 2027: Certain members are scheduled to transition from Managed Care to Fee-for-Service Medi-Cal.
July 2027: Lower asset limits are scheduled for certain Medi-Cal categories.
July 2027: Changes to routine dental benefits are scheduled for certain adults.
July 2027: Monthly premiums are scheduled for some members under specific eligibility rules.

Not every Medi-Cal member is affected by every change. Future implementation details may also be updated.

For a detailed explanation, read: 2026 Medi-Cal Changes Explained: 2026–2027 Updates .

You can also review the official DHCS Medi-Cal Changes page.

16. Key Takeaway

Medi-Cal is California's Medicaid program and provides free or low-cost health coverage to eligible California residents.

It can cover many health services, including doctor visits, hospital care, prescriptions, preventive services, mental health care, dental and vision care, and pregnancy-related services.

However, Medi-Cal is not a single eligibility category.

Your income, age, household circumstances, pregnancy, disability, Medicare status, assets in certain programs, immigration status, and other factors can affect the type of Medi-Cal coverage you receive.

If you believe you may qualify, you can apply during the year and have Medi-Cal or your county evaluate your eligibility.

California Benefits Guide Tip:

Before assuming that you do not qualify for Medi-Cal, identify the eligibility category that may apply to your circumstances. Children, pregnant individuals, older adults, and people with disabilities may be evaluated under different rules.

Official Sources and Resources

This guide is based on information from the California Department of Health Care Services (DHCS) and other official California health coverage resources.

Disclaimer:

This website provides general information about California public benefit programs and is for informational purposes only. It is not affiliated with or endorsed by any government agency and does not provide legal, medical, or professional advice. Program rules, eligibility requirements, benefits, and procedures may change. For the most current information and guidance about your individual situation, please contact the appropriate government agency, county office, health plan, or program administrator.