Medi-Cal Eligibility for California Nursing Home Care: 2026 Guide

What changed in 2026

California was the first state to eliminate its Medi-Cal asset test for all programs, effective January 1, 2024. For two years, an applicant's savings, property, and other resources did not count toward Medi-Cal eligibility — only income mattered. Citing budget constraints, the state reinstated an asset limit for the programs that pay for long-term care, effective January 1, 2026. New applicants must meet the reinstated limit to qualify. People already enrolled during the no-asset-test period generally do not have to document their assets until their first Medi-Cal renewal in 2026.

The 30-month look-back period for asset transfers, which had been suspended, is also back. This guide reflects the reinstated rules. Because this is an active, recently changed area of law, verify every figure with the California Department of Health Care Services or your county eligibility office before making any financial decision.

Asset limits and spousal protections

For long-term-care Medi-Cal (including nursing facility coverage) and related Aged & Disabled programs, the reinstated resource limit is $130,000 for a single applicant, with the limit increasing by $65,000 for each additional person counted in the household. Medi-Cal expansion categories for younger adults and children do not have an asset limit; this reinstated limit applies specifically to the aged, blind, and disabled programs that cover nursing facility stays.

When one spouse needs nursing facility care and the other remains at home, spousal impoverishment protections apply: the applicant (institutionalized) spouse is held to the $130,000 limit, while the community spouse at home may keep resources up to the Community Spouse Resource Allowance — approximately $162,660 for 2026. Countable assets typically include bank accounts, investments, and additional real property. A primary home, one vehicle, personal belongings, and certain retirement accounts are commonly excluded, but exclusion rules have exceptions — confirm which of a specific household's assets count before assuming anything is protected.

The look-back period and transfer penalties

Medi-Cal reviews asset transfers made in the 30 months (2.5 years) before a long-term-care application under the reinstated rules. Transfers made in 2024 and 2025, while the asset test was eliminated, are protected and will not be penalized even though they fall inside what would otherwise be the look-back window. Transfers made on or after January 1, 2026 are subject to review.

Not every gift or transfer triggers a penalty. A transfer valued below the Average Private Pay Rate for the year it was made ($14,440 for 2026) is not counted. Transfers above that amount can result in a period of Medi-Cal ineligibility for nursing facility coverage, calculated based on the value transferred; the maximum penalty period is 30 months from the date of the transfer. Gifting, adding a child to a deed, or moving money to avoid the asset limit without professional guidance can create exactly the kind of penalty this rule exists to catch.

Income rules and share of cost

Unlike the asset test, Medi-Cal's income rules for long-term care were not paused. Most nursing facility residents on Medi-Cal contribute toward the cost of their care through a share of cost: the county takes the resident's gross monthly income, subtracts a Personal Needs Allowance ($35 a month under the standard Medically Needy pathway, higher for some SSI or VA Aid and Attendance recipients), subtracts any health insurance premiums, and subtracts an allowance sent to a community spouse at home up to the Minimum Monthly Maintenance Needs Allowance ($4,066.50 a month for 2026 if the spouse's own income falls below that level). What remains is owed to the facility each month, with Medi-Cal covering the balance of the facility's Medi-Cal rate.

Example: a resident with $1,800 in monthly income and a $50 insurance premium, with no community spouse, would generally owe $1,800 − $50 − $35 = $1,715 per month as share of cost. The county eligibility worker calculates the actual figure for each household — use this only to understand the mechanics, not as a substitute for an official determination.

Clinical (level-of-care) eligibility

Financial eligibility is only half the requirement. Medi-Cal also requires a physician's order documenting that nursing facility care is medically necessary, and the stay must be expected to last at least one full calendar month beyond the month of admission for it to be treated as long-term care rather than a short-term stay. Facilities generally handle the clinical authorization paperwork as part of admission, but families should confirm it has actually been submitted rather than assuming it happened automatically.

How to apply

Applications can be filed online at BenefitsCal.com, in person or by mail through the county Human Services Agency (sometimes called the Department of Public Social Services or Department of Social Services depending on the county), or through the nursing facility, which often keeps application packets on hand for residents. On the application, answer yes to the question asking whether the applicant needs help with long-term care or home- and community-based services — this routes the application to long-term-care processing rather than general Medi-Cal.

Be ready to provide proof of identity, California residency, citizenship or immigration status, Social Security number, income, and the reinstated asset documentation discussed above. Processing can take weeks; if a facility stay has already started, ask the facility and the county about options for coverage during the application period.

Estate recovery

California may seek repayment from a Medi-Cal recipient's estate after death for long-term-care costs paid on their behalf, subject to exemptions (including protections while a spouse or certain dependents survive). Estate recovery rules and exemptions are their own detailed area of law — a household expecting to leave a home or other estate to heirs should raise this directly with DHCS or an elder-law attorney rather than assume any outcome.

Where to get help

For Medicare-specific questions or help comparing Medicare and Medi-Cal, HICAP offers free counseling at 1-800-434-0222. For the broader picture of how Medicare, Medi-Cal, private pay, and long-term-care insurance fit together, see our guide to paying for nursing home care in California. For help evaluating a specific facility once payment is sorted out, see our guide to choosing a nursing home.

Official sources

• CANHR — Overview of Medi-Cal for Long-Term Care
• CANHR — 2026 Asset Limit Reinstatement FAQ
• Justice in Aging — Reinstatement of the Medi-Cal Asset Limit
• California Department of Health Care Services — Medi-Cal
• BenefitsCal — apply for Medi-Cal online