How to Eliminate Medi-Cal Share of Cost

Using the 250% Working Disabled Program

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A Little-Known Strategy

• There is a Medi-Cal program that may allow you to:

  • Work (even part-time)

  • Keep full Medi-Cal coverage

  • Eliminate your Share of Cost (SOC)

• This program is called the 250% Working Disabled Program (WDP)

👉 Eligibility subject to county Medi-Cal determination. Must meet disability, income, and program requirements.

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🚨 You May Qualify with Very Small Income

• There is no minimum number of hours required to work (DHCS guidance)

• Even:

  • Part-time work

  • Self-employment

  • Very small income

may qualify as “working” (DHCS Working Disabled Program page)

👉 This is one of the most overlooked Medi-Cal strategies

• Email us [email protected]

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What This Means for You

• Instead of:

  • Paying a high monthly share of cost

• You may qualify for:

  • Full Medi-Cal coverage

  • With a $0 or low monthly premium (DHCS WDP program updates)

👉Email us [email protected]

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Why the Working Disabled Program Works

• Disability-based income (such as SSDI) is not counted the same way as earned income (program methodology explained in WDP materials)

• Earned income is:

  • Partially excluded

  • Not counted dollar-for-dollar (SSI income rules applied to Medi-Cal)

• Eligibility is based on income up to:

  • 250% of the Federal Poverty Level (DHCS program description)

👉Example (Simplified)

• SSDI income: $2,500/month

• Small part-time work: $300/month

Result:

• Only part of the $300 is counted

• SSDI may not disqualify eligibility

👉 The person may qualify for:

• Full Medi-Cal

• No Share of Cost

(Eligibility determined by county based on full rules)

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Share of Cost vs Working Disabled Program

• Share of Cost Medi-Cal

  • Pay large medical expenses before coverage begins

• Working Disabled Program

  • Coverage starts immediately

  • May have:

    • $0 premium

    • Or a small monthly premium

👉 This is why many people switch when eligible

• Email us [email protected]

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Quick Eligibility Check

• Are you considered disabled under Social Security rules?

  • Yes / No

• Do you have ANY earned income (even small)?  DHCS.Gov

  • Yes / No

• Is your income likely under about 250% of the Federal Poverty Level?

  • Yes / No / Not sure

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If You Answered YES to All 3:

👉 You may qualify for the Working Disabled Program
👉 You may be able to eliminate your Share of Cost

• Email us [email protected]

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Asset Rules (Important Update for 2026+)

• California previously eliminated asset limits

• Asset limits are reinstated as of 2026

• Current limits:

  • $130,000 (individual)

  • +$65,000 per additional household member

👉Some assets may still be excluded (home, vehicle, etc.)

• Email us [email protected]

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Important: County Approval Required

• The Working Disabled Program is:

  • Administered by your county Medi-Cal office

• You must:

  • Apply through the county

    • BenefitsCal.com

  • Documentation required (work + disability)

  • 
  •  

  • Provide documentation of:

    • Disability

    • Earned income

👉When This Strategy Works Best

• You currently have a high share of cost

• You can perform any level of work

• You want predictable coverage instead of monthly spend-down

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Most Agents Don’t Tell You This – it’s rather technical..

• There are ways to reduce or eliminate Share of Cost that:

  • Do not involve spending thousands on medical bills

  • Do not require giving up income

👉 The Working Disabled Program is one of those strategies

• Email us [email protected]

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Not Sure If You Qualify?

We can help you evaluate:

• Your income

• Your work situation

• Your current share of cost

👉 Request a Share of Cost Review
👉 Schedule a Zoom Consultation

• Email us [email protected]

 

• 

• Medi Cal working while disabled  dhcs.gov
  • 
  • pdf flyer 250 percent working while disabled  dhcs.gov
  • 
  • Email us [email protected]

Medi-Cal #Asset & Income Limits (2026)

For programs with an asset test (Aged/Blind/Disabled, Share-of-Cost, long-term care, Medicare Savings Programs):

• $130,000 for one person
• $195,000 for a couple
• +$65,000 for each additional household member (up to 10 people) (CalHealth Services)

These limits apply to countable assets, such as:

• Cash
• Bank accounts
• Stocks or brokerage accounts
• Certificates of deposit
• Additional real estate or second homes
• Extra vehicles (CalHealth Services)

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Assets That Do NOT Count

Several assets are exempt, including:

• Your primary residence
• One vehicle
• Household goods and personal property
• Some retirement accounts if you are taking distributions our webpage
• Burial plots and certain prepaid funeral plans (CANHR)

This is why many people technically have more wealth than the limit but still qualify.

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What If You’re Over the Asset Limit?

Yes — normally you must spend down assets until you fall below the limit.

Typical “spend-down” methods include:

Allowed spending

• Paying off debts (mortgage, credit cards, car loan)
• Home repairs or improvements
• Buying furniture or appliances
• Paying medical bills
• Prepaying rent or care costs
• Purchasing exempt assets (car, burial plan)

If your assets are still over $130,000 (or $195k for couples) when you apply or at renewal, Medi-Cal eligibility will be denied or terminated. (Justice in Aging)

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Important Rule: Look-Back Period

 

For long-term-care Medi-Cal,  our webpage California can review up to 30 months of financial history.

If someone gave away assets or transferred them for less than fair value, it can create a penalty period where Medi-Cal will not pay for care. (CunninghamLegal)

This is why planning is often done carefully with attorneys.

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Example

Let’s say a single person has:

• $200,000 in savings
• A home they live in (not counted)

Since the limit is $130,000, they must spend down about $70,000 before Medi-Cal eligibility.

They could do that by:

• Paying off debts
• Home improvements
• Medical expenses our webpage
• Buying exempt items

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The asset test only applies to “non-MAGI” Medi-Cal (mostly seniors, disabled, and long-term care).

MAGI Medi-Cal (Affordable Care Act expansion) has no asset test at all — eligibility is based on income only. (Justice in Aging)

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✅ Bottom line:

• Asset limit in 2026: $130k single / $195k couple
• If you exceed it, you generally must spend down assets before qualifying.
• Some assets (home, car, personal property) don’t count.
• Improper transfers can trigger penalties.
• Email us [email protected]  

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If you want, Chat GBT can also explain three little-known strategies people use to qualify without just burning through their savings (these come up a lot in Medi-Cal planning and many agents don’t know them).

 

SSI #Resources & Income Limits

 

• Medi-Cal section of the
  • Disability Benefits 101 website.
• Countable resources are the things you own that count toward the resource limit. Many things you own do not count.

 ^{CA Health Care Advocates *  DHCS}  *

1. 1.  asset questionnaire
   2. CANHR Fact Sheet
   3. Understanding Medi-Cal’s Asset Test for Seniors and People With Disabilities
   4. Western Poverty Law 
   5. Nolo - SSI Income & Asset Limits
   6. Income SSA.Gov
      1. SSA Site
   7. Will my settlement affect my government benefits?  VIDEO
   8. dhcs.ca.gov/Asset-Limit-Changes-for-Non-MAGI-Medi-Cal
      1. dhcs.ca.gov/asset test amendment
      2. dhcs.ca.gov/Asset-Limits-Report
   9. california healthline.org/sset-test-elimination
   10. FAQ's
   11. Our webpage on SSI Resources & Income
2. Have less than... of FPL  in countable monthly income for an individual ... for a couple). ^{ca health advocates.org ADFPL    *  AB 715 Fact Sheet * Western Poverty Law  *} 
   1. Share of Cost if income is too high, but you qualify on asset test?

 

Resources & Links

•  Insure Me Kevin.com  *
• DHCS.CA.Gov *
  • How to report assets Insure Me Kevin.com

Working Disabled Program 250% of FPL (WDP)
“There are no minimum hours or wages required”

“Replace Share of Cost with $0 Medi-Cal”

 

Most Agents Don’t Tell You This

• This program –

  • Allows you to work

  • Eliminates share of cost

  • May cost $0

  • eligibility is conditional:

    • Must meet disability + income  250% of FPL + SSI test – You would qualify for SSI if not that you were earning $$$

👉 And many people qualify without realizing it

What Is the Working Disabled Program?

• The Working Disabled Program allows individuals with disabilities to work and still qualify for full-scope Medi-Cal. (42 U.S.C. § 1396a(a)(10)(A)(ii)(XIII))

• Email us [email protected]

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Why This Matters for Share of Cost

• Many individuals placed into Medi-Cal with a Share of Cost (SOC) may instead qualify for:

  • $0 share of cost Medi-Cal

• This works because WDP uses more favorable income rules, especially for earned income. (DHCS Medi-Cal Eligibility Procedures Manual § 5H)

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How WDP Lowers Countable Income

• Earned income is not counted dollar-for-dollar. (20 CFR § 416.1112)

• Additional deductions may apply, including:

  • Impairment-related work expenses (IRWE) (20 CFR § 416.976)

• These rules can reduce income enough to:

  • Eliminate share of cost entirely

  • Or significantly reduce it

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#Basic Eligibility Requirements

To qualify, an individual must generally:

• Meet the definition of disabled under Social Security rules (Social Security Act § 1614(a))

  • without regard to ability to perform substantial gainful activity. DHCS.Gov

• Have earned income (even part-time work qualifies) (42 U.S.C. § 1396a(a)(10)(A)(ii)(XIII))

• Meet Medi-Cal income requirements after exclusions (DHCS Manual § 5H)

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Asset Rules (IMPORTANT – UPDATED FOR 2026)

• California previously eliminated the Medi-Cal asset test in 2024–2025.

• As of January 1, 2026, asset limits are reinstated, including for:

  • Working Disabled Program

  • Share of Cost Medi-Cal our webpage

  • Aged & Disabled programs our webpage

• Current limits:

  • $130,000 for an individual

  • +$65,000 per additional household member

• More on 2026 Asset Limits

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When WDP Is a Strong Strategy

• You currently have a high share of cost

• You can do any level of work (even minimal income)

• You want predictable, affordable coverage instead of SOC

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Key Planning Insight

• Even a small amount of earned income can unlock eligibility

• This creates a powerful strategy:

  • Shift from “spend down every month”

  • Email us [email protected]

 

DHCS is clear:

• You must apply through county office

👉 Add:

Important

• Must be approved by your county apply through BenefitsCal.com

• Documentation required (work + disability)

• 

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Bottom Line

• If you have Medi-Cal with a share of cost:

  • The Working Disabled Program may eliminate it entirely

  • While allowing you to earn income and keep coverage

• Not sure if you qualify?”

  • We’ll review:

    • Income

    • Work situation

    • Share of cost

  👉 Request a Share of Cost Review  Email us [email protected] 

  • Please include all relevant documents.

• 

• Medi Cal working while disabled  dhcs.gov
  • 
  • pdf flyer 250 percent working while disabled  dhcs.gov
  • 
  • Email us [email protected]