How the 250% Working Disabled Program May Eliminate a Medi-Cal Share of Cost

California’s   250% Working Disabled Program   may allow a person with a disability who performs some paid work to receive Medi-Cal without a monthly Share of Cost. The program’s monthly premium is currently $0.

This is not an automatic conversion. The person must satisfy the disability, paid-work, net countable income, property and other Medi-Cal eligibility requirements, and the county must approve the case.

Who May Qualify?

• Disability:
  • The applicant must meet the Social Security disability definition used by the program. A person does not necessarily have to be receiving an SSDI or SSI cash payment, and the usual substantial-gainful-activity test is not applied in the same manner for this Medi-Cal category.
    See DHCS All County Welfare Directors Letter 19-12.
• Some paid work:
  • The person must be working for pay, but there is no minimum number of hours and no minimum amount that must be earned.
• Net countable income:
  • Eligibility is based on net countable income, not simply total or gross monthly income. Disability-based income is excluded under the special Working Disabled Program calculation, and earned-income deductions may also apply.
• Income below 250% of the Federal Poverty Level:
  • For 2026, effective April 1, 2026, the 250% monthly figures are $3,325 for one person and $4,510 for two people. Because exclusions and deductions apply, a person’s actual gross income may be higher.
    See the  official DHCS 2026 Federal Poverty Level chart.
• Property requirements:
  • Medi Cal Resources Asset Limits
• Other Medi-Cal requirements:
  • California residency and all other applicable financial and nonfinancial Medi-Cal rules must also be met.

Paid Work Can Be Very Small or Informal

The  DHCS Working Disabled Program consumer flyer    explains that paid work may include:

• Self-employment;
• Working for a friend, relative or neighbor;
• Recycling bottles or cans;
• Pet care;
• Childcare;
• Reading, tutoring, sorting mail or performing another small paid task; or
• Other legitimate work for which the person receives payment.

The work must actually be performed and paid, but it does not have to be a traditional job with regular hours or a formal payroll department.

A Formal Pay Stub Is Not Always Required

When there is no regular pay stub, DHCS says that a signed note from the person paying the applicant may be used. The note should identify:

• The person performing the work;
• What work was performed;
• The dates or approximate frequency of the work;
• The amount paid; and
• The payer’s name, signature and contact information.

Self-employed applicants may use receipts, invoices, payment records, bank records or other reasonable documentation of the work and income. The county may request additional verification when necessary.

Why Someone With Disability Income May Still Qualify

The income test is more favorable than simply adding together every dollar received. Under   California Welfare and Institutions Code §14007.9:

• Disability-based income is excluded from the Working Disabled Program income calculation;
• Only the countable portion of earned income is included after applicable deductions;
• Certain retirement accounts are excluded from countable property; and
• A person may retain earnings in a separately identifiable account under the program’s rules.

For that reason, someone should not assume that SSDI or another disability payment automatically makes the person ineligible. The county must perform the complete Working Disabled Program calculation.

How to Request a Working Disabled Program Evaluation

A person who already has Medi-Cal with a Share of Cost generally does not need to submit a completely separate Medi-Cal application. DHCS instructs beneficiaries to contact their county and ask to be evaluated for the Working Disabled Program.

1. Gather proof of paid work.
   1. Use pay stubs, receipts, invoices, self-employment records or a signed statement from the person paying for the work.
2. Gather income and property information.
   1. Include proof of wages, disability income, other income, bank accounts and any other documents requested by the county.
3. Upload the documents through   BenefitsCal.
   1. Keep copies and confirmation showing what was uploaded and when.
      See our  BenefitsCal proof and upload instructions.
4. Contact the county Medi-Cal eligibility worker.
   1. Do not merely upload documents and wait. Ask the worker to confirm that the documents were received and specifically request a Working Disabled Program evaluation.
5. Use the program’s complete name.
   1. This helps prevent the request from being treated as a routine income change or ordinary Share of Cost recalculation.
6. Request a written Notice of Action.
   1. The written notice should show whether the program was approved or denied and explain the person’s hearing rights if the county’s decision is disputed.

What About IHSS?

The county Medi-Cal eligibility worker—not the IHSS social worker—determines eligibility for the Working Disabled Program. When Medi-Cal approves the new eligibility category and removes the Share of Cost, provide the written Medi-Cal Notice of Action to the IHSS worker so the related county records can be reviewed and updated.

What If the Person Does Not Qualify?

The Working Disabled Program is only one possible way to reduce or eliminate a Medi-Cal Share of Cost. A person who cannot perform paid work, does not meet the disability rules or does not satisfy another requirement may still be able to use allowable health-insurance premiums or medical expenses to reduce countable income.

• Review our  main Medi-Cal Share of Cost page.
• Use our Share of Cost calculator.
• Read the  Center for Health Care Rights plain-English Share of Cost guide,
  which explains the use of health, dental, vision, Medicare and other allowable expenses.

Plain-English and Legal References

1. California Department of Health Care Services — Working Disabled Program.
   1. Current program overview, county contact instructions, $0 premium and property limits.
2. DHCS Medi-Cal Eligibility Division Information Letter I 25-10 and Working Disabled Program flyer.
   1. Plain-English explanation of paid work, informal work arrangements, acceptable proof and the absence of minimum hours or minimum earnings.
3. California Advocates for Nursing Home Reform — 250% Working Disabled Program.
   1. Consumer-oriented explanation of income, work, property and disability requirements with supporting citations.
4. CANHR — Aged, Blind and Disabled Medi-Cal Programs fact sheet.
   1. Related explanation of regular Aged and Disabled Medi-Cal, Share of Cost calculations and allowable deductions.
5. Center for Health Care Rights — Medi-Cal Share of Cost guide.
   1. Plain-English explanation of Share of Cost and the use of health-insurance premiums and medical expenses.
6. DHCS All County Welfare Directors Letter 19-12.
   1. Detailed eligibility, work, income and verification instructions to counties. Any premium amounts shown in this older letter have been superseded by the later $0-premium guidance.
7. DHCS Medi-Cal Eligibility Division Information Letter 22-31.
   1. Confirms that Working Disabled Program premiums were reduced to $0 effective July 1, 2022.
8. California Welfare and Institutions Code §14007.9.
   1. California statutory authority for the 250% Working Disabled Program, income exclusions, property provisions and the state’s authority not to impose premiums.
9. 42 U.S.C. §1396a(a)(10)(A)(ii)(XIII).
   1. Federal Medicaid authority allowing coverage of working individuals with disabilities whose income is below 250% of the federal poverty level.
10. DHCS 2026 Federal Poverty Level Calculation Chart.
    1. Official 2026 monthly income figures, effective April 1, 2026 for the Working Disabled Program.

Important:
This page provides general educational information and is not a guarantee of Medi-Cal eligibility. Eligibility and the effective date of any change are determined by the applicant’s county Medi-Cal office after reviewing the complete facts and documentation.