MAGI Income Limits for Medi-Cal & Covered California

Quick answer: Do you qualify for Medi-Cal or Covered California based on your income?

✔ Under ~138% of the Federal Poverty Level → Medi-Cal
✔ Above ~138% → Covered California with premium subsidies

Based on your CURRENT monthly income — not just last year’s tax return.

Start Here:

Estimate Your Income  |  Already on Medi-Cal?  |  Over income? Review Share of Cost options

Income above the free Medi-Cal limit does not always mean you are out of options.

If your income is above Medi-Cal limits, you may qualify for a Covered California plan with financial assistance.

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Estimate Your Medi-Cal Income

Medi-Cal usually looks at your current monthly income, while Covered California is generally based on your expected annual income for the year.

If you are trying to figure out whether you may qualify for Medi-Cal, start with a simple estimate. Do not panic if your income changes during the year. Many people move between Medi-Cal and Covered California when income goes up or down.

Start with these 3 steps:

• Step 1: Estimate your household income for this month.
• Step 2: Count the people in your tax household.
• Step 3: Compare your income to the Medi-Cal limit for your household size.

For many people, the basic rule is simple: if your income is around or below 138% of the Federal Poverty Level, you may qualify for Medi-Cal. If your income is above that level, you may instead qualify for a Covered California plan with premium assistance.

Income can change. If you are self-employed, work part-time, have seasonal income, or recently started or lost a job, your eligibility may also change. That is why it is important to look at what you are earning now and where your income is headed.

Over the free Medi-Cal income limit?

You may still have options. Some people who are over the regular Medi-Cal income limit may be placed into a Medi-Cal Share of Cost program, and in some cases there are ways to reduce or eliminate that Share of Cost.

See how Medi-Cal Share of Cost may be reduced or eliminated

Real-Life Examples: Medi-Cal vs Covered California

These examples are simplified, but they show how income changes can affect your eligibility.

Example 1: Single Person, Steady Income

A single adult earns about $1,600 per month. This is generally below the Medi-Cal income limit.

Result: Likely qualifies for Medi-Cal.

Example 2: Income Increases During the Year

A person starts the year earning $1,400 per month and qualifies for Medi-Cal. Mid-year, they get a new job earning $2,500 per month.

Result: They may move from Medi-Cal → Covered California with premium assistance after reporting the change.

Example 3: Self-Employed with Fluctuating Income

A self-employed individual has some months with low income and other months with higher income.

Result: Medi-Cal may look at current monthly income, while Covered California looks at estimated annual income. Eligibility may shift during the year depending on income patterns.

Example 4: Married Couple, Moderate Income

A married couple earns a combined $3,500 per month.

Result: This may be above Medi-Cal limits for a household of two, but they may qualify for a Covered California plan with subsidies.

Example 5: Over Medi-Cal Income → Share of Cost

An individual’s income is too high for free Medi-Cal, but still limited.

Result: They may be placed into a Medi-Cal Share of Cost program instead of losing eligibility completely.

Learn how some people reduce or eliminate Share of Cost

Example 6: Temporary Drop in Income

A person loses their job or has a temporary drop in income.

Result: They may become eligible for Medi-Cal even if they previously had a Covered California plan.

“$1,800/month — borderline case”

Every situation is different. Income, household size, and timing all matter. If you are not sure where you fall, it is often easier to run a quick quote or ask for help.

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Common Mistakes People Make with Medi-Cal Income

A lot of Medi-Cal confusion comes from a few very common misunderstandings.

1. Using Last Year’s Tax Return Only

Many people think Medi-Cal eligibility is based only on last year’s tax return.

Reality: Medi-Cal often looks at your current monthly income. Covered California looks at your expected annual income.

2. Not Reporting Income Changes on Time

People get a new job, lose income, or have a change in hours and do nothing.

Reality: You may need to report important changes to your county. Not reporting changes can lead to delays, incorrect eligibility, or problems later.

See when and how to report changes

3. Thinking “I Make Too Much” Without Checking

Some people assume they do not qualify for Medi-Cal or any assistance and never apply.

Reality: You may still qualify for Covered California subsidies or even a Medi-Cal program depending on your situation.

4. Ignoring Share of Cost Options

People are told they have a Share of Cost and assume Medi-Cal is no longer useful.

Reality: Some people can reduce or eliminate Share of Cost depending on their situation.

Review Share of Cost strategies

5. Confusing Monthly vs Annual Income

This is one of the biggest sources of mistakes, especially for self-employed individuals.

Reality: Monthly income can affect Medi-Cal eligibility, while annual projections affect Covered California. Both may apply at different times.

6. Not Opening or Responding to Medi-Cal Mail

Some people miss renewal notices or requests for documents.

Reality: Missing a deadline can cause coverage to stop even if you still qualify.

7. Assuming All Income Is Treated the Same

People often assume every dollar they receive counts the same way.

Reality: Different types of income (earned income, unemployment, self-employment, etc.) can be treated differently depending on the program.

8. Waiting Too Long to Ask for Help

People often wait until they lose coverage or get a notice they don’t understand.

Reality: It is usually much easier to fix issues early rather than after coverage is stopped.

Bottom line: Small mistakes can lead to big coverage problems — but most are fixable once identified.

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Medi-Cal vs Covered California – Quick Decision Flow

Follow this simple path to see where you may fit.

Not sure where you fall?

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What Does Medi-Cal Cover?

Medi-Cal provides comprehensive health coverage — not just basic care.

Doctor visits, hospital care, prescriptions, mental health services, maternity care, dental (Denti-Cal), vision, and preventive services are all typically covered.

See full list of Medi-Cal benefits

Medi-Cal Eligibility in California

Plain English help for income rules, renewals, managed care, dual coverage, and Medi-Cal Share of Cost.

Medi-Cal is California’s Medicaid program. This page is designed to give you a clear starting point if you are trying to understand whether you may qualify, what can affect your eligibility, and where to go next. We do not charge any extra fee to help with Covered California health plans, and while we generally are not paid to work on Medi-Cal itself, we have spent years collecting practical Medi-Cal information and resources that may help you.

This page is an overview page. If you need details on a specific issue such as income, asset limits, renewals, managed care, dual coverage, or Share of Cost, use the section links below.

Start Here

Medi-Cal eligibility can depend on income, household size, age, disability status, pregnancy, immigration category, and program type. Some people qualify under MAGI rules, while others qualify under non-MAGI rules. Because the rules are different depending on the category, it is easy to get confused when reading state websites or trying to compare one person’s case to another.

A good first question is this: Are you trying to find out whether you qualify for Medi-Cal, or are you trying to fix a problem with existing Medi-Cal?

• If you are applying for the first time, start with income and household rules.
• If you already have Medi-Cal, you may need help with renewals, reporting changes, managed care, or other coverage.
• If your income is too high, you may want to review Medi-Cal Share of Cost options.

Main Medi-Cal Topics

1. Income Eligibility for Medi-Cal

Many people qualify for Medi-Cal based on monthly income. For MAGI Medi-Cal, the state generally looks at your current monthly income, not just your annual tax return. This is one reason people can move between Medi-Cal and Covered California when income changes.

Read more about Medi-Cal income eligibility

2. Asset Limits and Rule Changes

California changed the old Medi-Cal asset test for many programs, but the rules can still be confusing because older articles and older handbooks are still circulating online. Some people are reading outdated information and do not realize the rules changed.

Read more about Medi-Cal asset limit changes

3. Medi-Cal Share of Cost

If your income is too high for free Medi-Cal, you may be placed into a Share of Cost program. In some situations, a person may be able to reduce or eliminate Share of Cost through qualifying health expenses or insurance planning. This has been one of the more specialized Medi-Cal topics on our website.

Read more about Medi-Cal Share of Cost

4. Medi-Cal Managed Care and HMO Enrollment

Many Medi-Cal beneficiaries are placed into a managed care plan. But questions often come up when a person already has other insurance, wants to keep certain doctors, or is trying to understand whether they must enroll in an HMO. This topic deserves its own page because the rules and exceptions can get technical.

Read more about Medi-Cal managed care and HMO enrollment

5. Renewals and Reporting Changes

If you already have Medi-Cal, one of the most important things you can do is open your mail, complete renewals on time, and report important changes promptly. Income changes, household changes, and address changes can all affect your case. Many coverage problems begin when notices are missed or not understood.

Read more about renewals and reporting changes

6. Medi-Cal With Other Insurance or Medicare

People often ask whether they can have Medi-Cal with employer coverage, individual insurance, Medicare, or some other form of coverage. The answer is often yes, but the coordination of benefits can be confusing. This is especially important for people with Medicare, dual coverage, or employer plans.

Read more about Medi-Cal with other coverage

Common Questions

Does Medi-Cal look at monthly income or annual income?

For many Medi-Cal categories, especially MAGI Medi-Cal, the focus is on current monthly income. That is one reason someone can qualify for Medi-Cal even if their annual income later looks different on a tax return.

Can I move from Medi-Cal to Covered California?

Yes. If your income goes too high for Medi-Cal, you may become eligible for a Covered California plan with premium assistance, depending on your income and household circumstances.

What if my income goes up or down during the year?

You should report important changes to the county when required. Changes in income may affect whether you stay on Medi-Cal or move to Covered California.

What if I have Share of Cost?

Share of Cost usually means your income is above the free Medi-Cal level for your category. In some cases, planning options may help reduce or eliminate Share of Cost.

Do I have to join a Medi-Cal managed care plan?

Often yes, but there can be exceptions, complications, or special rules depending on your county, medical needs, and whether you also have other insurance or Medicare.

Before You Leave This Page

If you are overwhelmed, start with these three topics:

• Income eligibility
• Renewals and reporting changes
• Share of Cost help

If your income is too high for Medi-Cal, or if you may need a private health plan instead, we can also help with Covered California and individual health insurance options.

Get Instant Health Insurance Quotes

Email [email protected]

Important Note

This page is for general educational information. Medi-Cal eligibility can depend on your exact facts, your county, and the category of Medi-Cal involved. Rules can change, and county processing is not always consistent. Always review official notices carefully and confirm important issues with your county office or other official source.

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• Unpacking the Unwinding: Medicaid to Marketplace Coverage Transitions  Georgetown University 9/18/2024
• Medi-Cal to Covered California Enrollment Program Toolkit  Covered CA 10/15/2024
• AI  Summary
• To move from Medi-Cal to Covered California, you must report the income change to your local county Medi-Cal office within 10 days because they manage Medi-Cal eligibility. After the county office updates your income and your Medi-Cal case is closed, they will often update your Covered California account for you, which may allow you to enroll in a new plan with a premium subsidy. 
   
  Step 1: Report the change to your local county Medi-Cal office 
  • Contact your county social services or Medi-Cal office immediately. You can find a list of county offices on the DHCS website.
  • You can report changes online through BenefitsCal.com or by calling your county office.
  • Be prepared to provide proof of the income change, such as recent pay stubs or tax returns.
  • Report this change within 10 days of the income increase. 
   
  Step 2: Wait for the county to update your case 
  • The county office will process the change and determine if your income makes you ineligible for Medi-Cal.
  • If you are found ineligible for Medi-Cal, the county office will close your case. 
   
  Step 3: Confirm your Covered California account is updated 
  • Once your Medi-Cal case is closed, the county eligibility worker will often update the income information in your Covered California account to help facilitate your transition to a new plan.
  • Check your Covered California account to see if your eligibility for subsidies has changed.
  • If you have questions or don’t see the changes reflected in your account, call the Covered California Service Center at (800) 300-1506 for assistance. 
• Resources & Links
  • Comparison of Medi-Cal Benefits and Covered California Essential Health Benefits  Health Law.org 12/2014  
  • The Medi-Cal Maze: Why Many Eligible Californians Don’t Enroll  chcf.org  9/2021 
  • Can you get Medi Cal, Covered CA and Private Individual or Employer Group all at the same time?  Visit our Dual Coverage Webpage  
  • Instant Covered CA and Direct Quotes 
  • Automatic Medi Cal when you get SSI  Our webpage 

Much more on Medi Cal

• Medi Cal Explained CHCF 
  • More
  • Historical Guide 2006 CHCF 174 pages
  • Cal AIM  California Advancing and Innovating Medi-Cal — is a far-reaching, multiyear plan to transform California’s Medi-Cal program and to make it integrate more seamlessly with other social services. The goal of CalAIM is to improve outcomes for the millions of Californians covered by Medi-Cal, especially those with the most complex needs.
    • You Tube Videos
    • DHCS.CA.Gov
    • chcf.org/focus-on-cal aim
    • VIDEO Introduction to Medi Cal Los Angeles DPSS
  • California voters give Medi-Cal doctors a raise by passing Prop. 35
• 10 Essential Health Benefits
  • Video
• Our Webpage on Medi Cal Benefits
•          Denti Cal

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• Western #Poverty Law – Exact Legal Rules on Coverage for Low Income Californian’s

Advocate Guide to Medi Cal 

Nolo Social Security, Medicare, Medi Cal & Government Pensions

• Our Webpage on COVID 19

• CA State Senator Steven Bradford 35th District 
• His Webpage on COVID 19 Resources

• BIC Benefits Identification Card

  

• How to replace lost or stolen card?

FAQ’s “C-CHIP County Children’s Health Initiative Program”

• The County Children’s Health Initiative Program (C-CHIP)  sccgov.org  a health insurance program (Medi-Cal) that offers affordable and comprehensive medical, dental, and vision insurance for children age 0-19 who qualify.  Qualification is in 3 Northern CA counties and is for those who are just out of the normal Medi Cal income limits  266-322% Federal Poverty Level (FPL).
  • Learn more by clicking on the links below:
    • InsureKidsNow.gov
    • Health Care.Gov
    •  
    • LA County.Gov
    • cchi 4 families.org
    • Disability Benefits 101  – Excellent explanation!
    • Work Requirements?
    • CHIP Children’s Health Insurance Program