Medi-Cal for long-term care in California

What changed on January 1, 2026

California brought back an asset test for Medi-Cal programs for older adults and people with disabilities, including long-term care. The limit is $130,000 for one person, plus $65,000 for each additional person in the household (up to 10 people). From January 2024 through December 2025 there was no asset limit at all.

New applicants must meet the limit. People already on Medi-Cal face the test at their next annual renewal.

What counts, and what doesn’t

Countable assets include cash, bank accounts, stocks, bonds and other investments. Your home is generally exempt while you are alive, so qualifying for Medi-Cal long-term care does not by itself require selling it. Household goods, one car and some other items are also exempt.

Rules on retirement accounts, second properties and trusts are detailed. If the numbers are close, talk with an elder law attorney or HICAP before you apply.

The look-back on gifts and transfers

With the asset limit back, Medi-Cal again reviews transfers for less than fair value, such as gifts to children, before a nursing home application. California’s look-back is 30 months, shorter than the 60 months most states use.

It is phasing in. Transfers made from January 2024 through December 2025 are not reviewed, because there was no asset test then. For applications in 2026, the window starts at one month and grows by one month each month until the full 30 months applies in mid-2028.

A transfer inside the look-back can create a period when Medi-Cal will not pay for nursing home care. Don’t move money to qualify without advice.

When one spouse needs care

If one spouse needs nursing home care and the other stays at home, the spouse at home (the “community spouse”) can keep their own share of assets, up to the Community Spouse Resource Allowance: $162,660 in 2026, while the spouse in care keeps up to $130,000. The spouse at home can also keep a monthly income allowance.

What you still pay: share of cost

Once on Medi-Cal in a nursing home, most of the resident’s monthly income goes toward the cost of care. The resident keeps $35 a month for personal needs. Medi-Cal pays the rest of the approved rate.

Find nursing homes that take Medi-Cal: ask each one

Care outside a nursing home

Assisted living: in 15 counties, the Medi-Cal Assisted Living Waiver pays the care portion in participating homes for people who need a nursing-home level of care. The resident pays room and board.

At home: In-Home Supportive Services (IHSS), run by each county, can pay for help with daily tasks at home for eligible Medi-Cal members.

During the day: Community-Based Adult Services (CBAS) is the Medi-Cal adult day health benefit. See adult day programs.

Estate recovery

After a Medi-Cal member who received long-term care at 55 or older dies, the state can seek repayment of those costs. Since 2017, recovery is limited to the probate estate: assets that pass through probate, which can include a home. Assets held in a living trust or that pass outside probate are generally beyond its reach, and the state does not recover while a surviving spouse is alive. Recovery is also waived for a “homestead of modest value.”

How to apply

Apply through your county social services office or online at BenefitsCal. For free, unbiased help, call HICAP at (800) 434-0222. For transfers, trusts or a spouse at home, an elder law attorney is worth the fee.

Common questions