How Medi-Cal Helps Pay for Long-Term Care in California

Long-term care means the daily help many people need as they get older, like help with bathing, dressing, eating, using the bathroom, and moving around. This kind of help can cost thousands of dollars a month. Medi-Cal, California's Medicaid program, can pay for it when you qualify.

Medi-Cal pays for care in different settings, so you can often get help at home instead of moving into a facility. Here are the main ways it helps older adults in Southern California:

Many families mix these up because the names sound alike and lots of older adults have both. But they do very different jobs, especially for long-term care.

Medicare is the federal health plan for people 65 and older (and some younger people with disabilities). It pays for doctor visits, hospital stays, and medicines. Medicare may pay for a short stay in a skilled nursing facility (up to about 100 days) after a qualifying hospital stay. But it does not pay for ongoing custodial care, which is the everyday help most people need long term.

Medi-Cal is California's program for people with limited income. It does cover long-term custodial care, both in nursing homes and at home. If you have both, Medicare pays first for medical care, and Medi-Cal can 'wrap around' it, help with Medicare costs, and cover long-term care that Medicare leaves out.

To get Medi-Cal long-term care, you generally must be 65 or older, blind, or disabled, live in California, and meet income and asset rules. Here is the part that changed recently and is easy to get wrong.

California removed the asset limit for these programs in 2024. But starting January 1, 2026, the asset limit is back for non-MAGI Medi-Cal, which includes long-term care, the Aged, Blind, and Disabled program, and Medi-Cal with a Share of Cost. The good news: the new limit is much higher than the old $2,000 rule, so many people still qualify.

2026 asset limits (money and property that counts, like bank accounts and extra savings):

Medi-Cal also looks at your monthly income. If your income is low enough, you pay nothing. If it is higher, you may still get Medi-Cal but with a 'share of cost,' which is the amount you pay toward care each month before Medi-Cal covers the rest.

For 2026, a single person can have countable income up to about $1,836 a month (or $2,490 for a couple) and still get Medi-Cal with no share of cost through the Aged and Disabled program. Above that, a share of cost may apply.

If you live in a nursing home, the rules are different. You keep a small personal needs allowance (about $35 a month in California) and pay most of your remaining income toward your care, and Medi-Cal covers the rest. A husband or wife who still lives at home has extra protections so they are not left with nothing.

If you apply for nursing home Medi-Cal, California can review your finances from before you applied to check whether you gave away money or property to qualify. This is called the look-back period, and it also came back on January 1, 2026.

A few things to know so you do not get surprised:

You can apply for Medi-Cal in a few ways, and help is free. If you or a family member has trouble with English, you can ask for an interpreter and use a paper application offered in many languages.

Ways to apply for Medi-Cal:

For IHSS, first get Medi-Cal. Then contact your county IHSS office. A caseworker will visit your home to figure out which services you need and how many hours to approve.

Medi-Cal long-term care rules are complicated, and the 2026 changes make it even more important to get the details right. A small mistake, like moving money the wrong way, can cost you months of coverage.

Free, trusted help is available. Your county Medi-Cal office can guide you, and California's Health Insurance Counseling and Advocacy Program (HICAP) gives free, unbiased advice to older adults. Nonprofit legal groups like CANHR and Justice in Aging also publish clear guides. For complex cases, some families hire an elder law attorney, but start with the free options first.

This article is general information, not legal, medical, or financial advice. For advice about your own situation, talk to your county worker, a benefits counselor, or your doctor. If someone is having a medical emergency, call 911.