You or your family's eligibility for Medi-Cal is determined based on property, income, residency, and citizenship requirements. Download Medi-Cal Fact Sheet (Adobe Acrobat File 373kb)
If you are in one of the categories below, you may be eligible for Medi-Cal:
- CalWORKs (California Work Opportunity and Responsibility to Kids) recipients.
- Supplemental Security Income/State Supplemental Payment (SSI/SSP) recipients.
- Families with incomes too high to qualify for cash assistance (i.e.: CalWORKs or SSI/SSP), but who would otherwise qualify for cash assistance based on other eligibility requirements (i.e.: disability or pregnancy), or individuals who are eligible for but choose not to receive cash assistance [Medically Needy (MN)].
- Individuals who are blind or disabled according to Social Security rules.
- Individuals 65 years old or older.
- Children under 21 years old.
- Pregnant women.
- Some adults in long-term care who do not qualify for public assistance or are not considered medically needy (MN).
- Families transitioning from CalWORKs to employment.
- Qualified low-income Medicare recipients.
- Some individuals on a special treatment program, such as tuberculosis or kidney dialysis.
- Refugees.
Below are further eligibility considerations:
Property - A person's assets or additional property are counted in determining eligibility for all programs except those for children and pregnant women. Many rules and exceptions apply when determining how a family's property will be counted. For all Medi-Cal programs, if a family lives in their home, it is not counted toward the property limit.
Though property limits vary among individual cases, for most applicants they are as follows:
| # of People |
Limit |
| 1 |
$2,000 |
| 2 |
$3,000 |
| 3 |
$3,150 |
| 4 |
$3,300 |
| 5 |
$3,450 |
| 6 |
$3,600 |
| 7 |
$3,750 |
| 8 |
$3,900 |
| 9 |
$4,050 |
| 10 or more |
$4,200 |
Income - Income limits vary among the different Medi-Cal programs and cannot be exceeded (see chart below for maximum monthly income amounts). For the most part, when determining Medi-Cal eligibility, your family's income is measured against the Federal Poverty Level (FPL). Individuals or families who exceed income limits may still be still be able to receive Medi-Cal coverage, but it is not free and these recipients are required to pay a share of the cost of their health services.
Some considerations include:
- Families with pregnant women and infants can have an income at or below 200% of the FPL.
- Families with children 1-5 years old can have income at or below 133% of the FPL.
- Families with children 6-19 years old can have income at or below 100% of the FPL.
Here are more breakdowns of family size and FPL monthly income amounts:
| Family Size |
100% |
133% |
200% |
| 1 |
$867 |
$1,153 |
$1,734 |
| 2 |
$1,167 |
$1,552 |
$2,334 |
| 3 |
$1,467 |
$1,951 |
$2,934 |
| 4 |
$1,767 |
$2,350 |
$3,534 |
ACWDL 01-16
Residency - You must be a California resident to be eligible for Medi-Cal.
Citizenship - Only citizens and qualified aliens are entitled to full Medi-Cal benefits; non-qualified aliens or undocumented immigrants are entitled to emergency and pregnancy-related benefits only.
Who Is Not Eligible for Medi-Cal?
Low income or medical need alone does not necessarily qualify a person for Medi-Cal. People between the ages of 21 and 65 who are not disabled, blind, have a deprived child at home, are pregnant, or reside in a nursing home are generally not eligible for Medi-Cal.
If You Are Eligible, What Do You Receive?
Below are some of the basic services that Medi-Cal provides for those who are eligible:
- Hospital inpatient and outpatient care.
- Skilled nursing care.
- Doctor visits.
- Laboratory tests.
- X-rays.
- Family planning.
- Examinations for children under 21 years old.
- Emergency services.
- Dental care.
- Pharmaceuticals.
**Not all Medi-Cal recipients are eligible for the full package of benefits and there are time limits for some of the services offered.
Where Do You Go to Receive Medi-Cal benefits in San Mateo County?
- County hospitals.
- District and private hospitals.
- Academic medical centers.
- Community clinics.
- Some private physicians.
- Many home and community-based providers.
Act Now
If you think Medi-Cal can help you or your family, visit or call and speak to our helpful and multi-lingual Human Services Agency staff.
Please note: Information on this web site is for reference only.
