Long-Term Care Medicaid in California: 2026 Guide

In California, Medicaid is called Medi-Cal. It is run by the California Department of Health Care Services (DHCS), and eligibility is decided by your county social services office. Long-Term Care Medicaid in California can pay for nursing home care and for some care at home. California’s rules changed a great deal in 2026: the asset limit came back on January 1, 2026, and a 30-month look-back is being phased in. This guide explains the 2026 rules in plain language.

At a glance: California 2026 figures

Item	2026 figure
Income limit (applicant)	No fixed cap for nursing home care (income above allowances goes toward the cost of care)
Asset limit (single applicant)	$130,000 in countable (nonexempt) property
Asset limit (couple, both applying)	$195,000, plus $65,000 for each additional household member
Home equity limit	$1,130,000
Spouse at home: resource allowance (CSRA)	$162,660
Spouse at home: monthly income allowance (MMMNA)	$4,067
Personal needs allowance (nursing home)	$35 a month
Look-back period	30 months, being phased in (see below)
Penalty divisor	$14,440 a month (statewide average private pay rate)

Figures last updated for 2026. Sources are listed at the end of this page.

Figures change periodically. Double-check current amounts with the California Department of Health Care Services before relying on them.

What Long-Term Care Medicaid covers in California

Nursing home care. Medi-Cal pays for care in a certified skilled nursing facility for people who need that level of care. You pay most of your income toward the cost each month (your “share of cost”), and Medi-Cal pays the rest.

Care at home and in the community. California offers several home and community-based services (HCBS) programs. Each has its own rules, and some have limited openings or wait lists. Ask DHCS or your county which ones serve your area:

In-Home Supportive Services (IHSS): help with personal care and household tasks so you can stay at home, run through your county.
Assisted Living Waiver: help paying for care services in a participating assisted living setting in some counties. Room and board is not covered.
Multipurpose Senior Services Program (MSSP): care management and services for people 65 and older who would otherwise need a nursing home.
Community-Based Adult Services (CBAS): adult day health care.
PACE (Program of All-Inclusive Care for the Elderly): for people 55 and older in a PACE service area. A PACE team provides and coordinates all care, often at a PACE center.

Assisted living. Medi-Cal does not pay for room and board in assisted living. The Assisted Living Waiver may help with care costs where it operates.

Who qualifies

A person generally must:

be 65 or older, or blind or disabled;
live in California and be a U.S. citizen or have a qualifying immigration status;
need a nursing facility level of care. For nursing home care, this is based on a doctor’s orders and the facility’s assessment. Each home care program has its own assessment, done by the county or the program;
meet the income and property (asset) rules below, as decided by the county social services office.

Income rules

How income is counted depends on the Medi-Cal program. For nursing home care, most of the resident’s income goes toward the cost of care as a monthly share of cost. The resident keeps a personal needs allowance of $35 a month, and money can be set aside for a spouse at home and for health insurance premiums.

The exact income limits for each home care program, and whether a given income level qualifies, should be checked with DHCS or your county. This guide does not print an income figure for California because none was verified on an official page for 2026.

Asset rules

From January 1, 2024, through December 31, 2025, Medi-Cal had no asset limit for most programs for older adults and people with disabilities. That ended on January 1, 2026. California restored the property limit through Assembly Bill 116. In 2026:

$130,000 for one person
$195,000 for a couple
$65,000 more for each additional household member (up to 10 people)

Only nonexempt (countable) property counts. Countable property generally includes cash, bank accounts, stocks, bonds, mutual funds and real estate other than the home. Some items are usually exempt, such as the home you live in or plan to return to, one vehicle, household goods and personal belongings, and certain burial funds. DHCS has said the property test does not return for some special programs, including the Pickle, Disabled Adult Child and Disabled Widow(er) programs. Ask your county how a specific asset, such as a retirement account or rental property, is treated.

People already on Medi-Cal. If you qualified during 2024 or 2025 without a property test, your property will be reviewed at your 2026 renewal. Your county will send a notice explaining what is needed.

Spousal protections

Assets: When one spouse needs long-term care, the spouse at home can keep a Community Spouse Resource Allowance of $162,660 in 2026, in addition to the $130,000 the applicant may keep. The home, one car and belongings are not counted. After approval, there is a short transfer period (about 90 days from the approval notice) to move property above $130,000 out of the applicant’s name to the spouse at home.
Income: The spouse at home keeps their own income. If it is below $4,067 a month, part of the applicant’s income can be set aside for them. This also applies to some couples where one spouse uses home care programs.
After approval, property in the at-home spouse’s name alone is no longer counted for the applicant.

Look-back and penalties

California’s look-back rules are different from most states. California uses a 30-month look-back, not the 60 months used elsewhere, and it is being phased back in after a two-year pause:

Transfers made from January 1, 2024, through December 31, 2025, will never be reviewed and cannot cause a penalty.
From July 1, 2026, the county reviews only months from January 2026 onward. The look-back grows by one month each month.
For long-term care requests made on or after July 1, 2028, the full 30 months is reviewed.

The state checks whether you, or your spouse, gave away money or property, or sold something for less than it was worth, during the look-back period. Common problem transfers include cash gifts to family, adding a child to a deed or account, and selling property to a relative below its value. Transfers between spouses are allowed.

How the penalty works. If a transfer is not allowed, Medi-Cal sets a penalty period: time when it will not pay for long-term care. The county divides the amount given away by the penalty divisor ($14,440 a month in 2026).

Example: Suppose you gave your daughter $50,000 in March 2026 and later applied for nursing home care. $50,000 divided by $14,440 is about 3.5 months without Medi-Cal payment for long-term care.

The rules on when a penalty starts can be complex. Ask your county how they apply to your dates.

Estate recovery in California

California’s Medi-Cal Estate Recovery Program is run by DHCS.

Whose estates: members who received benefits on or after age 55, or who were permanently in a nursing facility.
What is recovered: for deaths on or after January 1, 2017, payments for nursing facility services, home and community-based services, and related hospital and prescription drug services.
What can be recovered from: only assets in the probate estate. Property that passes by survivorship, through a trust, or by a payable-on-death or transfer-on-death designation is not recovered.
When it does not apply: DHCS does not recover from the estate of a member survived by a spouse or registered domestic partner. Federal rules also protect a surviving child under 21 or a child who is blind or disabled.
Hardship waivers: DHCS can waive all or part of a claim for substantial hardship, including a “homestead of modest value” (a home worth 50% or less of the county’s average home price).
If a member owns nothing at death, nothing is owed.

How to apply

Online: BenefitsCal, California’s benefits website
In person, by mail or by phone: at your county social services office. DHCS lists every county office on its website.
For home care programs (IHSS, MSSP, CBAS, PACE, Assisted Living Waiver): you also contact the program or your county. Each program does its own assessment.

Gather what you can before you apply. The caseworker may ask for:

Photo ID, Social Security card and Medicare card
Proof of age and of U.S. citizenship or immigration status
Proof that you live in the state (for example, a utility bill or lease)
Proof of all income: Social Security award letter, pension statements, annuity statements
Bank, credit union and investment statements (often for the full 60-month look-back period)
Deeds, property tax bills and the value of any real estate
Life insurance policies (showing cash value) and prepaid funeral or burial contracts
Vehicle titles
Health insurance cards and long-term care insurance policies
Power of attorney or guardianship papers, if someone is applying for you
For a spouse at home: their income and assets too, since both spouses’ assets are counted at the start

If you cannot find a document, apply anyway and tell the caseworker. They can explain what else is accepted.

Free public help in California

DHCS and your county social services office: Medi-Cal applications and eligibility.
Area Agencies on Aging: local information on long-term care services.
HICAP (Health Insurance Counseling and Advocacy Program): California’s free Medicare counseling program (SHIP), through the California Department of Aging.
California Long-Term Care Ombudsman Program: free advocates for residents of nursing homes and assisted living.

Recent and upcoming changes

A 2025 federal law (Public Law 119-21) makes two changes that affect Long-Term Care Medicaid in every state, including California:

Retroactive coverage gets shorter on January 1, 2027. Today, Medicaid can pay bills from up to 3 months before the month you apply, if you would have qualified then. For applications from January 1, 2027, this window shrinks to 2 months for older adults and people with disabilities. In plain terms: from 2027, it matters more to apply soon after care starts, so that earlier bills are not left unpaid.
Home equity cap on January 1, 2028. States will no longer be able to set a home equity limit above $1,000,000 (except for some farm property). California’s 2026 home equity limit is $1,130,000, which is above the new cap. California will have to lower its limit to no more than $1,000,000 by January 1, 2028.

The federal amounts that change each year (for example, the allowances for a spouse at home) will be updated on this page for 2027 once they are published.

State programs

Each program below has its own page with who qualifies, services, how to apply and waiting lists:

Frequently asked questions

Does Medi-Cal have an asset limit again? Yes. From January 1, 2026, a single person can keep up to $130,000 in countable property, and a couple $195,000. The home, one car and personal belongings are usually not counted.

I was approved in 2025 with no asset test. What happens now? Your property will be reviewed at your 2026 renewal. If you have more than the limit, your county notice will explain the transfer period and what you need to do.

How long is the look-back in California? California uses 30 months, not 60. Transfers from 2024 and 2025 will not be reviewed. From July 1, 2026, the review covers months from January 2026 onward, growing until the full 30 months applies in July 2028.

How much can my spouse keep? In 2026, $162,660 in assets on top of the $130,000 the applicant may keep, plus the home, a car and belongings, and income of up to $4,067 a month.

Does Medi-Cal pay for assisted living? Not for room and board. The Assisted Living Waiver can help with care services in some counties, and it may have a wait list.

Will Medi-Cal take my home after I die? Only if the home is in your probate estate, and not while a spouse or registered domestic partner survives you. Hardship waivers, including one for homes of modest value, are available.

Figures change periodically. Double-check current amounts with the California Department of Health Care Services before relying on them.

Sources

DHCS, ACWDL 26-02, 2026 spousal impoverishment caps and property limits
DHCS, MEDIL I 26-03, reinstatement of the asset test
DHCS, ACWDL 26-03, 2026 average private pay rate
DHCS, ACWDL 25-18, look-back reinstatement
DHCS 7077, Notice Regarding Standards for Medi-Cal Eligibility
DHCS, Estate Recovery
DHCS, Estate Recovery brochure
BenefitsCal
CMS, 2026 SSI and spousal impoverishment standards
Public Law 119-21 (2025)

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.