Here’s What You Need to Know

Keep your Medi-Cal:

Stay Informed to Stay Covered

Your health care matters. Stay informed about upcoming Medi-Cal changes so you can take action and avoid gaps in doctor visits, prescriptions, or other health care. 

CenCal Health provides Medi-Cal coverage in San Luis Obispo and Santa Barbara Counties.  Most CenCal Health members will not see changes, but some may experience updates to benefits, eligibility, or care.

Questions? We’re here to help. Visit the official Department of Health Care Services (DHCS) Medi-Cal Changes page here for the latest statewide information.

Keep Your Medi-Cal

  • If you miss your renewal deadline, you could lose your health care benefits and experience a gap in coverage. Log in to BenefitsCal.com immediately to submit your late information online and see if you can get your benefits back right away.

    If it has been more than 90 days since your deadline, you will need to start a new application at BenefitsCal.com.  For additional information and assistance refer to keepcencal.org or contact your local DSS office.

3 Simple Steps to

Protect Your Benefits

Your local Department of Social Services (DSS) will try to renew your Medi-Cal automatically, using the information they already have. If they need more information, they will mail you a renewal form. If you miss the deadline, you could lose your health care benefits and have a gap in coverage. Follow these three steps to protect your coverage:

1

Update Your Contact Info

Moved recently or changed your phone number? Contact your local DSS office or update it online.

Resources

2

Watch Your Mailbox

Keep a close eye out for a bright yellow envelope from your county.

3

Respond On Time

If your DSS office asks for more information and you need support, contact your case manager or request Medi-Cal navigation support through Central Coast Coverage.

Resources

Most Medi-Cal members will not see any changes to their coverage

You can still:

  • See your doctor or go to the hospital

  • Get emergency help

  • Get your medicine

  • Get support for mental health or addiction

  • Have checkups and vaccines to stay healthy

  • Get long-term care if you need it

  • Get rides to your appointments if you need it

  • See a dentist

  • Get eye exams and glasses

What Medi-Cal Members Need to Know

January 2026

  • As of January 1, 2026, some adults can no longer sign up for full-scope Medi-Cal coverage because of their immigration status. 

    Who this applies to:

    Important to know:

    • If you already have full-scope Medi-Cal, you can keep it, no matter your immigration status.

    • You must renew on time and still meet Medi-Cal rules.

    • If your Medi-Cal ends, you have three months to sign up again.

    • If you miss the three-month period, you must apply again. You will only be able to get restricted-scope Medi-Cal, which covers:

      • Emergency care

      • Pregnancy care

      • Nursing home care

    Who can still get full-scope Medi-Cal, no matter their immigration status

    • Children ages 0-18

    • Pregnant people (during pregnancy and for one year after)

    • People under age 26 who were in foster care on their 18th birthday

January 2027

  • Starting January 1, 2027, some adults will need to work, volunteer, go to school, or be in training to get to keep their Medi-Cal. Medi-Cal will send you a letter if this applies to you.

    Who this applies to

    • Adults ages 19-64 who get Medi-Cal through the Affordable Care Act expansions, including adults covered under the new rules for immigrants.

    Who this does not apply to

    These work or volunteer rules do not apply to:

    • Children (0–18)

    • Adults 65 and older

    • Pregnant people (during pregnancy and one year after)

    • Parents of children ages 0-13

    • People with disabilities

    • People with serious physical or mental health conditions, or substance use problems

    • People released from jail or prison in the last 90 days

    • People on Medicare Part A or Part B

    • American Indians or Alaska Natives

    • People under age 26 who were in foster care on their 18th birthday

    Your county Medi-Cal office will tell you if you need to follow the work rules of if they need more information to show you qualify for an exemption.

    Important to know

    Members must do one or more of the following:

    • Work at a job and earn at least $580 a month

    • Be a seasonal worker and earn an average of $580 a month over the last six months

    • Be in a job training program (that helps you learn skills to get a job) for at least 80 hours a month

    • Volunteer or do community service for at least 80 hours a month

    • Go to school at least half-time (usually two or three classes, or about six to eight credits each semester)

    • Do a mix of the activities above so the total is at least 80 hours a month or at least $580 a month

    If you are required to meet the rules and do not, you could lose your Medi-Cal.

    When you get a letter from Medi-Cal or your county office, open it right away and respond quickly.

    Medi-Cal will send more information before this rule starts, including ways to help you meet the rules.

  • Starting January 1, 2027, Medi-Cal will pay for fewer months of medical bills from before you applied. If this rule applies to you, Medi-Cal will send you a letter.

    Who this applies to

    • Adults ages 19-64 without children ages 0-18

    Important to know

    New rules:

    • Adults without children: Medi-Cal will pay for one month of past medical bills.

    • Everyone else: Medi-Cal will pay for two months of past medical bills.

  • Starting January 1, 2027, some Medi-Cal members will have their eligibility checked twice a year instead of once.

    New members (people who enroll after January 1, 2027) will have their first eligibility check six months after joining Medi-Cal. 

    Renewing members (people on Medi-Cal before January 1, 2027) will transition to the new six-month schedule at their next renewal date after March 1, 2027. 

    Who this applies to

    • Adults ages 19-64 who get Medi-Cal through the Affordable Care Act (ACA) expansions, including those affected by the immigrant-related changes listed earlier.

    Who this does not apply to

    These members will continue to renew once a year:

    • People not in the ACA new adult group

    • Pregnant or postpartum people

    • Alaska Native or American Indian members

    • People under age 26 who were in foster care on their 18th birthday

    Important to know

    If you miss deadlines, you could lose your Medi-Cal coverage.

  • Starting January 1, 2027, some members will get their care through Fee-for-Service (FFS) Medi-Cal instead of a health plan. This changes how you get care, not whether you can keep Medi-Cal.

    Who this applies to

    • People who are undocumented.

    • Some people with green cards who are in the five-year waiting period before they can get full-scope federal Medicaid.

    • People considered Permanently Residing in the U.S. Under Color of Law (PRUCOL), meaning they are allowed to stay in the U.S. even without formal immigration status.

    See the Immigration Status Categories chart for details.

    Important to Know

    • You will stay covered if you renew on time.

    • You will not be in a health plan any more. Instead, you can go to any doctor or clinic that accepts FFS Medi-Cal.

    • “Fee-for-Service” does not mean you pay. Medi-Cal still pays for your care.

    • Specialty mental health and substance use treatment will continue through County Behavioral Health Plans.

    • Your medicines will still be covered by Medi-Cal Rx.

    • Dental care is not changing for most members. How dental care works depends on your county.

    • Enhanced Care Management and Community Supports (services only available in health plans) will not continue in FFS Medi-Cal.

    • Other help is still available, like Community Health Workers, chronic care management, doula services, and county mental health programs.

    • DHCS will offer new help during this change, including a nurse advice line and community navigators to guide you and answer questions.

    • You will get more information before the change begins.

July 2027

  • Starting July 1, 2027, some Medi-Cal members will stop getting full-scope dental services.

    Who this applies to

    Important to know

    You can still get emergency dental care, including: 

    • Bad tooth pain

    • Infections

    • Tooth removal

    You will continue to get full dental benefits if you are:

    • A child (ages 0-18)

    • Pregnant (during pregnancy and up to one year after)

    • Under age 26 and were in foster care on your 18th birthday

  • Starting October 2026, the federal government will change how it classifies some immigration statuses. These changes affect whether some adults can continue keep federally funded full-scope Medi-Cal. If you are affected, you will get state-funded full-scope Medi-Cal until June 30, 2027.

    Who this applies to

    • Refugee and asylees: People who left their home country for safety and don’t yet have a Green Card.

    • Humanitarian parolees: People allowed into the U.S. for urgent reasons for at least one year.

    • Survivors of domestic violence or human trafficking who have with a pending immigration case.

    Please see the Immigration Status Categories chart to see if you are in one of these groups.

    Important to Know

    Starting July 1, 2027, people in this group will only be able to get pregnancy-related care and emergency services.

  • Starting July 1, 2027, some Medi-Cal members will need to pay a monthly fee (called a premium) to keep their full-scope Medi-Cal.

    Who this applies to

    Important to know

    If you don’t pay, your Medi-Cal will change to restricted-scope, which covers:

    • Emergency care

    • Pregnancy-related care

    • Nursing home care

    You will not have to pay a premium if you are:

    • A child (0-18)

    • Pregnant (through pregnancy and up to one year after)

    • Under age 26 and were in foster care on your 18th birthday

October 2028

  • Starting October 1, 2028, some adults on Medi-Cal may need to pay a fee (called a copayment) for certain services.

    Who this applies to

    Adults (19-64) who:

    • Are not pregnant

    • Are not on Medicare

    • Make more than $15,560 a year

    Important to know

    • You may have to pay a fee for some types of care, like seeing a specialist doctor (for example, a heart doctor of skin doctor), or getting certain treatments or tests.

    • You won’t pay more than 5 percent of your household’s income in a year.

    • You will not have copayments for:

      • Community health centers or rural clinics

      • Emergency care

      • Regular checkups

      • Care during pregnancy

      • Care for children

      • Mental health and substance use treatment

Resources:

Need Help? Connect with Local Support

You don’t have to navigate these changes alone. Reach out online or call your local office for direct assistance.