Medicaid for nursing home and home care in California

Who qualifies

To get long-term care through Medi-Cal, you must live in California, be 65 or older or blind or disabled, need the care, and meet the income and asset rules.

The income rule: share of cost

Medi-Cal's long-term care groups include a medically needy program, so higher income does not have to rule you out. If your income is above the limit for free Medi-Cal ($1,836 a month for one person), you can still qualify with a share of cost.

• A share of cost works like a monthly deductible. You pay that amount toward your care each month, and Medi-Cal pays the rest.
• In a nursing home, you keep $35 a month for personal needs. Most of the rest goes toward your care.

What counts and what does not

Counts as an asset: cash, bank accounts, second homes, second vehicles, and other money or property you own, wherever it is.

Does not count:

• Your home, if you plan to return to it, or if your spouse, registered domestic partner, or a dependent relative lives there
• Your main vehicle
• Household items such as furniture and clothing
• Retirement funds that are paying out to you regularly

Any extra homes do count.

If you are married and your spouse stays at home

California protects the spouse who stays home.

• Assets: In 2026, your spouse can keep up to $162,660 (the community spouse resource allowance). This applies when you first become eligible. Assets above what you can keep must be moved out of your name within about 90 days of the approval notice. At renewals in 2026, this limit does not apply again.
• Income: Your spouse keeps all income paid in their own name. If that is less than $4,067 a month, some of your income can go to your spouse to bring them up to that amount. Medicare and other health insurance premiums your spouse pays are taken off first.

Giving away assets: the new look-back

• Medi-Cal looks at transfers made in the 30 months before you enter a nursing home.
• Transfers made before January 1, 2026 are not counted.
• Gifts or sales for less than full value on or after January 1, 2026 can cause a penalty that delays your long-term care coverage.
• Gifts to your spouse, to someone for your spouse's benefit, or to a blind or disabled child do not cause a penalty. Neither does selling something for full value.

Programs that pay for care

Nursing home care

Medi-Cal pays the nursing home after your share of cost.

In-Home Supportive Services (IHSS)

IHSS pays for help at home if you have Medi-Cal and live in your own home (not a hospital, nursing home or licensed care home). Apply with form SOC 295 at your county IHSS office. A county social worker visits you at home and decides which services you need and how many hours a month the county will pay for. You must also turn in a completed Health Care Certification form (SOC 873) before services start. You hire and supervise your own provider, or the county may offer one.

Home and Community-Based Alternatives (HCBA) Waiver

For people at risk of moving to a nursing home who want to stay home. The waiver is full and has had a waiting list since July 12, 2023, so get on the list early. Contact the Waiver Agency for your county and fill out form DHCS 1320. People who have lived in a health care facility for at least 60 days when they apply get priority for open spots. Questions: (833) 388-4551.

Multipurpose Senior Services Program (MSSP)

For people 65 and over on Medi-Cal who could be placed in a nursing home and live in an MSSP site area. It offers care management plus help such as adult day care, personal care, respite, rides and meals. It is not offered everywhere.

Assisted Living Waiver

Pays for care in assisted living for people 21 and older who need nursing home level care and have full Medi-Cal with no share of cost. It is offered only in Alameda, Contra Costa, Fresno, Kern, Los Angeles, Orange, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, San Mateo, Santa Clara and Sonoma counties. There is a waiting list. Contact a Care Coordination Agency from the list on the DHCS website to start.

PACE

All-in-one medical and home care for people 55 and over who live in a PACE service area, need nursing home level care, and can live safely at home when they join. Use the PACE Services Locator on the DHCS website, or call DHCS at (916) 713-8444.

How to apply

1. Apply for Medi-Cal online at BenefitsCal.com, by mail, by phone, or in person at your county social services office. Call the Medi-Cal Helpline at (800) 541-5555 to find your county office.
2. Report what you own. Since January 1, 2026, you must list your assets and give proof when you apply. The county should give you form MC 007, which explains how to spend down assets.
3. Wait for the notice. It will say whether you qualify and what your share of cost is.

After you apply

• Renewals: You must report and prove your assets at each renewal. If your coverage ends because asset papers are missing, you have 90 days to send them.
• Changes: Tell your county about changes in income, assets or where you live.
• Appeals: You have 90 days from the notice to ask for a state hearing (120 days for a Medi-Cal renewal decision). Call the State Hearings Division at (800) 743-8525, use the online request at acms.dss.ca.gov, or write to State Hearings Division, P.O. Box 944243, Mail Station 9-17-442, Sacramento, CA 94244-2430.

Things people often miss

• The asset limit drops on July 1, 2027. Plan ahead if you have savings between the two limits.
• Spending down is allowed. You can use extra money for medical bills, clothing, household items, rent or mortgage, home repairs, or paying off debts.
• Estate recovery. After death, Medi-Cal may ask to be paid back from the estate of someone who got care at 55 or older. It cannot while a spouse is alive, or if there is a child under 21 or a blind or disabled child. It never collects more than what the person owned at death, and it may reduce or waive a claim that would cause substantial hardship. Estate Recovery: (916) 650-0490.

Free help

• HICAP: Free, confidential counseling on Medicare and long-term care planning. Counselors are trained in Medi-Cal too. Call 1-800-434-0222.
• Area Agencies on Aging: Call 800-510-2020 to find your local agency.
• Long-Term Care Ombudsman (24/7): 1-800-231-4024 for problems in a nursing home.

See paying for a nursing home, Medicare, and all benefits in California.

Phone numbers: Free help lines for California agencies

Check what you may qualify for