Yes, Medi-Cal does cover long-term care in California, including nursing home stays, paid in-home caregivers, and assisted living through a waiver program. Qualifying takes two things: a medical finding that you need this level of care, and meeting financial rules that changed significantly on January 1, 2026, when California reinstated asset limits and a transfer look-back period for long-term care applicants.
What Medi-Cal Pays For
Long-term care under Medi-Cal falls into three distinct programs, each matched to a different living situation.
Skilled Nursing Facilities
Medi-Cal pays for round-the-clock nursing home care indefinitely, as long as you keep meeting the medical and financial rules. Coverage includes both medical care and custodial care, meaning help with eating, bathing, dressing, and moving around. This is different from the short rehabilitative stays Medicare covers after a hospitalization.
In-Home Supportive Services
If you can stay in your own home with help, the In-Home Supportive Services program pays a caregiver to assist with housekeeping, meals, laundry, bathing, and medical appointments. The county assesses how many hours you need, and you hire your own caregiver, who can be a family member or friend.1CDSS.ca.gov. In Home Supportive Services
Assisted Living Waiver
The Assisted Living Waiver covers care in licensed residential care facilities for people who need nursing-home-level care but would do better in a smaller community setting. Enrollment is capped and demand is heavy. As of December 2025, roughly 14,800 people were enrolled and more than 18,300 were on the waitlist.2DHCS – CA.gov. ALW Enrollment and Waitlist The waiver also requires that you have no share of cost, so it is effectively limited to lower-income applicants.3DHCS – CA.gov. Assisted Living Waiver
One boundary worth noting: standalone room and board in a private assisted living facility, outside the waiver, is not something Medi-Cal pays for.
The Medical Level-of-Care Standard
Before Medi-Cal pays anything toward long-term care, you need a formal determination that you require a “nursing facility level of care.” The assessment looks at whether you can independently handle Activities of Daily Living: bathing, dressing, eating, toileting, and moving from a bed to a chair. A licensed nurse or physician documents the limitations.
The bar is real. Someone who needs occasional help with grocery shopping will not meet this standard. For nursing facility placement or the Assisted Living Waiver, assessors are looking for people whose health or safety would be at immediate risk without consistent hands-on help. IHSS uses a somewhat lower threshold, since the whole point of the program is to support people who can still live at home with assistance.
Financial Eligibility
Meeting the medical standard is only half the picture. Medi-Cal also applies income and asset rules that determine whether you qualify and how much you pay toward your own care.
Income and Share of Cost
For nursing home care, there is no income cap. Instead, nearly all of your monthly income is redirected to the facility, and Medi-Cal pays the rest. You keep a personal needs allowance of $35 per month, or $62 if you receive SSI. Some of your income may be redirected to an at-home spouse through the spousal rules described below.
For home and community-based services, including IHSS and the Assisted Living Waiver, the income limit is $1,801 per month. If you earn more, you can often still qualify through a share-of-cost arrangement, which works like a monthly deductible: you pay a set amount toward medical bills each month and Medi-Cal picks up everything beyond that. The share of cost is calculated by subtracting a maintenance need allowance from your monthly income. In 2026, that allowance is $600 for an individual and $934 for a couple.4CA.gov. Share of Cost – Medi-Cal Manual
Asset Limits Are Back as of January 2026
This is where things changed. California eliminated all Medi-Cal asset limits on January 1, 2024, becoming the first state to stop counting bank accounts and other property for eligibility. That policy is over. Effective January 1, 2026, asset limits are back for all non-MAGI Medi-Cal programs, including long-term care.5DHCS – CA.gov. DHCS Asset Limit Fact Sheet
The current limits are $130,000 in countable assets for one person, with an additional $65,000 for each additional household member, up to ten people.6DHCS – CA.gov. Asset Limit Frequently Asked Questions Countable assets include bank accounts, investments, and property beyond your primary home. Your main residence, one vehicle, and certain other categories remain exempt. If you enrolled during the no-asset-limit window and now exceed these thresholds, you could lose coverage at your next redetermination.
The 30-Month Transfer Look-Back
Alongside the reinstated asset limits, California introduced a 30-month look-back for anyone entering a nursing home on or after January 1, 2026. Medi-Cal will review any assets you gave away or sold below fair market value during the 30 months before entering the facility. Transfers made before January 1, 2026, are not counted.6DHCS – CA.gov. Asset Limit Frequently Asked Questions
If the state finds you transferred assets to qualify, it can impose a penalty period during which you are ineligible for nursing facility coverage. Gifting money to children or signing a house over to a relative within that window can leave you without coverage exactly when you need it. The penalty length depends on the value of what was transferred relative to nursing home costs. Any planning around these rules should happen well in advance, with an elder law attorney, not after a health crisis forces the question.
Protections for a Spouse Who Stays at Home
When one spouse enters a nursing home and the other remains at home, federal law prevents the at-home spouse from being left with nothing. The protections cover both assets and income.
For assets, the at-home spouse keeps a Community Spouse Resource Allowance. In 2026, this ranges from a minimum of $32,532 to a maximum of $162,660, depending on the couple’s total countable resources.7Centers for Medicare and Medicaid Services. 2026 SSI and Spousal Impoverishment Standards The couple’s home and one vehicle are typically exempt on top of this allowance.
For income, the at-home spouse is entitled to a Monthly Maintenance Needs Allowance drawn from the institutionalized spouse’s income. In 2026, that figure runs from $2,643.75 to $4,066.50 per month, based on the at-home spouse’s own income and housing costs.7Centers for Medicare and Medicaid Services. 2026 SSI and Spousal Impoverishment Standards These protections are automatic under federal rules, but you have to document both spouses’ income and assets during the application.
Applying for Long-Term Care Coverage
Applying requires documentation of your identity, California residency, income, and medical condition. You will need your Social Security number, proof you live in California, Social Security benefit statements, pension records, and any other income documents.8Department of Health Care Services. Medi-Cal Help Center Medical records or a physician’s statement confirming your functional limitations also need to go in. With asset limits back, be ready to document bank accounts and other property, especially for nursing facility coverage where the transfer look-back now applies.
You can apply through the BenefitsCal online portal, by mail to your county social services office, or in person. Federal regulations require the county to decide most applications within 45 days, or 90 days if eligibility depends on a disability determination.9GovInfo. 42 CFR 435.911 Timely Determination of Eligibility You will receive a Notice of Action showing the decision, your effective coverage date, and any share of cost.
What the State Can Recover After You Die
After a Medi-Cal recipient dies, the Department of Health Care Services can file a claim against the estate for long-term care costs it paid. California has limited its estate recovery program to what federal law requires: nursing facility services, home and community-based services, and related hospital and prescription costs for recipients who were 55 or older when they received the care. For nursing facility services specifically, recovery can apply regardless of age at the time of care.10California Legislative Information. California Welfare and Institutions Code 14009.5
Recovery reaches only assets that pass through probate. Property held in a living trust, in joint tenancy, or in other arrangements that bypass probate is generally out of reach. The state also cannot pursue recovery when the deceased is survived by a spouse or registered domestic partner, a child under 21, or a child of any age who is blind or permanently disabled.11Medicaid.gov. Estate Recovery California further requires the state to waive its claim when the estate is a homestead of modest value and recovery would cause substantial hardship.10California Legislative Information. California Welfare and Institutions Code 14009.5 You can ask DHCS once per calendar year for an estimate of what might be recoverable from your estate.