Major changes are coming to Medi-Cal, due to new federal laws and California state policy. Medi-Cal eligibility rules will change in 2026 and 2027, affecting many residents across the Inland Empire who rely on Medi-Cal for their healthcare.
The good news? As trusted partners in the community, nonprofits and community-based organizations (CBOs) are uniquely positioned to guide members through these changes with compassion, clarity and confidence.
Below is a brief overview of the current major updates and practical ways your nonprofit can support members at every step. For an extensive list of Medi-Cal changes, please visit here.
Eligibility Changes for Members – UIS Population
As of January 1, 2026, several changes for members with unsatisfactory immigration status (UIS) have been implemented including:
- New adult applicants (age 19+, not pregnant) will only qualify for restricted scope Medi-Cal.
- Retroactive Medi-Cal benefits will be shortened to 30 days prior to the application date (previously 90 days).
- Children under 19 and pregnant individuals will continue to be eligible for full-scope Medi-Cal with dental benefits, regardless of immigration status.
- By January 1, 2027, adults ages 19–59 with UIS will transition from Medi-Cal to fee for service.
- Starting July 1, 2027, full dental benefits for adults 19+ with UIS will end, except for emergency dental services. Those with UIS will also have to pay a monthly premium starting July 2027, however the amount will be decided by the next governor.
It is critical that members affected by these changes continue to renew their Medi-Cal throughout 2026 to continue to keep their health care coverage.
Work Requirements for Adults
New work-related requirements will take effect on January 1, 2027, for some Medi-Cal members aged 19–64 without children under the age of 13. To remain eligible, affected individuals must meet one of the following:
• Earn at least $580 per month
• Participate in job training for at least 80 hours per month
• Volunteer or complete community service for at least 80 hours per month
• Attend school at least part-time
These new work or volunteer rules do not apply to:
- Children (0–18) or older Adults (65 and older)
- Pregnant people, including one year postpartum, regardless of birth outcome
- Parents with children age 0-13
- People with disabilities
- People with serious health or mental health conditions or substance use problems
- People who were released from jail or prison within the last 90 days
- People on Medicare Part A or Part B
- Tribal members
- Foster youth or former foster youth age 0-26
Six-Month Eligibility Checks
Also, starting January 1, 2027, adults ages 19–64 will undergo twice‑a‑year eligibility checks instead of once annually.
This change does not apply to:
- Tribal members
- Pregnant individuals
- Children
- Foster youth and former foster youth age 0-26
- People who with disabilities (including those receiving SSI)
Because missing deadlines could result in loss of coverage, early communication and reminders will be more important than ever.
How Your CBO Can Help Members Navigate these Medi-Cal Changes
You and your teams can help share information through trusted channels and partners such as promotoras, CHWs, faith partners/churches and community events.
Step 1: Educate 📚
Nonprofits can be a powerful resource simply by helping community members understand and plan for these changes. Start with the Medi-Cal renewal process:
- Members must renew their Medi-Cal annually to keep benefits active (and for some, this may happen more frequently in 2027).
- Renewal packets are mailed about 60 days before the due date in an easily recognizable golden/yellow envelope.
- Members must return their forms—and all required verifications—on time to avoid losing coverage or being moved to restricted-scope benefits.
Step 2: Communicate Often! 📢
We all know the saying: people need to hear a message seven times before it sticks. That’s especially true for something as important as retaining healthcare coverage.
Helpful messages your CBO can share include:
- “Watch for the golden/yellow envelope!”
- “Don’t wait—renew your Medi-Cal today!”
- “Your local CBO can help you apply or manage your benefits.”
You can also share resources from IEHP, including this flyer.
Step 3: Utilize BenefitsCal.com 💻
CBOs can use BenefitsCal.com, the official online portal for California public assistance programs.
Staff can create a CBO Manager or CBO Assister account to help community members by:
- Submitting applications
- Uploading required documents
- Tracking their benefits
- Generating reports
And ultimately help community members keep their Medi-Cal! Learn more about creating a CBO account here.
Your organization could offer onsite renewal support such as workshops for community members and partnering with managed care health plans for enrollment days.
Together, We Can Support Our Community ❤️
These upcoming Medi-Cal changes are significant, but they don’t have to result in widespread loss of coverage. By staying informed, spreading the word and offering hands-on assistance, nonprofits and CBOs can make a tremendous difference for community members across the Inland Empire.
For County or Health Plan Specific Assistance
You can reach out or direct members to the following:
San Bernardino County
(877) 410-8829
Mon–Thu: 7:00 am – 5:00 pm
Fri: 7:00 am – 4:30 pm
Closed on holidays
Riverside County
(877) 410-8827
Mon–Fri: 8:00 am – 5:00 pm
Closed on holidays
IEHP Eligibility & Outreach
(888) 860-1296
Mon–Fri: 8:00 am – 5:00 pm
To schedule an in‑person appointment at an IEHP Community Wellness Center (CWC), call (866) 228‑4347.
For additional information on Medi-Cal and the most up-to-date information visit the Department of Healthcare Services (DHCS) website.