California Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in California.
7.6 million Medicaid long-term care recipients nationwide
California Department of Health Care Services (DHCS)
Processing Time
45-90 days for standard applications, 30 days for emergency nursing facility applications
California Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in California, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). California follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$1,732/month
Married Couple (One Applying)
$2,349/month
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$2,000
Community Spouse (At-Home Spouse)
$3,000
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
California Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $9,200/month average (the average monthly nursing home cost in California).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in California
Nursing Home Care
Medicaid pays 100% of nursing home costs in California once eligibility is established. The average monthly cost is $9,200/month average. Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
Assisted Living Waiver (ALW): California's ALW program serves approximately 3,800 individuals statewide in licensed Residential Care Facilities for the Elderly (RCFE). The program covers personal care services, case management, and other supportive services, but does not cover room and board costs.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
California offers 3 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Assisted Living Waiver (ALW)
Provides services for individuals who qualify for nursing facility level of care but choose to receive services in an assisted living facility. Covers personal care, case management, and supportive services.
Program Details →Home and Community-Based Alternatives Waiver
Serves nursing facility-eligible adults age 21 and older, providing in-home care services as an alternative to institutional care.
Program Details →Multipurpose Senior Services Program (MSSP)
Community-based case management program serving frail elderly individuals who are eligible for Medi-Cal and at risk for nursing facility placement.
Program Details →How to Apply for Medicaid in California
California Medicaid applications typically take 45-90 days for standard applications, 30 days for emergency nursing facility applications. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in California through:
- Online through BenefitsCal
- Mail to county social services office
- In-person at county office
- Through hospital or nursing facility social worker
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in California from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
California-Specific Programs and Resources
Aged and Disabled Federal Poverty Level (A&D FPL) Program
Free Medi-Cal for low-income individuals age 65+ or disabled adults with income up to 138% of federal poverty level. No share of cost.
Learn MoreProgram of All-Inclusive Care for the Elderly (PACE)
PACE programs in California provide comprehensive medical and social services to frail elderly individuals, allowing them to remain in the community. Available in select counties.
Learn MoreNeed Help with California Medicaid?
Contact California Department of Health Care Services (DHCS) for specific questions about eligibility, application status, or covered services.