Work and Community Engagement Rule
Starting in 2027, some adults ages 19 to 64 may need to meet new work, school, training, volunteer, or income requirements to keep their Medi-Cal coverage. The State will also begin checking eligibility more often for some members. The State will also send more information before these changes begin.
For now, the most important step is making sure your contact information is up to date so you do not miss important notices. Log into BenefitsCal to make sure your contact information is up to date.
What Is the Work and Community Engagement Rule?
Beginning in 2027, some adults ages 19 to 64 will need to show that they are:
- Working
- Volunteering
- Doing community service
- Attending school
- Participating in a job-training program
- Earning income
Meeting one of these requirements may help you keep your Medi-Cal coverage.
Does This Rule Apply to Me?
You may be excused from the Work and Community Engagement Rule if any of the exemptions apply to you:
Health and Disability Exemptions
You may be excused if you:
- Have a serious, complex, or ongoing medical condition
- Have a serious mental health condition
- Have a disability that prevents you from meeting the requirement
- Have a substance use disorder, are in treatment, or have been referred to treatment
Family and Caregiving Exemptions
You may be excused if you:
- Care for a person with a disability or serious medical or mental health condition
- Are a parent, guardian, or caregiver of a child age 13 or younger
- Are pregnant, were pregnant within the last 12 months, or qualify for postpartum care
Other Exemptions
You may be excused if you:
- Are meeting CalWORKs work requirements
- Receive CalFresh and are not exempt from CalFresh work requirements
- Are a veteran with a total disability
- Were in foster care on your 18th birthday and are under age 26
- Are American Indian or Alaska Native
- Are currently in jail or prison
Other Situations That May Qualify You for an Exemption
When your Medi-Cal is renewed, you may qualify for an exemption if, at any time since your last renewal, you:
- Were under age 19
- Were eligible for Medicare Part A or enrolled in Medicare Part B
- Were released from jail or prison within the last 90 days
- Received care in a hospital, nursing facility, or psychiatric facility
- Traveled outside your local area for treatment of a serious medical condition
- Lived in a county with very high unemployment or a federally declared disaster
- Qualified for any of the exemptions listed above
The state may already have information that shows you qualify for an exemption. If so, you may receive a notice telling you that no additional action is needed.
How Can I Meet the Requirement?
If you do not qualify for an exemption, you may meet the requirement in any of the following ways.
Earn Income: You can qualify if you earn at least $580 before taxes in any month since your last renewal. If your work hours change from month to month or you have seasonal employment, your income may be averaged over six months.
Work, Volunteer, or Complete Job Training You can qualify by completing a total of 80 hours in a month through any combination of:
- Paid work
- Volunteer work
- Community service
- Job-training programs
Attend School: You can qualify by attending school at least part-time. If you attend school less than part-time, you may be able to combine your school activities with work, volunteering, community service, or job training to meet the requirement.
What Happens If I Do Not Meet the Requirement?
If you do not qualify for an exemption and do not meet the Work and Community Engagement Rule, you could lose your Medi-Cal coverage.
For now, the most important step is making sure your contact information is up to date so you do not miss important notices. Log into BenefitsCal to make sure your contact information is up to date.
Before any action is taken, you will receive written notice explaining:
- What information is needed
- What actions you can take
- How to appeal the decision if you disagree
If you lose Medi-Cal because you do not meet these requirements, you may not qualify for financial assistance through Covered California and could be responsible for the full cost of health insurance coverage.
If your circumstances change, you can apply for Medi-Cal again at any time.
What You Should Do Right Now
Make Sure Your Contact Information Is Current
Your county Medi-Cal office will send important information about these changes. Make sure your mailing address Phone number and email address are up to date so you do not miss letters, emails, or text messages. Log into BenefitsCal to make sure your contact information is up to date.
Need Help?
If you have questions about your Medi-Cal eligibility or these upcoming changes:
- Contact your county Medi-Cal office
- Visit the DHCS Work Rules website
- Call the Medi-Cal Helpline at 800-541-5555
- Log in to your BenefitsCal account for notices and updates