Losing Medi-Cal in California in 2026 feels sudden, but the notice you received starts two separate clocks. The first clock is the 90-day Marketplace Special Enrollment Period (SEP) that HealthCare.gov and Covered California give people who lose Medicaid or CHIP coverage, longer than the standard 60-day window for other coverage losses. The second clock is the 90-day period California gives you to fix a paperwork termination or request a State Hearing. Many Medi-Cal terminations are procedural, meaning the county did not receive a renewal packet or proof of income, so your first move is to find out which kind of termination you have. If your income is truly above 138% of the Federal Poverty Level ($22,025 for a single adult in 2026), a Covered California plan with a premium tax credit is the usual replacement. If your income is at or below that line, you likely still qualify for Medi-Cal and should reapply right away. Both routes can run at the same time so that you avoid a gap in coverage.
California changed several Medi-Cal rules in 2026, and those changes explain why some adults are losing coverage now. Under H.R. 1 (signed July 4, 2025), the Department of Health Care Services (DHCS) reinstated the asset test for aged and disabled applicants on January 1, 2026, froze new full-scope enrollment for adults 19 and older without satisfactory immigration status on January 1, 2026, and applies a narrower federal definition of qualified non-citizen starting in October 2026. Work and community engagement requirements for the Medi-Cal adult expansion group begin in January 2027, with six-month renewals following. Covered California is a state-based exchange, so you enroll at coveredca.com or by phone, not through healthcare.gov. Because these rules shift month by month, confirm every date with DHCS and Covered California before relying on it. This page walks through the deadline, the documents, the 2026 income table, and the plan options so you can pick the right path before the 90-day window closes.
7 Steps to Get Coverage
Common Mistakes That Cost People Thousands
Californians who lose Medi-Cal most often run into these avoidable problems in 2026.
- Waiting for the Medi-Cal appeal result before enrolling in Covered California, which can burn the 90-day SEP while the hearing is still pending.
- Ignoring the county renewal packet or mail notice; Medi-Cal terminations for missing paperwork can often be reversed within 90 days, but only if you respond.
- Reporting 2025 income to Covered California instead of projected 2026 income, which can set the wrong premium tax credit and trigger a repayment on Form 8962.
- Assuming a Covered California plan costs more than it does; at 138% to 150% FPL, state help and cost-sharing reductions can make a Silver plan very low cost in 2026.
- Forgetting to pay the first premium after Covered California auto-selects a plan, which leaves you uninsured despite a completed application.
- Dropping children's coverage along with your own; Medi-Cal for Kids (CHIP) stays available up to 266% FPL in 2026 even when an adult loses Medi-Cal.
Why Medi-Cal Coverage Ends in California in 2026
Medi-Cal terminations in California in 2026 fall into four main categories, and each category points to a different next step. Procedural terminations happen when the county does not receive a renewal packet, proof of income, or a response to a request for information, and DHCS allows a 90-day window to return the missing items and restore coverage. Income terminations happen when verified data from the IRS or employers shows household income above 138% of the Federal Poverty Level ($22,025 for one person in 2026), which points you to Covered California. Eligibility-rule terminations follow the H.R. 1 changes, including the January 1, 2026 asset limit of $130,000 for one person for aged and disabled applicants, and the October 2026 narrowing of qualified non-citizen categories for federally funded full-scope Medi-Cal. Age-out terminations occur when a young adult leaves a children's program. Check the reason code on your Notice of Action first, because a procedural error can be corrected in days while an income-based termination needs a Marketplace plan.
Medi-Cal Rule Changes Coming in 2026 and 2027
California's Medi-Cal program is changing in stages under H.R. 1, and each stage affects who can come back after a termination. On January 1, 2026, DHCS froze new full-scope enrollment for adults 19 and older without satisfactory immigration status; adults already enrolled keep coverage if they complete their renewal, and a late renewal carries a 90-day grace period to reestablish eligibility. In October 2026, federal rules narrow the definition of qualified non-citizen to lawful permanent residents, specified Cuban and Haitian entrants, and Compact of Free Association residents, and DHCS reports that affected adults move to state-funded full-scope Medi-Cal until June 30, 2027. In January 2027, adults in the expansion group face work and community engagement requirements of 80 hours per month (or $580 in monthly earnings), six-month renewals, and shorter retroactive coverage of one month for expansion adults. Reapply early in 2026 if you qualify, because the 2027 rules make returning more paperwork-intensive.
Medi-Cal vs Covered California Income Decision in 2026
Medi-Cal income eligibility in California for adults ages 19 to 64 is capped at 138% of the Federal Poverty Level, which equals $22,025 for one person and $45,540 for a family of four in 2026. Adults above that line move to Covered California, where premium tax credits apply from 138% to 400% FPL ($63,840 for one person in 2026) now that enhanced federal credits have expired. Silver plans carry 2026 cost-sharing reductions up to 250% FPL, lowering deductibles to the Enhanced 94, 87, and 73 actuarial value levels. Households above 400% FPL pay full price for Covered California plans in 2026 unless California state help applies, so Bronze and catastrophic-style choices become relevant. California's Medi-Cal for Kids covers children up to 266% FPL in 2026, which means a family can mix Medi-Cal for children with Covered California coverage for parents. See the Medicaid income limits and ACA income limits pages for the full state-by-state comparison, and use the income table on this page to place your household before choosing.
Why Each Document Matters for Your Covered California SEP
The Medi-Cal Notice of Action is the single most important document because it proves the qualifying life event that opens your Marketplace SEP. Covered California usually verifies a Medi-Cal loss through state data sharing, but an uploaded termination letter resolves any mismatch quickly. Pay stubs and your 2026 income estimate set your premium tax credit, and an inaccurate estimate produces a repayment on Form 8962 when your 1095-A arrives in early 2027. Proof of California residence confirms plan availability by county, since Covered California carriers price by rating region. Immigration documents determine which Medi-Cal and Covered California programs apply after the 2026 rule changes, and Medi-Cal Benefits Identification Card numbers speed up case lookups at BenefitsCal.com. Keep digital copies of everything, because a pended Covered California application can be cancelled if documents are not received by the deadline shown in your account. If an employer plan is also available, a written statement of Medicaid loss supports HIPAA special enrollment within 60 days.
Frequently Asked Questions
What is the Special Enrollment Period after losing Medi-Cal in California?
Covered California gives you 90 days from the last day of your Medi-Cal coverage to pick a Marketplace plan in 2026. For example, if Medi-Cal ends October 31, 2026, your window runs through January 29, 2027. Federal rules also let you select a plan up to 60 days before Medi-Cal ends if you know the date, which avoids a coverage gap. Coverage generally starts the first of the month after you choose a plan and pay. If you miss the 90-day SEP, the next chance is Open Enrollment beginning November 1, 2026, so confirm the closing date at coveredca.com.
How do I document losing Medi-Cal for a Covered California application?
Upload your Medi-Cal Notice of Action or termination letter showing the end date and your name. Covered California often verifies the loss through state data, but the letter resolves mismatches fast. Add Social Security numbers, pay stubs or a 2026 income estimate, and proof of California residence. If you cannot find the notice, log in to BenefitsCal.com or call the Medi-Cal Member Helpline at 800-541-5555 to request a copy. Upload everything before the document deadline in your Covered California account, because a missing proof can cancel an SEP enrollment.
What happens if I miss the 90-day window after losing Medi-Cal?
Missing the 90-day Marketplace SEP generally means no Covered California plan until Open Enrollment, which begins November 1, 2026 for 2027 coverage, and you could go months uninsured. You still have options: Medi-Cal is year-round, so reapply at any time if your income is at or below 138% FPL ($22,025 for one person in 2026). Children can enroll in Medi-Cal for Kids anytime. You may qualify for another SEP, such as a move or job-based coverage loss, so check coveredca.com for exceptions.
Can I get retroactive coverage after losing Medi-Cal?
Medi-Cal can cover medical bills from up to three months before the month you reapply, if you were eligible then. That retroactive coverage shrinks in January 2027 to one month for expansion adults and two months for other groups, per DHCS. A Covered California plan does not go back in time; it starts the first of the month after you enroll and pay. Reinstatement after a procedural termination usually restores coverage back to the termination date, closing the gap entirely. Reapply quickly in 2026 to protect the longer retroactive window.
What is the difference between COBRA and Covered California after losing Medi-Cal?
COBRA applies only if you lost employer coverage earlier and still hold an election right, since Medi-Cal loss alone does not create one. COBRA costs 102% of the full premium, often $400 to $900/mo for one person in 2026, while Covered California premiums after tax credits are usually far lower for incomes between 138% and 400% FPL. COBRA matters mainly if you are mid-treatment with a provider outside Covered California networks. COBRA's election window is 60 days from the qualifying event, so compare the two before the earlier deadline passes.
What California-specific rules apply when I lose Medi-Cal in 2026?
California runs its own exchange, so enroll at coveredca.com, not healthcare.gov. DHCS reinstated an asset limit of $130,000 for one person for aged and disabled applicants on January 1, 2026, and froze new full-scope enrollment for adults 19 and older without satisfactory immigration status. A State Hearing request must be filed within 90 days of your notice. Work and community engagement requirements for expansion adults start in January 2027. Check BenefitsCal.com and the DHCS changes page for updates that affect your case.
Do I qualify for Medi-Cal again after losing it?
Adults ages 19 to 64 qualify when 2026 household income is at or below 138% of the Federal Poverty Level: $22,025 for one person, $29,863 for two, $37,702 for three, and $45,540 for four. Medi-Cal uses current monthly income, so a drop in pay can requalify you even if you were over the line earlier in the year. Reapply at BenefitsCal.com or coveredca.com anytime. If income is above the limit, premium tax credits make a Covered California plan the usual alternative.
What happens to my children's coverage if I lose Medi-Cal?
Children's coverage is evaluated separately from yours. Medi-Cal for Kids, California's CHIP, covers children under 19 up to 266% FPL in 2026 and enrolls year-round. If your child's coverage ended too, reapply at BenefitsCal.com right away with income and identity documents. Children can have Medi-Cal while parents buy a Covered California plan, which is common for families near the income line. Income-eligible children can enroll regardless of immigration status in 2026, and Covered California can place the rest of the household in the right plan.
