Medi-Cal, California's Medicaid program, runs the state's Medicare Savings Programs (MSPs): Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), and Qualifying Individual (QI). In 2026, California residents with Medicare qualify when countable monthly income is at or below $1,350 for QMB, $1,616 for SLMB, or $1,816 for QI (single), and assets are under $130,000 (single) or $195,000 (couple). QMB pays Medicare premiums and cost sharing. SLMB and QI pay the 2026 Part B premium of $202.90 a month, or $2,434.80 for the year.
California applicants often assume Medi-Cal Medicare Savings Programs work like the MAGI-based Medi-Cal that covers adults under 65. They do not. The programs use non-MAGI rules, count only the applicant and a spouse, and apply an asset test that returned on January 1, 2026. Covered below: the 2026 limits by household size, what each tier pays, the asset limit, how to apply through your county or BenefitsCal, documents, denial reasons, and appeals. For related help, see Medicare Extra Help in California and dual-eligible benefits in California.
Quick Answer: Do You Qualify for Medi-Cal Medicare Savings Programs in California (2026)?
Yes, California's Medi-Cal Medicare Savings Programs (QMB, SLMB, QI) can pay your Medicare costs if you have Medicare Part A, your 2026 monthly income is at or below $1,816 (single) or $2,455 (couple), and your assets are under $130,000 (single) or $195,000 (couple). QMB pays Part A and B premiums and cost sharing. SLMB and QI pay the 2026 Part B premium of $202.90 a month.
California residents qualify for a Medi-Cal Medicare Savings Program when four tests are met in 2026. First, you are enrolled in Medicare Part A (QMB) or Parts A and B (SLMB and QI). Second, your countable monthly income is under the tier limit from the table below. Third, your countable assets are under California's 2026 limit of $130,000 for one person or $195,000 for a couple. Fourth, you live in California. Medi-Cal does not require a minimum age, so adults under 65 with Medicare through disability can also apply. Federal rules at medicare.gov and medicaid.gov set the three tiers, and California's Department of Health Care Services (DHCS) runs them through county offices.
Medi-Cal Medicare Savings Program Income Limits by Household Size (2026)
Medi-Cal sets Medicare Savings Program income limits as a share of the Federal Poverty Level (FPL). The 2026 FPL is $15,960 for one person, so QMB covers income up to 100% FPL, SLMB covers income above 100% FPL up to 120% FPL, and QI covers income above 120% FPL up to 135% FPL. California applies the federal standards, which add a $20 monthly general income disregard in 2026. The 2026 monthly limits for one person are therefore $1,350 for QMB, $1,616 for SLMB, and $1,816 for QI, and for a married couple $1,824, $2,184, and $2,455 (Medicare.gov, ASPE 2026 poverty guidelines).
California counts household composition differently for this program than for MAGI Medi-Cal. Medicare Savings Programs are non-MAGI: the county counts the income of the applicant and a spouse living in the home, not children, parents, or other relatives, so family size above two does not raise the 2026 limit. The household-size table on this page lists sizes 3 to 8 only as a 2026 reference at 135% FPL. Income that counts includes Social Security before the Medicare premium is withheld, pensions, wages, and interest. The $20 disregard is already built into every 2026 figure on this page.
California Asset Limit for Medi-Cal Medicare Savings Programs (2026)
California brought back an asset test for Medi-Cal Medicare Savings Programs on January 1, 2026. DHCS All County Welfare Directors Letter 25-27 (December 2, 2025) sets the 2026 limit at $130,000 for an individual and $195,000 for a couple, with $65,000 added for each additional household member up to 10 people. Federal law caps most states at about $9,950 for one person and $14,910 for a couple in 2026, but DHCS received federal approval from the Centers for Medicare and Medicaid Services to use the higher California figures. From January 1, 2024 through December 31, 2025 California had no asset limit for these programs.
Medi-Cal generally counts cash, bank accounts, stocks, bonds, and property other than your home. Medi-Cal generally does not count the home you live in, one vehicle, and household belongings, and the county applies the burial and life insurance rules in its non-MAGI guidance. California changed its asset rules in 2024 and again in 2026, so confirm the current limit with your county before you rely on a savings balance near $130,000. Asset limits do not apply to MAGI Medi-Cal for adults under 65, only to the non-MAGI programs that include Medicare Savings Programs.
What Each Medi-Cal Medicare Savings Program Pays in California (2026)
Medi-Cal QMB is the most complete tier. In 2026 it pays the Medicare Part B premium of $202.90 a month, the Part B deductible of $283, the Part A premium for people who owe one (up to $565 a month in 2026), and the Part A and Part B coinsurance and copayments, including the 2026 Part A inpatient deductible of $1,736. Providers who accept Medicare cannot bill a QMB enrollee for Medicare cost sharing. QMB starts the first of the month after the county documents eligibility and is not retroactive (medicaid.gov, Medicare.gov, NCOA 2026 chart).
Medi-Cal SLMB and QI pay only the Part B premium, which is $202.90 a month or $2,434.80 for 2026, and both require Medicare Parts A and B. SLMB and QI can reach back up to 3 months before the application month if you met the rules then. QI is limited to people who do not qualify for full Medi-Cal, is first-come, first-served, and must be renewed every year. Enrollees in any tier are automatically deemed eligible for Part D Extra Help, and Social Security stops withholding the Part B premium once the state starts paying it.
How to Apply for Medi-Cal Medicare Savings Programs in California (2026)
California residents apply for a Medi-Cal Medicare Savings Program through their county social services office, online at BenefitsCal, by phone, by mail, or in person. Applications are accepted year-round for QMB and SLMB, with no enrollment window. QI funding is limited each year, so apply early in January. Free counseling is available from HICAP, California's State Health Insurance Assistance Program, at 1-800-434-0222. Even if your 2026 income looks slightly over a limit, applying is free and the county checks every tier and full-scope Medi-Cal for you.
- Step 1: Compare your monthly income to the 2026 limits ($1,350, $1,616, or $1,816 single; $1,824, $2,184, or $2,455 couple).
- Step 2: Add up your countable assets and compare them to $130,000 (single) or $195,000 (couple) for 2026.
- Step 3: Gather your Medicare card, income proof, and identity and residency documents.
- Step 4: Apply at BenefitsCal, your county office, or by phone, mail, or in person, and ask for the Medicare Savings Program.
- Step 5: Answer county requests for more information by the date on the notice, and keep a copy of everything you send.
- Step 6: Read your Notice of Action, confirm the tier and start date, and renew each year (QI requires a new application).
Documents Needed to Apply for Medi-Cal Medicare Savings Programs (2026)
California counties verify Medi-Cal Medicare Savings Program applications against the 2026 income and asset limits, so having documents ready shortens the wait. Counties usually decide within 45 days, or up to 90 days when a disability determination is needed. Many counties can check Social Security, Medicare, and some bank data electronically, but any item they cannot verify becomes a request to you with a deadline printed on the notice. Missing documents are the most common avoidable reason for a denial or a delay.
- Medicare card showing Part A and Part B start dates
- Social Security or pension award letter for 2026
- Recent bank, savings, and investment statements (to show assets under the 2026 limit)
- Proof of California residency (lease, utility bill, or mortgage statement)
- Identity document (driver license, state ID, or passport)
- Spouse's income and asset records if you are married and living together
Is California a Medicaid Expansion State, and How Does Medi-Cal Treat Medicare Enrollees?
California is a Medicaid expansion state, so Medi-Cal covers adults under 65 up to 138% FPL (2026: $22,025 a year for one person) using MAGI rules, and the ACA gap that affects non-expansion states (AL, FL, GA, KS, MS, SC, TN, TX, WI, WY) does not exist there. Adults entitled to Medicare are not in the MAGI expansion group, so they qualify through non-MAGI pathways such as Medicare Savings Programs, full-scope Medi-Cal for seniors and people with disabilities, or both together as dual-eligibles. About 12 million Americans have both Medicare and Medicaid.
Medi-Cal is California's Medicaid program, run by DHCS and administered by the 58 county offices. The 2025 federal Medicaid work requirement for expansion adults aged 19 to 64, which states must apply no later than January 1, 2027, targets the MAGI expansion group and does not apply to Medicare Savings Programs. Immigration limits also matter: since January 1, 2026, California gives new undocumented adults 19 and older restricted-scope Medi-Cal only, and Medicare itself requires lawful status.
Common Reasons California Medi-Cal Medicare Savings Program Applications Are Denied, and How to Appeal
California counties most often deny Medi-Cal Medicare Savings Program applications because countable income is over the 2026 limit, assets are over $130,000 (single) or $195,000 (couple) in 2026, the applicant has no Medicare Part A, or requested documents arrive late. QI applicants are also denied when they qualify for full Medi-Cal or when 2026 QI funding runs out. A denial for income does not always end the matter: the county should then screen you for full-scope Medi-Cal, which has its own limits and the same 2026 asset test.
California applicants can appeal any Medi-Cal denial or reduction by requesting a State Hearing from the California Department of Social Services within 90 days of the date on the Notice of Action. Request the hearing online, by phone, by mail, or at the county office, and ask the county to keep benefits in place if you appeal before the effective date of a reduction. HICAP counselors and legal aid offices help with appeals at no cost. Reapplying with corrected income or asset information is also free and can be faster than a hearing.
Frequently Asked Questions
What is the Medi-Cal Medicare Savings Program income limit for a family of 4 in California in 2026?
Family size above two does not change the limit. Medi-Cal budgets only you and a spouse living with you, so the 2026 monthly limits are $1,350 (QMB), $1,616 (SLMB), and $1,816 (QI) for one person and $1,824, $2,184, and $2,455 for a couple. A family of 4 is treated as a one-person or two-person unit for this program, though the other members may qualify for MAGI Medi-Cal.
What counts as income for Medi-Cal Medicare Savings Programs, and is it MAGI?
Medicare Savings Programs use non-MAGI rules. California counts Social Security before the Medicare premium is withheld, pensions, wages, interest, and similar income of you and a spouse, then subtracts the $20 general disregard that is already built into the 2026 limits. MAGI, which counts tax-household income for adults under 65, does not decide this program.
What documents do I need to apply for Medi-Cal Medicare Savings Programs?
Bring your Medicare card, 2026 Social Security or pension award letters, recent bank and investment statements, proof of California residency, an identity document, and your spouse's income and asset records if you live together. Counties can verify some items electronically, but anything they cannot verify becomes a request with a deadline, so respond quickly.
What happens if my Medi-Cal Medicare Savings Program application is denied?
Read the Notice of Action to see whether the reason is income, assets, a missing Medicare part, or missing documents. You have 90 days to request a State Hearing from the California Department of Social Services. You can also reapply for free with corrected information, ask the county to screen you for full-scope Medi-Cal, or call HICAP at 1-800-434-0222.
Can I work and still get a Medi-Cal Medicare Savings Program in 2026?
Yes, if your total countable monthly income stays within the 2026 limit for the tier you want. Wages count toward the 2026 single-person limits of $1,350, $1,616, or $1,816, and the county applies the $20 general disregard plus any other disregard that fits. Ask the county to run the numbers before you decide to cut hours, because one tier lower can still pay your Part B premium.
Is California a Medicaid expansion state?
Yes. California expanded Medi-Cal to adults under 65 with income up to 138% FPL, which is $22,025 a year for one person in 2026. Medicare enrollees are not in that MAGI expansion group, so seniors and people with disabilities use Medicare Savings Programs or full-scope non-MAGI Medi-Cal. The 10 non-expansion states are AL, FL, GA, KS, MS, SC, TN, TX, WI, and WY.
How long does a Medi-Cal Medicare Savings Program application take?
California counties generally decide within 45 days of the application, or up to 90 days when a disability determination is needed. QMB starts the first of the month after eligibility is documented. SLMB and QI can reach back up to 3 months before the application month. Complete documents and a fast reply to county requests are the best ways to shorten the wait.
What is the difference between a Medicare Savings Program and full Medi-Cal?
A Medicare Savings Program pays Medicare premiums, and for QMB also deductibles and coinsurance, but does not cover other services. Full-scope Medi-Cal for seniors and people with disabilities also covers services Medicare does not, such as long-term care, and has its own income rules and the same 2026 asset limit of $130,000 (single) or $195,000 (couple). Many people have both.
