CalOptima Health partners with the County of Orange Social Services Agency (SSA) to promote Medi-Cal enrollment and renewal at community events. An SSA worker meets with a member to answer questions and process her renewal.
ORANGE, Calif. (December 23, 2025) — With major changes coming to Medi-Cal starting January 1, 2026, CalOptima Health is urging Orange County residents to learn about how they may be impacted, and encouraging all who are currently eligible but not yet enrolled to apply before the new year. Among the changes are updated eligibility requirements, reinstatement of asset limits for a relatively small group of beneficiaries, and specific documentation needed to maintain coverage.
Medi-Cal, California’s Medicaid program, provides essential health coverage for low-income individuals and families, including children, adults, older adults, people with disabilities, and pregnant individuals. While Medi-Cal remains a cornerstone of accessible health care in Orange County, changes impacting eligibility for certain adults without “satisfactory” immigration status, including a freeze on new enrollments for most adults ages 19 and older who do not have satisfactory immigration status will go into effect in 2026. Those already enrolled can remain covered so long as they timely complete annual renewals and meet all eligibility requirements, however if coverage lapses, these beneficiaries will not be allowed to reapply underscoring the critical importance of fulfilling necessary filings in the new year. Children and pregnant individuals will continue to be eligible for full-scope Medi-Cal regardless of immigration status.
New policies will also reinstate an asset limit for certain Medi-Cal eligibility categories starting in 2026 and change how Medi-Cal counts financial resources for older adults, people with disabilities, and those applying under non-MAGI (Modified Adjusted Gross Income) rules. Under these updated rules, applicants and members will need to demonstrate that their countable assets are below specified limits at the time of application or renewal in 2026. If countable assets exceed the limit and are not brought into compliance, coverage may be discontinued at renewal.
CalOptima Health strongly encourages anyone who believes they may be eligible for Medi-Cal but is not currently enrolled to apply before January 1, 2026, to avoid a potential gap in their health coverage. In addition, current Medi-Cal members should review the new eligibility requirements and ensure their contact and income/asset information is up to date to maintain coverage through renewals.
“Access to quality health care is critical for individuals and families across Orange County,” said Michael Hunn, Chief Executive Officer of CalOptima Health. “We urge all residents who may qualify for Medi-Cal to take action now — complete your application, gather any necessary documentation, and stay informed about new eligibility requirements so you and your loved ones can continue to receive the care you need without interruption.”
CalOptima Health member support specialists are available to assist with questions about enrollment, eligibility requirements, documentation related to the asset limit reinstatement, and how to prepare for upcoming Medi-Cal changes.
Residents are also encouraged to visit www.benefitscal.com to check eligibility and apply for Medi-Cal coverage, or contact CalOptima Health Member Support at 1-888-587-8088 for personalized assistance.
A county organized health system, CalOptima Health provides quality health care coverage for low-income children, adults, seniors and people with disabilities in Orange County, California. CalOptima Health’s mission is to serve member health with excellence and dignity, respecting the value and needs of each person. CalOptima Health serves nearly 878,000 members with a network of more than 9,000 primary care doctors and specialists and 42 acute and rehab hospitals. Visit www.caloptima.org.