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Full health coverage for undocumented adults in 2026: who can still enroll and what it costs

Full Medi-Cal for undocumented adults changed this year, and more changes come in 2027. You still have options. Here is who can sign up, how to keep what you have, what it will cost, and where to get care if you cannot enroll.

Where this applies
California (Medi-Cal is a state program). County programs on this page are for San Mateo County and Santa Clara County residents. Public charge is a federal rule.
Facts checked
Who it’s for

Undocumented adults 19 and older and their families in California, and the people helping them. Children, pregnant people and former foster youth will also find their rules here.

On this page

Take the next step

You deserve care, and there is still care for you. We know these changes are worrying. The rules changed, but many doors are still open. Here is what changed and what you can do now.

This page covers health coverage for undocumented adults. For counseling and mental health, see Mental health care without fear. For other help with daily needs, see Everyday needs. This page is general information, not legal or medical advice.

What changed on January 1, 2026?

Since January 1, 2026, undocumented adults 19 and older cannot newly sign up for full Medi-Cal. The state calls this the "Adult Expansion Freeze."

If you already had full Medi-Cal by January 1, 2026, you can keep it. You must renew on time and still meet the other Medi-Cal rules. If you applied before January 1, 2026, the freeze does not stop that application.

The freeze is tied to immigration status. Some people with other statuses are outside it. The state's freeze eligibility chart shows full scope Medi-Cal for adults with DACA or other deferred action, other PRUCOL groups (people the government knows are here and is not acting to remove), and green card holders in the five year waiting period. The same chart shows restricted scope for new applicants 21 and older with TPS or a pending TPS application. If you have a pending case or another status, ask your county worker which row fits you.

Who can still sign up for full Medi-Cal?

These people can still apply for full Medi-Cal, whatever their immigration status:

  • Children under 19
  • People who are pregnant, during the pregnancy and for one year after
  • People under 26 who were in foster care on their 18th birthday

Can't enroll yourself? Your children may still qualify. Apply for them.

How do I keep my Medi-Cal?

  • Renew on time. Your county mails a renewal packet. Fill it out. Send it back by the date on the letter.
  • Keep your address and phone number current with your county, so every letter reaches you.
  • If your Medi-Cal ends, act fast. You have three months to sign up again. After three months, you are treated as a new applicant, and the freeze applies. You could then get only restricted scope Medi-Cal.

What will change in 2027?

These changes reach everyone the state lists with "unsatisfactory immigration status." That includes undocumented members, and also people with DACA and other PRUCOL statuses and green card holders still in the five year wait.

January 1, 2027: a new way to get care. You leave your Medi-Cal health plan and get care through Fee for Service. This applies at every age, including children and pregnant members in this group. The state says this changes how you get care, not whether you keep Medi-Cal.

  • Bring your Medi-Cal Benefits Identification Card (BIC) to every visit. Health plan cards will not work. Replace a lost card through your county or BenefitsCal.
  • Enhanced Care Management and Community Supports end for this group, because only health plans offer them. Community Health Worker, doula and chronic care management services stay.
  • Medicines stay covered through Medi-Cal Rx. Specialty mental health and drug or alcohol treatment stay with your county.
  • DHCS says it will mail notices about the move starting December 1, 2026.
  • Find a doctor or clinic that takes Fee for Service on the state's Find care page, or call the Medi-Cal Help Line, 1-800-541-5555.

July 1, 2027: a monthly premium. Adults ages 19 to 59 in this group will have to pay a monthly fee, called a premium, to keep full Medi-Cal. For some statuses, such as green card holders in the five year wait, the DHCS chart starts the premium at age 21.

  • Who does not pay: adults 60 and older, children under 19, pregnant people (and for one year after), and people under 26 who were in foster care on their 18th birthday.
  • How much: not set yet. It will be $30 to $50 per person each month. State law sets that range, and the governor will set the exact amount in May 2027 (LAO, checked October 23, 2026). The 2026 to 2027 budget plan expects $50. The state's Medi-Cal FAQ and some county pages still show $30, the amount set in 2025. Your county will tell you the final amount by letter.
  • If you do not pay: your Medi-Cal changes to restricted scope.

July 1, 2027: dental for emergencies only. Adults in this group keep emergency dental care, such as help for tooth pain, infections and pulling a tooth. Full dental care ends. The state budget moved this cut from July 2026 to July 2027. Children, pregnant people and former foster youth under 26 keep full dental. If you need dental work, ask your dentist about getting it done before July 1, 2027.

What is restricted scope Medi-Cal?

Restricted scope Medi-Cal is still open to adults who cannot get full Medi-Cal because of immigration status. It covers:

  • Emergency care
  • Pregnancy care
  • Nursing home care

It is not full coverage. It covers only these kinds of care. Apply the same way you would for full Medi-Cal.

What can I get if I cannot enroll?

You still have places to go for care. Your county and local clinics can help.

San Mateo County: ACE

San Mateo County says legal status is not required for county funded coverage. ACE (Access and Care for Everyone) gives health coverage to low income adults 19 and older who live in the county and do not qualify for other programs.

  • Cost: the ACE page lists a $360 application fee. Most members then pay $360 a year, in full or $30 a month. The county health page says the fee can be waived based on income, and most visits have a $15 copay that can also be waived. Ask about both.
  • Where you get care: San Mateo Medical Center and its clinics, Ravenswood Family Health Center in East Palo Alto, and North East Medical Services in Daly City.
  • How to apply: call the Health Coverage Unit at 650-616-2002, or ask for a Community Health Advocate at a San Mateo Medical Center clinic or at Ravenswood.

Santa Clara County: PCAP and HAP

Primary Care Access Program (PCAP) is a low cost county program for primary and preventive care. The county lists these rules: age 19 or older, living in Santa Clara County, household income at or below 650% of the federal poverty level, and no access to other coverage such as full Medi-Cal, Covered California, Medicare or job insurance.

  • You pick a community clinic and get your care there. Specialty care and hospital stays need approval first. Dental and vision are not covered. Copays may apply.
  • How to apply: call (888) 363-3394, option 1, or visit a participating clinic and ask for an Enrollment Counselor.
  • The PCAP rules list age, county residence, income and no other coverage. They do not list immigration status. Santa Clara Valley Healthcare says its hospitals and clinics are open to everyone regardless of immigration status, and patients are not asked about status when they come for care.

Healthcare Access Program (HAP) helps pay bills at county hospitals and clinics for people who are uninsured. At or below 400% of the federal poverty level, care can be free. Discounts reach up to 650%. Call 866-967-4677, Monday to Friday, 8 a.m. to 4:30 p.m. Bring proof of identity and income. The HAP page does not mention immigration status.

Community health centers

Federally funded health centers may not turn you away because you cannot pay. They must offer a sliding fee based on income and family size, and a full discount (a small fee is allowed) if your income is at or below the federal poverty level. Find one with Find a Health Center.

In East Palo Alto: Ravenswood Family Health Center, 1885 Bay Road. Its Eligibility and Enrollment team helps people apply for coverage: 650-330-7416. Ravenswood also has clinics in Mountain View, Sunnyvale and Palo Alto.

Will using Medi-Cal affect my immigration case?

Public charge. A new federal public charge rule took effect on September 18, 2026. It replaced the 2022 rules. It applies to applications for admission and for green cards filed on or after that date. Public charge does not apply to most immigrants already in the United States, and some groups are exempt.

  • Medi-Cal can now count. The California Health and Human Services Agency says the benefits officers may now look at include Medi-Cal, if public charge applies to your case. They weigh it with other facts, so the result depends on the case.
  • Applying counts too. USCIS says officers may weigh an application or approval for a benefit on or after September 18, 2026, unless you show you withdrew or disenrolled. Benefits you received before that date count only if they were cash aid or long term care.
  • Your children's benefits. USCIS does not count benefits your children or other relatives receive as yours. But if a child gets a benefit because your income is low, the officer may look at your low income.
  • County programs. USCIS counts means tested benefits from federal, state and local government, and names government health coverage as one example. It does not list emergency Medi-Cal, ACE or PCAP by name, so treat them as programs that could be weighed.

If you have, or plan to file, an immigration case, talk with a trusted immigration attorney or a DOJ accredited representative before you apply for or cancel any benefit. See Free legal help in the Bay Area and How to find a lawyer you can trust. Watch out for immigration scams.

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Printed from https://donotlosehope.com/guides/medi-cal-adults-2026/. Facts checked October 21, 2026. Free information, not legal advice.

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