Let's consider someone in their mid-50s who left their job in San Jose. They own a home and have a decent retirement account, but their actual income this year is quite low. These individuals use Medi-Cal.

Can someone with significant assets qualify for Medi-Cal? The MAGI Medi-Cal for adults under 65 is based on income for eligibility. The asset limit of $130,000 that was reinstated in January applies to the non-MAGI category for those over 65 or disabled.

The income thresholds for 2026, according to the Health Consumer Alliance, are $22,025 annually for one person and $29,864 annually for two people. These figures correspond to 138% of the federal poverty level and will be in effect until December 31 of this year.

However, the rules will change next year. Due to H.R.1 signed in July 2025, the renewal period for the ACA expansion group, referred to as the MAGI New Adult Group by DHCS, will shorten from 12 months to 6 months.

There is a common misconception here. Not everyone will switch to a 6-month renewal cycle all at once on January 1, 2027.

According to the guidance ACWDL 25-30 sent by DHCS to counties on December 30, 2025, applicants who apply before December 31, 2026, will be reviewed during their regular renewal in 2027. For example, if someone's renewal date is in November 2027, they will be reviewed then, and from that point on, the 6-month cycle will begin.

Conversely, new applicants after 2027 will be subject to review from the start.

So, you need to know when your renewal month is. You can check this through your BenefitsCal account or with your county office.

In fact, a more significant change than the renewal period is the new work requirement that comes with it. Adults aged 19-64 in this group must show 80 hours of work, job training, volunteering, or enrollment in school at least half-time each month.

This is crucial for early retirees. There is no exemption for retirement on the DHCS waiver list.

The list includes Medicare recipients, parents of children under 13, caregivers for disabled individuals, pregnant women, veterans with full disability ratings, and those classified as medically frail.

However, instead of 80 hours, you can also show monthly income of over $580. This amount is calculated by multiplying the federal minimum wage of $7.25 by 80 hours.

The same guidance states that for individuals with fluctuating income, the average of the previous 6 months will be considered, listing examples of gross income that include earned income, unemployment benefits, retirement income, and dividends. According to this, individuals with retirement income or dividends exceeding $580 per month will meet the requirements without needing to work.

This document is a preliminary guideline, and I have not verified whether there are changes based on the CMS interim final rule released in June 2026.

It cannot be definitively stated whether withdrawals from Roth accounts or spending savings will be counted as income based solely on this document. If you are living solely off account balances, it is safer to consider the 80 hours of volunteering as a realistic path.

The criteria for renewal are not strict. You only need to meet the requirement for any one month since your last review. For example, a person renewing in August can pass if they earned over $580 in April.

If verification cannot be completed, benefits will not be cut off immediately. If exemptions or activities are not recorded during renewal, the county will give you 30 days to meet the requirements.

The issue lies with mail. The county first verifies through electronic records, and retirees without payroll records are likely to be missed here.

According to California LAO data, the estimated number of individuals subject to 6-month renewals is 4.9 million based on 2025-26, and the estimated number subject to work requirements is 3.5 million. The number of individuals likely to lose eligibility is estimated to be between 1 million and 2 million.

I do not oppose the intent of the program. It is a program funded by taxes, and it makes sense to frequently verify the eligibility of working-age adults.

However, it is an administrative failure when someone who qualifies is cut off due to missing a single letter, which is unrelated to personal responsibility.

If you think you might exceed the income threshold, Plan B is Covered California. The open enrollment for 2027 started on November 1 and runs until January 31 of next year, and to be covered starting January 1, you must complete the process by December 31.

The enhanced tax credits expired last year, and the preliminary average increase rate for 2027 released by Covered California in July is 9.9%. State subsidies apply up to 200% of the FPL, which is $31,920 for one person.

Roth conversions or capital gains from stock sales will also be counted as taxable income, affecting both the Medi-Cal income threshold and tax credit calculations.

If I were you, I would first check my renewal month. I would update my address and contact information on BenefitsCal. I would gather my 1099s and dividend statements in one folder.

If I have no income, I would proactively find a volunteer organization and keep track of my hours. DHCS has stated that additional guidelines for community service recognition will be provided.

For those nearing 65, the calculations are slightly different. Once you become eligible for Medicare, you qualify for an exemption from the work requirement, and Medi-Cal for those over 65 will maintain the 12-month renewal cycle.

Taxes and insurance are intertwined, so the answers will vary based on individual circumstances. Be sure to consult with professionals like representatives from the Santa Clara County Social Services Agency or Covered California certified enrollers.

Don't wait for notifications to arrive. If I were you, I would organize my renewal month and income documentation before the year ends.