Medi-Cal changes set to roll out beginning Oct. 1 – Welcome to San Bernardino County

"San Bernardino County Update", yellow arrowhead and "SBCounty.gov

Male doctor checks a smiling female patient's blood pressure during an office visit in a medical exam room. Anatomy charts hang on the wall.

San Bernardino County encourages residents to prepare for upcoming federal Medi-Cal eligibility and benefit changes beginning in October.

Beginning in October, some Medi-Cal members may experience changes to their eligibility requirements or benefits due to new federal requirements.

Guidance from the California Department of Health Care Services (DHCS) and the Centers for Medicare and Medicaid Services (CMS) is still being developed, and implementation details may change as additional federal and state guidance is released.

Beginning Oct. 1 and continuing through 2027, several federal Medi-Cal changes are expected to affect certain Medi-Cal members, particularly adults enrolled in Affordable Care Act (ACA) expansion programs, also referred to as the new adult group.

These changes may include:

Changes to qualified noncitizen (QNC) eligibility rules

Beginning Oct. 1, federal law will change which noncitizens may qualify for federally funded Medi-Cal programs. Individuals who may continue to qualify include lawful permanent residents, Cuban or Haitian entrants and certain individuals residing in the United States under the Compact of Free Association (COFA).

New work and community engagement requirements

Beginning Jan. 1, 2027, certain adults ages 19 through 64 enrolled in the ACA expansion population may be required to complete at least 80 hours per month of qualifying activities to maintain coverage.

Medi-Cal renewals every six months for certain adults

Beginning Jan. 1, 2027, certain adults enrolled in the ACA expansion population may be required to complete Medi-Cal eligibility renewals every six months instead of annually.

Reduced timelines for retroactive Medi-Cal coverage

Beginning Jan. 1, 2027, retroactive Medi-Cal coverage will change from three months to:

One month for ACA expansion adults.
Two months for all other Medi-Cal members.

New cost-sharing requirements

Beginning in October 2028, certain ACA expansion adults may also be subject to new cost-sharing requirements, including copayments, deductibles or other out-of-pocket costs, depending on household income and program eligibility.

Important: Not all Medi-Cal members will be affected by these changes. Additional details regarding eligibility requirements, exemptions, timelines and reporting responsibilities will be shared as more information becomes available.

What you can do now

To help avoid interruptions in coverage, Medi-Cal members are encouraged to:

Make sure their mailing address, phone number and email address are current.
Check mail and online accounts regularly for Medi-Cal notices.
Respond promptly to requests for information.
Submit the requested documents by the stated deadlines.
Report household or income changes within the required time frame.

Current Medi-Cal members are encouraged to review their case information and ensure their contact information is up to date.

San Bernardino County will continue working with community partners, the Department of Health Care Services and the Centers for Medicare and Medicaid Services to provide updates, resources and support as additional implementation guidance becomes available. For the latest updates, please visit the San Bernardino County Transitional Assistance and DHCS websites.

Additional County Update News – June 18, 2026