What is the look back period for Medi-Cal?

Editorial team Published on

The California Medi-Cal long-term care look-back period is 30 months (2.5 years) preceding an application for nursing facility services.

Key Rules and Details

  • Duration: Unlike the 60-month (5-year) federal Medicaid standard, California maintains a 30-month look-back window.
  • Asset Limits: Reinstated asset limits cap countable resources at $130,000 for an individual and $195,000 for a couple (with primary homes and one vehicle remaining exempt).
  • Penalties for Transfers: Giving away assets or selling them below fair market value during the 30-month window can trigger a penalty period of ineligibility for nursing home care.
  • Exempt Transfers: Transfers made between January 1, 2024, and December 31, 2025 (during the temporary no-asset-test period) are generally excluded from penalties, but transfers made or reviewed on or after January 1, 2026, are subject to the reinstated rules.

How to avoid the 5 year lookback?

You can avoid Medicaid's five-year look-back penalties by using legal asset-protection strategies or completing transfers before the 60-month window begins.

Proactive Planning Strategies

  • Irrevocable Trusts: Transfer assets into a Medicaid Asset Protection Trust. The five-year clock starts the day assets move into the trust, shielding them once the period passes.
  • Early Gifting: Make structured gifts outside the 60-month window. Any transfer completed more than five years before applying is free from review.
  • Exempt Asset Conversion: Turn countable assets into exempt ones. Pay off debts, repair your home, upgrade a vehicle, or buy prepaid funeral plans.

Exempt Transfers

  • Spousal Transfers: Move any amount of assets to a healthy spouse (community spouse) without a penalty.
  • Caregiver Child Exception: Transfer your home to an adult child who lived with you for at least two years and provided care that delayed your nursing home entry.
  • Disabled Child or Sibling: Transfer property or assets to a blind/disabled child or a sibling who already holds an equity stake in the home.

Emergency Strategies (If Care is Needed Now)

  • Medicaid-Compliant Annuities: Convert excess liquid cash into a predictable income stream for a healthy spouse.
  • Half-a-Loaf Strategy: Gift a portion of your assets and use the remaining funds to pay for care during the resulting short penalty period.
  • Promissory Notes: Structure a portion of assets as a legitimate loan with a Medicaid-compliant repayment agreement.

What is the income limit for Medi-Cal in 2026?

For most adults aged 19 to 64, the 2026 Medi-Cal income limit is 138% of the Federal Poverty Level, which is $1,800 per month ($21,597 per year) for a single person.

Income Limits by Household Size (138% FPL)

For standard MAGI-based Medi-Cal (adults, expansion groups):

  • 1 person: $1,800 / month ($21,597 / year)
  • 2 people: $2,432 / month ($29,187 / year)
  • 3 people: $3,065 / month ($36,777 / year)
  • 4 people: $3,697 / month ($44,367 / year)
  • 5 people: $4,330 / month ($51,957 / year)

You can check complete, official household charts directly through the Department of Health Care Services Eligibility Chart.

Limits for Other Groups

  • Children and Pregnant Individuals: Qualify at higher thresholds, up to 266% of the Federal Poverty Level (~$3,774/month for a single-person household).
  • Aged, Blind & Disabled (ABD): The basic non-MAGI limit sits around $1,801/month for a single individual (factoring in California's standard income disregard).
  • Working Disabled Program: Allows higher earnings up to 250% of the FPL (~$3,260/month for individuals).

How much money can I have in my bank account for Medi-Cal?

How much money you can have in your bank account for Medi-Cal depends on which type of Medi-Cal program you are enrolled in.

The asset and resource rules for California's Medicaid program operate under the following limits:

1. Most Adults & Children (MAGI Medi-Cal)

If you qualify for Medi-Cal based primarily on your income (such as lower-income adults ages 19–64, pregnant individuals, and parents/children), there is no asset limit. Your bank account balance, savings, and investments do not affect your eligibility at all; only your monthly income is evaluated.

2. Older Adults & People with Disabilities (Non-MAGI Medi-Cal)

If you are age 65 or older, blind, disabled, or need long-term nursing home care, California has reinstated asset tests.

  • Current Limit (Through June 30, 2027): You can have up to $130,000 in countable assets for an individual ($195,000 for a married couple). You can add $65,000 for each additional household member up to 10 people.
  • Upcoming Limit (Starting July 1, 2027): The asset limit is scheduled to drop to $21,000 for an individual and $31,000 for a couple (plus $1,550 for each additional household member).

Note: Money in checking, savings, and digital wallets (like Venmo or Apple Pay) all count toward these totals. However, your primary home, one vehicle, and household goods are exempt from being counted.

3. SSI-Linked Medi-Cal

If you receive Supplemental Security Income (SSI), your Medi-Cal is automatically tied to your SSI eligibility. SSI retains a strict federal bank account and resource limit of $2,000 for a single person or $3,000 for a married couple.

How to protect your savings

If you have a disability and are worried about the asset limit, you can save money without affecting your Medi-Cal eligibility by using a CalABLE Account. CalABLE allows eligible individuals to save up to $529,000 tax-free for qualified disability expenses, and these funds are entirely excluded from standard Medi-Cal asset limits.

For more details on what resources are counted and how to complete your renewals, you can review the official California Department of Health Care Services Asset FAQs.

What will disqualify you from Medi-Cal?

Exceeding income limits, having excess assets (for seniors or people with disabilities), or failing to meet residency and renewal requirements will disqualify you from Medi-Cal.

Income Limits

  • Adults (Ages 19–64): Household income above 138% of the Federal Poverty Level (FPL) can disqualify you from free coverage, though higher earners may qualify for a "share of cost" or Covered California.
  • Aged, Blind, and Disabled: Strict monthly income caps apply depending on your specific category.

Asset Limits (Seniors 65+ and Disabled Individuals)

  • Excess Property/Cash: For non-MAGI programs (seniors and disabled individuals), countable assets over $130,000 for a single person or $195,000 for a couple will disqualify you.
  • Asset Transfers: Transferring assets for less than fair market value within the 30-month look-back period can trigger penalties and loss of long-term care coverage.

Residency and Documentation

  • State Residency: You must be a resident of California. Moving out of state permanently disqualifies you.
  • Failure to Renew: Not responding to annual eligibility checks or failing to report household changes within 10 days can result in termination.
  • Immigration Status Rules: New enrollment restrictions apply to certain undocumented adults under current state guidelines.

You can check your status or ask questions through the Medi-Cal Helpline.

5 things you need to know about Medicaid's lookback period.

9 related questions found

What is the 3 month rule for Medi-Cal?

The "3-month rule" in Medi-Cal most commonly refers to the three-month grace period to re-enroll after losing coverage, or historically, the 3-month retroactive coverage period for past medical bills.

1. Three-Month Re-enrollment Grace Period

  • What it is: If your full-scope Medi-Cal coverage ends (such as missing a renewal deadline), you have a 3-month window to sign up again and restore your full benefits.
  • Who it affects: Recently, under updated enrollment guidelines for certain adult groups (such as specific adult immigrants or those undergoing eligibility transitions), missing this 3-month re-application window means you may lose full-scope coverage and be downgraded to restricted-scope Medi-Cal (which only covers emergency, pregnancy, and nursing home care).
  • Managed Care Plan Protection: If you temporarily lose Medi-Cal and re-enroll within 3-month grace parameters, you can also retain your previous health plan.

2. Retroactive Coverage (Past Medical Bills)

  • What it is: Medi-Cal previously allowed up to 3 months of retroactive coverage, meaning the program could help pay for medical services you received in the three months before the month you officially applied, provided you were eligible during those months.
  • Current Limits: Due to recent federal policy adjustments, retroactive coverage has been shortened for many groups (reduced to 1 month for ACA expansion adults and 2 months for children, older adults, and individuals with disabilities). You must request retroactive help through your local county social services office within one year of receiving the service.

What is exempt from Medicaid lookback?

Certain asset transfers are exempt from the Medicaid look-back period and will not trigger a penalty, primarily including transfers to a spouse, a disabled child, or a qualifying caregiver child.

Exempt Asset Transfers

  • Transfers to a spouse: You can transfer any amount of assets to your legal spouse without facing a penalty.
  • Transfers to a disabled child: Giving assets or transferring property to a child of any age who is blind or permanently disabled is allowed.
  • Caregiver child exemption: You can transfer your primary home to an adult child who lived in the home with you for at least two years prior to your nursing home placement and provided care that delayed that placement.
  • Sibling with equity interest: You can transfer a share of your home to a sibling who already has an ownership interest in the property and lived there for at least one year before you applied for Medicaid.

Exempt Financial Strategies

  • Fair market value sales: Selling an asset for what it is actually worth does not violate the look-back rule, provided you keep proper documentation.
  • Medicaid-compliant annuities: Converting a lump sum into a monthly income stream that meets strict state rules is allowed because it removes the cash from your countable asset pool.
  • Irrevocable funeral trusts: Funding specific irrevocable burial or funeral reserves does not trigger a penalty, up to state-specified dollar limits.
  • Personal caregiver agreements: Paying a family member for care is allowed, but only if a formal, signed contract was created before the care and payments were given.

How much money can you make and still be on Medi-Cal?

For most adults aged 19 to 64, you can make up to 138% of the Federal Poverty Level (FPL) and still qualify for no-cost Medi-Cal.

Income Limits by Household Size (Annual)

  • 1 person: $21,597 per year (about $1,800 per month)
  • 2 people: $29,187 per year (about $2,432 per month)
  • 3 people: $36,777 per year (about $3,065 per month)
  • 4 people: $44,367 per year (about $3,697 per month)
  • 5 people: $51,957 per year (about $4,330 per month)

You can check official details or apply through the Department of Health Care Services.

Special Rules and Higher Limits

  • Children: Children under 19 can qualify with higher household income limits (up to 266% FPL).
  • Pregnant Individuals: Pregnant individuals qualify at higher limits (up to 213% FPL).
  • Older Adults or Disabled Individuals: Different income and asset rules apply if you are 65 or older, or have a disability.
  • Share of Cost: If your income is above the limit, you might still qualify with a "Share of Cost," meaning you pay a specific monthly amount for medical bills before Medi-Cal covers the rest.

Will people lose Medi-Cal in 2026?

Yes, some people will face a loss of Medi-Cal coverage in 2026 due to newly implemented federal restrictions and reinstated state rules.

Who is at Risk of Losing Coverage

  • Certain Immigrant Populations: Starting October 1, 2026, federal changes narrow the definition of qualified non-citizens for federal Medicaid funding, impacting certain refugees, asylees, and humanitarian parolees (though California provides a bridge of state-funded coverage for some groups through June 30, 2027).
  • Seniors and Individuals with Disabilities: Effective January 1, 2026, California reinstated the asset limit test ($130,000 for an individual; $195,000 for a couple) for non-MAGI programs like long-term care. Those exceeding these countable property limits during their 2026 annual renewals will lose eligibility unless they reduce their assets.
  • People Who Miss Renewal Deadlines: Regular checks and stricter administrative renewal requirements mean that failure to return paperwork on time can result in canceled coverage.

Exempt Groups Who Will Keep Medi-Cal

  • Children ages 0–18
  • Pregnant and postpartum individuals
  • Current and former foster youth under age 26

You can read official updates and guidance directly from the California Department of Health Care Services.

What if my income is too high for Medi-Cal?

If your income is too high for free Medi-Cal, you can shop for discounted private health insurance through Covered California, or qualify for Medi-Cal through a "Share of Cost" program.

Options If Your Income Is Too High

  • Covered California: This is the state’s official health insurance marketplace. If you make too much for regular Medi-Cal, you can get financial help and tax credits to lower the cost of a private plan. Losing Medi-Cal gives you a special window to sign up.
  • Share of Cost Medi-Cal: If your income is just a bit over the limit (often for seniors or people with disabilities), you might qualify for a program with a "Share of Cost". This works like a monthly deductible. You pay your own medical bills up to a certain amount each month, and then Medi-Cal pays for the rest of your care.
  • Working Disabled Program: If you have a disability and work, California lets you earn a higher income and still keep Medi-Cal, sometimes for little or no cost.
  • Deductions and Adjustments: Make sure you report all tax deductions and household changes. Certain expenses or changes in tax filing can lower your countable income to fit the limits.