California Medicaid Nursing Home Coverage
Medi-Cal (California Medicaid) pays for nursing home care for income-eligible California seniors. This guide covers eligibility rules, income and asset limits, the application process, required documents, and important rules families need to understand before applying.
Eligibility at a Glance
Income Limit
$2,742/mo
300% of SSI · Individual
Asset Limit
$0
Countable assets · Individual
Look-Back Period
5 Years
Asset transfer review
Spousal Assets Protected
$154,140
Community Spouse Resource Allowance
Spousal Income Protected
$3,854/mo
Min. Monthly Maintenance Allowance
Avg. Nursing Home Cost
$11,000/mo
Medicaid rate: ~$295/day
California Nursing Home Medicaid Income Limit
California Medi-Cal nursing home income limit is 300% of SSI ($2,742/month in 2026). California uses a 'share of cost' (SOC) system — most income above the 'maintenance needs allowance' goes to the nursing home. For nursing home applicants, Medi-Cal no longer has a resource (asset) limit as of January 2024 — California eliminated the Medi-Cal asset test. Income limits still apply.
California Nursing Home Medicaid Asset Limit
California eliminated the Medi-Cal asset/resource limit effective January 1, 2024 — seniors with any amount of savings, investments, or property can now qualify for Medi-Cal nursing home coverage based on income alone. This is a major policy change and makes California one of the most accessible Medi-Cal states. The home is still subject to estate recovery. Confirm with DHCS as this is a recent policy change.
California 5-Year Look-Back Rule
California Medicaid reviews all asset transfers made within 5 years (60 months) of the application date. Transfers for less than fair market value during this period may result in a penalty period during which Medicaid will not pay for nursing home care. Consult a California elder law attorney before transferring any assets.
Important California Nursing Home Medicaid Rules
No Asset Limit (since Jan 2024)
California eliminated the Medi-Cal asset and resource test effective January 1, 2024. Prior to this change, single applicants had a $130,000 asset limit (couples $195,000). Now, seniors with any amount of savings, home equity, or investments can qualify for Medi-Cal nursing home coverage based on income alone. This is the most significant Medi-Cal reform in decades. However, Medi-Cal Estate Recovery still applies — the state may recover costs from the estate after death.
Share of Cost (Patient Pay Amount)
California Medi-Cal nursing home residents pay a monthly 'share of cost' (SOC) — essentially all income minus a $80/month personal needs allowance, $35.10 health insurance premium deduction (if applicable), and spousal maintenance needs allowance. The SOC goes to the nursing facility; Medi-Cal pays the remainder of the approved facility rate.
Estate Recovery
Despite eliminating the asset test, California still pursues Medi-Cal estate recovery. After a Medi-Cal nursing home recipient's death (age 55+), California DHCS may file claims against the probate estate for Medicaid costs paid. This includes the primary residence if it passes through probate. California elder law attorneys can advise on estate planning strategies (trusts, beneficiary deeds) to limit recovery exposure.
PACE Programs in California
California has one of the largest PACE (Program of All-Inclusive Care for the Elderly) networks in the US. PACE provides comprehensive care for dual-eligible (Medicare + Medi-Cal) seniors as an alternative to nursing home placement. Major PACE providers: On Lok (San Francisco), SCAN (Los Angeles/Southern CA), InnovAge (Sacramento), CalOptima PACE (Orange County), and many others. PACE covers all costs for dual-eligible participants.
How to Apply for California Nursing Home Medicaid
California Department of Health Care Services (DHCS)
Phone: 800-952-5253 · Website: dhcs.ca.gov
- 1Step 1 — Contact your county DHCS office or apply online at benefitscal.com. In Los Angeles County, call 866-613-3777. For Medi-Cal nursing home coverage, applications are also accepted at the nursing facility's social worker office.
- 2Step 2 — The nursing home typically assists with Medi-Cal applications for admitted residents. A facility-based Medi-Cal application is the most common pathway for nursing home coverage.
- 3Step 3 — Gather required documentation (see below). As of 2024, you no longer need to document assets/savings for Medi-Cal nursing home eligibility — income documentation is the primary requirement.
- 4Step 4 — Medi-Cal determination typically takes 45 days (90 days if disability determination needed). Most nursing homes admit on 'Medi-Cal pending' status — confirm this policy with each facility before admission.
- 5Step 5 — Once approved, Medi-Cal pays the facility directly. The resident pays a monthly 'share of cost' — typically most income minus a personal needs allowance ($80/month).
Documents Required for California Nursing Home Medicaid
Gather these documents before starting your application. Missing documents are the #1 cause of application delays.
- Proof of California residency (utility bill, lease, government mail)
- Birth certificate or proof of age
- Social Security card and most recent SSA award letter
- Medicare card (if applicable)
- Proof of all income: Social Security, SSI, pension, VA benefits, rental income
- Recent tax returns (prior 2 years) — may be requested
- Bank statements for the past 3 months (asset test eliminated as of 2024, but income verification needed)
- Proof of U.S. citizenship or qualifying immigration status
- Physician's certification of need for nursing home level of care
* Gather 5 full years (60 months) of bank statements for ALL accounts. This is the single most common documentation gap in Medicaid nursing home applications.
California Nursing Home Medicaid by the Numbers
1,224
Licensed Nursing Homes
97,000
Medicaid Beds
71%
Medicaid Bed %
$11,000
Avg Monthly Cost
Sources: CMS, California Department of Health Care Services (DHCS), 2026 data.
Is There a Waitlist for California Nursing Home Medicaid?
California nursing home Medicaid (Medi-Cal) does not have a waitlist for nursing home level of care — all eligible seniors who need SNF-level care are entitled to coverage.
Find Medicaid-Accepting Nursing Homes in California
Our care advisors can identify nursing homes in California with open Medicaid beds and help you start the application process — no phone call required.
California Nursing Home Medicaid FAQs
Does Medi-Cal cover nursing home care in California?▾
Yes — Medi-Cal (California Medicaid) covers skilled nursing facility care for income-eligible seniors. As of January 2024, California eliminated the asset test — there is NO asset or resource limit for Medi-Cal nursing home eligibility. The income limit is $2,742/month. Seniors above the income limit pay most of their income to the nursing home as a 'share of cost'; Medi-Cal covers the rest. Apply at benefitscal.com or through your county DHCS office.
Did California really eliminate the Medi-Cal asset limit?▾
Yes — California eliminated the Medi-Cal resource (asset) test effective January 1, 2024. Seniors with any amount of savings, property, or investments can now qualify for Medi-Cal nursing home coverage based on income alone. This was a landmark policy change. However, Medi-Cal estate recovery still applies — the state may recover costs from the estate after the recipient's death.
What is the average cost of nursing home care in California?▾
The average cost of nursing home care in California is approximately $11,000/month ($367/day) for a semi-private room in 2026 — among the highest in the nation. San Francisco and the Bay Area average $12,000–$15,000/month. Los Angeles County averages $10,500–$12,000/month. Inland Empire and Central Valley are lower at $8,000–$9,500/month.
How does California PACE work for nursing home alternatives?▾
California has over 40 PACE programs statewide serving dual-eligible (Medicare + Medi-Cal) seniors aged 55+. PACE provides all-inclusive care — medical, home care, day programs, transportation, dental, vision, and medications — at no cost to dual-eligible participants. It's the gold standard alternative to nursing home placement for Californians who need intensive care but prefer to remain at home or in an assisted living setting.
How long does Medi-Cal nursing home approval take in California?▾
Medi-Cal nursing home applications typically take 45–90 days to process. Most California nursing homes accept residents on 'Medi-Cal pending' status during review. Coverage typically backdates to the application date. Los Angeles County applications may take longer due to volume. The nursing home's social worker is usually the best resource for accelerating the application.
What is California's Medi-Cal estate recovery program?▾
California's Department of Health Care Services (DHCS) recovers Medi-Cal costs from the estates of deceased recipients aged 55 and older. Recovery is limited to probate assets — property that passes through a will or intestate succession. Non-probate assets (assets held in a trust, joint tenancy, beneficiary designation) are generally protected from estate recovery. California elder law attorneys commonly recommend revocable living trusts to protect the primary residence.
Related California Medicaid Guides
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