Medi-Cal Share of Cost Program’s Monthly Maintenance Need Level to Rise to 138% FPL in 2025

older father and son smiling - Medi-Cal

California’s 2022-23 fiscal year budget includes spending over $300 billion, $100 billion of which is surplus funds. As summarized in Justice in Aging’s budget analysis, the State is using this surplus to make strong investments in all five goal areas of California’s Master Plan on Aging: Goal 1 – Housing for All Ages and Stages; Goal 2 – Health Reimagined; Goal 3 – Inclusion and Equity, not Isolation; Goal 4 – Caregiving that Works; and Goal 5 – Affording Aging. One of many positive changes in Goal 2 is the significant increase of Medi-Cal Share of Cost Program’s monthly maintenance need level to 138% of the federal poverty limit (FPL).

Currently, an adult who is even just $1 over the monthly income limit for free full Medi-Cal, has to pay over $900 in a Share of Cost before Medi-Cal will cover any of their health care costs in a given month. They are only allowed to keep $600 of their monthly income, known as the monthly maintenance income limit. This income limit is exceptionally low and hasn’t been updated in over 40 years. And it forces low-income older adults and people with disabilities to spend 60% or more of their monthly income towards the cost of their care. This leaves little room for other basic needs such as food, rent, transportation costs, etc.

Under this year’s final budget, however, effective January 1, 2025, Medi-Cal’s maintenance need income limit will be increased to 138% of the federal poverty level. And, the limit will increase each year with the cost of living adjustments. This is great news and one we and our partners have been advocating for for decades. It will significantly decrease people’s struggle to meet basic needs and increase their quality of life.

This change is subject to a budget appropriation and California Health Advocates, together with our partners, will continue to monitor the situation, keep you posted and advocate for an earlier start date.  

For more information on the budget and its investments in California’s Master Plan on Aging, see our partner’s at Justice in Aging budget analysis.

Karen Joy Fletcher

Our blogger Karen Joy Fletcher is CHA’s Communications Director. With a Masters in Public Health from UC Berkeley, she is the online “public face” of the organization, provides technical expertise, writing and research on Medicare and other health care issues. She is responsible for digital content creation, management of CHA’s editorial calendar, and managing all aspects of CHA’s social media presence. She loves being a “communicator” and enjoys networking and collaborating with the passionate people and agencies in the health advocacy field. See her current articles.