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Medi-Cal Renewal Process

Starting January 1, 2026, UIS Medi-Cal members, who do not renew their benefit prior to their redetermination date, will lose access to primary care, preventive care, and specialist services that come with full-scope Medi-Cal.

 

Children (18 and under) will continue to receive full scope Medi-Cal, if eligible, regardless of immigration status.

Help Members Keep their Medi-Cal Coverage

Overview

The Annual Eligibility Redetermination (AER), also known as the Medi-Cal Renewal Process, is currently underway across our state. This initiative is the biggest challenge facing the Medi-Cal program in its history. 

 

The impact on providers across the entire health care system will be significant, potentially resulting in:

  • Increased use of the emergency department for primary care
  • Decreased capacity of bed availability
    • Delays in hospital discharges while awaiting coverage
    • Increased length of stay for patients with delayed preventative or chronic care
  • Increased cost of care
  • Interruptions of ongoing care

2026 Medi-Cal Policy Changes

Important Reminder - Unsatisfactory Immigration Status (UIS)

Effective January 1, 2026, IEHP members with UIS already enrolled in Medi-Cal will continue to receive full scope Medi-Cal coverage, EXCEPT for members 19 years of age or older who allow their eligibility to lapse. They will not be able to re-enroll in full scope Medi-Cal.

 

Additional Policy Change Information:

  • UIS members not renewing their benefit prior to their redetermination date will lose their full scope Medi-Cal coverage.
  • UIS members under 19 years of age are still eligible for reinstatement to full scope Medi-Cal even if their eligibility lapses, as long as they meet all the eligibility requirements.
  • Effective January 1, 2026, adults 19 years of age or older with UIS who are not currently enrolled in Medi-Cal are no longer eligible for full scope Medi-Cal benefits under the enrollment freeze. However, they can apply for Restricted Scope Medi-Cal (emergency care, pregnancy-related care, nursing home care).
  • Effective July 1, 2026, UIS members 19 years of age or older (and not pregnant) will lose dental coverage, except emergency dental care.
  • Full dental coverage for pregnant UIS members and children under 19 will remain in effect, regardless of immigration status. 

 

It will be important for UIS members who are already enrolled in the Medi-Cal program to renew their coverage in a timely manner. UIS members who allow their Medi-Cal eligibility to lapse will be removed from Primary Care Provider (PCP) panel assignment.

 

 

Impact for Providers:

  • Lower capitation payments
  • Lower targeted rate increase (TRI) payments
  • Lower qualifying Global Quality Pay for Performance payments
  • Specialists and Ancillary providers may see a potential decrease in referral volume 

 

However, with every challenge comes opportunities to help our collective health care mission and partnership grow even stronger.


IEHP takes this challenge seriously, and we are committed to helping all IEHP members keep their Medi-Cal coverage and our provider network keep their assigned members.

 

 

To review the full statements made by IEHP CEO, Jarrod McNaughton, regarding the 2026 Medi-Cal eligibility changes, see below:

Resources to Help with the Medi-Cal Renewal Process

The following resources for providers offer more information about the Medi-Cal Renewal Process and tools to help your office proactively engage and encourage all IEHP members to renew their Medi-Cal coverage on time.

 

IEHP will continue to update you as policies related to Medi-Cal eligibility are implemented and share all tools developed to serve you and our members throughout this critical time. 

 

 

Medi-Cal Renewal FAQs, Flyers and Related Information for Providers
Medi-Cal Renewal FAQs and Related Information for IEHP Members

IEHP Eligibility Renewal Support Team

IEHP’s Eligibility Renewal Support team is here to answer calls from Members needing more one-on-one support during the Medical-Renewal process!

 

Please let your patients and our Members know that additional application support is just a phone call away.

We support:

  • Application print outs
  • Assistance in connecting with the appropriate county department
  • Serving as a centralized eligibility hub for all eligibility-related issues (on hold, disenrolled, out of area, etc.)
  • Helping Members update contact information (national change of address, undeliverable address, etc.)
  • Online submissions via BenefitsCal.com

 

IEHP Eligibility Renewal Support Team Hotline

  • Phone and Hours of Operation: 1-888-860-1296, Monday-Friday, 8 am - 5 pm (PST)

Additional Communication from IEHP

IEHP’s Medi-Cal Renewal Process provider-specific notices are available here for your convenience.  

 
You will need Adobe Acrobat Reader 6.0 or later to view the PDF files. You can download a free copy by clicking here.