Santa Cruz County health officials are informing the local immigrant community about significant changes to Medi-Cal enrollment set to take effect on January 1, 2026. These modifications will particularly impact residents with an Unsatisfactory Immigration Status, who will no longer be eligible for full state-funded Medi-Cal coverage. However, a crucial enrollment window will remain open throughout 2025, allowing individuals in this category to secure coverage before the changes take effect.
Details on Enrollment Changes
According to a release from the county, residents with Unsatisfactory Immigration Status who enroll in Medi-Cal before the end of the year will maintain access to the program beyond January, provided they keep their enrollment status active. Irma Marquez, director of the Human Services Department’s Employment and Benefit Services Division, emphasized, “If you already have Medi-Cal or if you enroll before January, you can stay enrolled in full scope Medi-Cal regardless of your immigration status.”
Marquez further clarified that the new rules will affect those applying for coverage for the first time after January 1, 2026. Existing Medi-Cal beneficiaries can continue accessing a wide range of services, including doctor visits and prescriptions, as long as they fulfill mandatory reporting requirements.
Notably, individuals aged 18 and younger, as well as pregnant residents who are not currently enrolled, will still qualify for comprehensive Medi-Cal coverage after the implementation date, according to the county’s announcement.
Understanding Unsatisfactory Immigration Status
The term Unsatisfactory Immigration Status refers to individuals whose immigration situations do not meet the criteria for full Medi-Cal benefits. This may occur if their status is not recognized or has not yet been verified by relevant authorities, as outlined by the California Department of Health Care Services.
Currently, approximately 95% of Santa Cruz County’s nearly 260,000 residents have some form of health insurance. Local health officials have highlighted the importance of maintaining high insurance rates, which help reduce overall healthcare costs by minimizing the burden of uncompensated care on providers, especially hospitals.
Additional Medi-Cal changes set to take effect in 2026 include a requirement for enrollees with Unsatisfactory Immigration Status to renew their coverage every six months. Furthermore, a new monthly premium of $30 will be introduced, with potential loss of coverage for failure to pay for three consecutive months. Enrollees may regain full-scope coverage without dental benefits if premium payments are made within 90 days.
Connie Moreno-Peraza, director of the county Health Services Agency, stated, “The health of our entire community is a priority for us. We will continue to meet the basic health care needs of our low-income and uninsured residents through our County Health Centers, working alongside community partners to help keep community members informed of changes that may impact their access to or eligibility for healthcare coverage.”
Residents seeking information on local social safety net services can visit santacruzcountyca.gov/Sanctuary.aspx. For inquiries about employment and benefit services, the division can be reached at 888-421-8080. Additionally, details about Medi-Cal dental providers are available at smilecalifornia.org/find-adentist, or residents can call customer service at 800-322-6384. More information about Medi-Cal can also be found on the California Department of Health Care Services website at dhcs.ca.gov/Medi-Cal/Pages/changes.aspx.
