IHSS Income Eligibility 2026: Medi-Cal Limits and What Counts as Income

By the Unified Savers Editorial Team

IHSS eligibility rules are set by California state law and the California Department of Social Services (CDSS). Income limits may change annually. Contact your county IHSS office or SEIU 2015 at 1-877-734-8673 for current information specific to your situation.

IHSS in California is not a stand-alone program — it is funded through Medi-Cal (California’s Medicaid program), which means income eligibility for IHSS is determined by Medi-Cal income rules. In 2026, most adults qualify for Medi-Cal at incomes up to 138% of the federal poverty level (FPL) — approximately $20,120 per year for a single adult, or $41,400 for a family of four. If you qualify for Medi-Cal, you may qualify for IHSS based on functional need. IHSS itself imposes no separate income test beyond Medi-Cal eligibility.

How IHSS and Medi-Cal Income Eligibility Are Connected

IHSS services are paid for by a combination of federal (Medicaid) funds, state funds, and county funds. Because federal Medicaid dollars flow through Medi-Cal, California requires that IHSS recipients be eligible for Medi-Cal — either as a primary beneficiary or through Medi-Cal’s Share of Cost program.

This creates two pathways to IHSS eligibility based on income:

Pathway 1 — Free Medi-Cal (no monthly cost): Individuals with incomes at or below 138% FPL qualify for free Medi-Cal under the Affordable Care Act expansion. No monthly premium or share of cost. If you receive free Medi-Cal, you meet the IHSS income requirement automatically.

Pathway 2 — Medi-Cal with Share of Cost: Individuals with higher incomes may still qualify for Medi-Cal, but they must pay a monthly “share of cost” — similar to a deductible — before Medi-Cal begins covering services. Once the monthly share of cost is met, IHSS services are covered for the remainder of that month. Recipients on Share of Cost must meet their share each month to maintain active IHSS coverage.

Seniors (age 65+) and people with disabilities have additional Medi-Cal pathways with different income and asset thresholds. As of January 2024, California eliminated the Medi-Cal asset test — formerly, recipients had to have less than $130,000 in assets. This change significantly expanded eligibility for older Californians with savings.

2026 Medi-Cal Income Limits by Household Size

These figures represent the approximate 138% FPL thresholds for standard Medi-Cal in 2026. Actual limits are updated annually by the federal government and may differ slightly:

For each additional person, add approximately $591/month. These are gross income limits — see the next section for what types of income count and what is excluded.

What Counts as Income for Medi-Cal IHSS Eligibility

Not all money received counts as income for Medi-Cal purposes. California follows federal Medicaid income counting rules with some state-specific adjustments. Understanding what counts — and what doesn’t — can significantly affect eligibility determinations.

Income that COUNTS toward the limit:

• Wages, salary, tips, and self-employment income
• Social Security retirement benefits (SSA)
• Social Security Disability Insurance (SSDI)
• Veterans’ benefits (most types)
• Pension and retirement income
• Alimony received
• Rental income
• Interest and dividends (some types)
• Unemployment insurance benefits

Income that does NOT count (excluded):

• Supplemental Security Income (SSI) — SSI recipients automatically qualify for Medi-Cal in California
• Child support received (in most cases)
• IHSS wages received as a provider (since 2014, IHSS wages paid to live-in providers are excluded from income by IRS and Medi-Cal rules)
• Most foster care payments
• Value of SNAP/CalFresh food benefits
• Most student financial aid
• Workers’ compensation (in most cases)

Important note for IHSS providers who are also family members: If you are paid as an IHSS provider for a family member in your home, your IHSS wages may be excluded from both federal income tax and Medi-Cal income calculations. This exclusion applies to live-in spouses and parents of minor children receiving IHSS services. Consult your county social services office to confirm how your IHSS wages are counted in your specific household situation.

Income Deductions That Can Lower Your Countable Income

Even if your gross income appears to exceed the Medi-Cal limit, California allows certain deductions that reduce your “countable income” for eligibility purposes:

• Work expenses for people with disabilities: Blind and disabled individuals can deduct certain work-related expenses from income, including transportation, attendant care needed for work, and specialized equipment
• Irregularly received income: Lump-sum income (a tax refund, a one-time payment) may be counted differently than recurring income
• Income of household members: Medi-Cal counts income of the household, but the rules about whose income is included vary by application type

If your income is close to the limit, it is worth requesting a formal Medi-Cal eligibility determination from your county welfare office rather than assuming you don’t qualify.

What Happens If Your Income Exceeds Free Medi-Cal but You Still Need IHSS

If your income is above 138% FPL, you do not automatically lose IHSS eligibility — you may qualify for Medi-Cal with a Share of Cost instead. Here is how it works in practice:

Your county social worker calculates your monthly Share of Cost (SOC) based on your income minus a maintenance allowance. The SOC is the amount you must spend on qualifying medical expenses each month before Medi-Cal begins paying. Once the SOC is met, IHSS services are covered for that month.

For some recipients, the monthly SOC is very high — sometimes nearly equal to their monthly income — making it effectively unaffordable. If you are in this situation, contact your county IHSS office and ask about programs that may help cover the SOC, or consult a benefits counselor through your local legal aid organization.

Reporting Income Changes to Maintain IHSS Eligibility

Once you are receiving IHSS services, you are required to report changes in your income to your county social services office. Failure to report income changes can result in overpayment determinations and potential recovery of payments made on your behalf.

Income changes that must be reported:

• New employment or change in wages
• Receipt of Social Security benefits for the first time
• Beginning or ending receipt of pension or retirement income
• Marriage or divorce (which changes household income composition)
• Any other income increase that exceeds 10% of your previous reported income

Most counties require reporting within 10 days of a change. Annual redetermination of Medi-Cal (and therefore IHSS) eligibility occurs each year, at which time all income information is reviewed.

FAQ

Q: I receive SSI — do I automatically qualify for IHSS?
A: SSI recipients in California automatically qualify for Medi-Cal without a separate income test. This means you meet the IHSS income requirement. However, IHSS is still a functional eligibility program — you must also be assessed by a county social worker as needing in-home assistance with daily living tasks. Income alone does not determine IHSS service hours.

Q: My IHSS provider wages push my household income over the Medi-Cal limit. What happens?
A: IHSS wages paid to live-in providers (including spouses and parents of minor children) are generally excluded from Medi-Cal countable income under both federal and California rules. If you are an IHSS provider living in the same home as the recipient, report your wages to your county and ask specifically whether they are excluded under the live-in provider exemption before assuming you are ineligible.

Q: Can I own a home or have savings and still qualify for IHSS?
A: Yes. California eliminated the Medi-Cal asset test in January 2024. There is no longer a limit on savings, checking accounts, retirement accounts, or home equity for Medi-Cal eligibility. Prior to 2024, the asset limit was $130,000 for individuals. This change made IHSS accessible to many older Californians and people with disabilities who had previously been excluded due to modest savings.

Related Resources on Unified Savers:

• What Is IHSS California — Overview of the IHSS program, who it serves, and how to apply
• IHSS Eligibility Requirements California — Full eligibility rules including functional and residency requirements
• Medi-Cal IHSS Connection — How Medi-Cal and IHSS work together
• IHSS Hours Calculation California — How authorized service hours are determined after eligibility is established