Medi-Cal, CalAIM, and board and care: what pays for what

Medi-Cal can help pay for a licensed board and care home in Los Angeles County, but only for the care services. It does not pay rent. The resident pays room and board from their own income. Once that is clear, the rest of the system makes much more sense.

What changed in 2026

On January 1, 2026, California reinstated an asset limit for older adults on Medi-Cal. It is $130,000 for one person, plus $65,000 for each additional household member. It applies to the Aged, Blind and Disabled program, Medi-Cal with a share of cost, long-term care, and the Medicare Savings Programs.

These do not count toward the limit: the home they live in, one vehicle, household items, and retirement accounts that pay regular distributions. Cash, bank accounts, a second car, and other property do.

For long-term care, Medi-Cal can look back 30 months for assets given away or transferred to qualify. Speak to an elder law attorney before moving money.

Income limits

Free Medi-Cal under the Aged and Disabled program is available up to 138 percent of the federal poverty level: about $1,836 a month for one person and $2,490 for a couple, effective April 1, 2026. DHCS updates the figure each spring. Above that, someone may still qualify with a share of cost.

Route one: CalAIM Community Supports

CalAIM lets Medi-Cal managed care plans pay for assisted living services through Community Supports. The two relevant supports are:

• Nursing facility transition: for members who have lived in a nursing facility for 60 days or more and are willing to live in an assisted living setting instead.
• Nursing facility diversion: for members who are receiving, or meet the minimum criteria for, nursing-facility level of care and want to stay in the community.

Services are delivered through the member's Medi-Cal health plan and the providers it contracts with, including licensed residential care homes.

Route two: the Assisted Living Waiver

The Assisted Living Waiver is available in Los Angeles County. It serves people 21 and older with full-scope Medi-Cal and zero share of cost, whose needs are equal to nursing-home residents, and who can live safely in assisted living. It has a waitlist: as of February 2026, 20,262 people were waiting statewide, according to DHCS. Ask for current wait times.

The room and board rule

For an older adult on SSI and SSP living in a licensed care home, the 2026 payment is $1,626.07 a month. They keep at least $182 a month for personal needs, and the rest goes to the home.

How the referral works

1. Confirm your parent's Medi-Cal status, health plan, and whether they have a share of cost.
2. A referral goes to a contracted Community Supports provider for their health plan.
3. The provider assigns a care navigator, who handles assessment and authorization with the plan.
4. A licensed home in the plan's network is identified that can meet the care level.
5. Once authorized, the resident moves in and pays room and board, and the plan pays for care.

How GentlePlacement fits in

We are not a contracted Community Supports provider and do not work for any health plan. We are a private placement service. When a family qualifies, we submit the referral to the contracted agencies whose care navigators handle authorization, find a home in their network with an opening, and stay with the family until move-in. Our fee is paid by the receiving home, never by the family or the plan.

Take the free Medi-Cal eligibility check.