Medi-Cal's transportation benefit covers rides to medical appointments by wheelchair van, stretcher van, ambulance or ordinary vehicle for members who qualify, and DHCS says most members will not see changes to their coverage. But the rules for keeping Medi-Cal are changing. Under the federal law known as H.R. 1, signed July 4, 2025, many Medi-Cal adults will face new work and community engagement rules and will have to renew their coverage every six months instead of once a year.

The California Department of Health Care Services (DHCS) projects that these changes will cause many people to lose coverage over the next few years, and when Medi-Cal ends, so do the rides. This guide explains who is affected, who is exempt, the key dates, and the steps that keep coverage (and transportation) in place.

For many transport patients: DHCS says the work rules do not apply to adults 65 and older or people on Medicare Part A or Part B, and that people with a disability or a serious physical or mental health condition that keeps them from meeting the rule can be excused, among others. Many people who ride by wheelchair van, stretcher van or ambulance may fall into one of these groups, but do not assume you are exempt: watch the mail and respond to Medi-Cal on time.

Who the New Rules Apply To

Both changes target the "New Adult Group": adults ages 19 to 64 with lower incomes who get Medi-Cal because of their income, not because they are pregnant, have a disability, are in foster care or have Medicare. DHCS describes this group as adults with incomes below 138% of the federal poverty level. California has also extended the work rules to adults with unsatisfactory immigration status who receive full-scope Medi-Cal through state-only funding, even though H.R. 1 does not require it, according to the Legislative Analyst's Office.

The Work and Community Engagement Rules

To keep Medi-Cal, adults who are subject to the rules will need to show that in at least one month since their last renewal they did one of the following, according to DHCS:

When the work rules start

The federal law takes effect January 1, 2027, and DHCS says it applies to all Medi-Cal applications submitted on or after that date. For people already on Medi-Cal, DHCS plans to apply it as their coverage comes up for renewal in 2027; its August 2026 member letter says the rules "will not go into effect until March 2027." Medi-Cal will send a letter to members the rules apply to.

Who is exempt

DHCS lists these groups as not subject to the work rules:

DHCS's member letter is more specific: it says a disability or a serious mental health condition must keep you from meeting the rule. It also adds other reasons a person can be excused, including being a caregiver for someone with a disability or a serious medical or mental health condition, having a serious, complex or ongoing medical condition that keeps you from meeting the rule, being a veteran with a full (total) disability, meeting the CalWORKs work requirement, or receiving CalFresh and not being excused from the CalFresh work program. It also lists short-term reasons that count for a month, such as receiving care in a hospital, nursing facility or psychiatric facility, or traveling outside your area to get treatment for a serious medical condition.

DHCS says it may be able to use information it already has to excuse you automatically, and that it will send a notice if so. If it does not have enough information, you will have the chance to provide it. Your county Medi-Cal office will tell you whether you need to follow the rules or need to show that you qualify for an exemption.

One caution: in its January 2026 implementation plan, DHCS said it would provide more information on the "medically frail" exemption criteria at a later date, and KFF later reported that a June 2026 federal rule adopted a narrower definition of medical frailty than states expected. California is a lead plaintiff in a multi-state lawsuit challenging parts of that federal rule. If you have a serious medical condition, keep records of your diagnosis and treatment and respond promptly to any request from Medi-Cal.

Renewals Every Six Months

H.R. 1 also requires states to check eligibility for the New Adult Group at least every six months. DHCS says that starting March 1, 2027, some members will have their eligibility checked twice a year instead of once:

DHCS says people who are not in the New Adult Group (such as children, adults 65 and older, and people eligible through disability-based pathways), pregnant and postpartum members, American Indian and Alaska Native members, and people under 26 who were in foster care on their 18th birthday stay on yearly renewals. DHCS warns that missing deadlines could result in loss of coverage.

How Many People Could Lose Coverage?

Estimates vary and have changed over time, so it helps to know who said what:

What This Means for Medi-Cal Rides

DHCS's member page says most Medi-Cal members will not see changes to their coverage, and it specifically lists getting rides to appointments as something members can still do. These rules do not change the transportation benefit itself:

The risk is losing Medi-Cal itself. A person who misses a renewal deadline or does not report an exemption can lose coverage, and with it, covered rides to dialysis, chemotherapy, physical therapy and doctor visits. For someone who needs a wheelchair van or stretcher several times a week, a gap in coverage can mean a gap in care. If coverage ends, DHCS says you can reapply for Medi-Cal at any time, and the notice you receive will explain your options, including your right to appeal.

Two more points worth knowing:

How to Keep Your Medi-Cal (and Your Rides)

  1. Update your contact information with your county Medi-Cal office, including your mailing address, phone number and email. DHCS asks members to report changes such as a new address or income within 10 days.
  2. Create a BenefitsCal account at BenefitsCal.com to track notices, upload documents and opt in to text and email messages.
  3. Watch for the yellow envelope. If Medi-Cal needs more information to renew your coverage, it sends a renewal form in a yellow envelope. Return it before the due date online, by mail, in person or by phone.
  4. Respond to any request about the work rules, even if you believe you are exempt. If you are a caregiver or have a serious medical condition, say so and provide what is requested.
  5. Ask your doctor for help with documentation if you need to show a medical exemption. DHCS notes that treatment records for a serious or chronic condition, or a recent inpatient stay, are examples of documentation providers could produce.
  6. Keep going to your appointments. DHCS encourages members to keep their doctor visits and other appointments.
  7. Get help if you need it. Call the Medi-Cal Helpline at (800) 541-5555, find your county office at dhcs.ca.gov/COL, or call the Health Consumer Alliance at (888) 804-3536 for free legal help.

Other Medi-Cal Changes on the Calendar

How West Coast Ambulance Can Help

West Coast Ambulance provides wheelchair and stretcher transportation across Los Angeles, Orange and Kern Counties, and BLS ambulance and critical care transport in Los Angeles and Orange Counties. Covered Medi-Cal rides are arranged through the patient's Medi-Cal health plan or its transportation broker; rides booked with us directly or online are private pay. Before a scheduled trip, our team can check your insurance benefits for free. Call dispatch at 800-880-0556, available 24/7/365. For more on how Medi-Cal rides work, read Does Medi-Cal Cover Medical Transportation?

Frequently Asked Questions

When do Medi-Cal work requirements start?

The federal work and community engagement rules take effect January 1, 2027 and apply to Medi-Cal applications submitted on or after that date. For people already enrolled, DHCS plans to apply them as coverage comes up for renewal in 2027, and its August 2026 member letter says the rules will not go into effect until March 2027.

Who is exempt from the Medi-Cal work requirements?

DHCS lists children, adults 65 and older, pregnant and postpartum people, parents and caregivers of children 13 and younger, people with disabilities, people with serious physical or mental health conditions or substance use problems, people on Medicare Part A or Part B, people recently released from jail or prison, American Indians and Alaska Natives, and former foster youth under 26. DHCS's member letter says a disability or medical condition must keep you from meeting the rule, and it also excuses caregivers of someone with a disability or serious medical condition, among others.

When do Medi-Cal six-month renewals start?

DHCS says six-month renewals begin March 1, 2027 for some adults ages 19 to 64 in the New Adult Group, starting with renewals due in March 2027. Members with renewals due in January or February 2027 switch in 2028, and new applicants start on January 1, 2027. People who are not in the New Adult Group, pregnant and postpartum members, American Indian and Alaska Native members, and former foster youth under 26 keep yearly renewals.

Will Medi-Cal still cover rides to medical appointments in 2027?

DHCS says most members will not see changes to their coverage and can still get rides to their appointments. Non-Emergency Medical Transportation by ambulance, wheelchair van or stretcher van requires a provider's prescription, and Non-Medical Transportation is available to full-scope members with no other way to get to an appointment. The risk is losing Medi-Cal coverage itself by missing a renewal or work-rule requirement.

What should I do if I lose Medi-Cal?

DHCS says you will get a written notice explaining what you need to do before your Medi-Cal ends, including your right to appeal, and you can reapply at any time. For help, call the Medi-Cal Helpline at (800) 541-5555, contact your county Medi-Cal office, or call the Health Consumer Alliance at (888) 804-3536 for free legal help.

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