Apply for Medi-Cal

Step 1 of 3: Tell us about your household. We'll show your eligibility estimate next, and you only pay if you decide to proceed.

Full legal name *

Date of birth *

Home address *

ZIP code *

We use this to mail your application to the right office.

Phone number *

How many people in your household? *

Count yourself, spouse, children under 22, and anyone you regularly buy and prepare food with.

Total monthly gross income (before taxes) *

Monthly rent or mortgage *

Total monthly housing cost. If you own, include mortgage + property tax + insurance.

Do you pay utilities (heat, electric, water) separately from rent? *

Number of children under 18 *

Anyone in the household 60+ or has a disability? *

Citizenship or immigration status *

Most benefits are available to US citizens and lawful permanent residents. Your status is not shared with immigration authorities.

Email (for receipt + status updates) *

We send a confirmation when your application is mailed. We do not sell or share your email.

You'll only pay if your eligibility looks good. Price for this application: $60.