Medi-Cal Renewal Keeps IHSS: What to Do If Medi-Cal Lapses

Don't let Medi-Cal lapse. If it does, fix it within 90 days and tell your IHSS social worker. This guide is for IHSS recipients and the providers who care for them. It explains why a Medi-Cal lapse can put IHSS at risk and what to do about it.

Why Medi-Cal matters for IHSS

IHSS is tied to Medi-Cal. When Medi-Cal ends, IHSS can be affected. One way this happens is a missed renewal: the recipient does not complete the Medi-Cal renewal.

This guide is general information. The county decides each case. This page is not affiliated with CDSS, DHCS or any county.

What the rule says

State guidance (ACL 12-36) sets two paths. If Medi-Cal ends because the recipient did not complete the renewal, the county terminates IHSS services. If Medi-Cal ends because the recipient's circumstances changed, the recipient should be considered for state-funded IHSS-Residual.

The guidance is from July 24, 2012. We found no later document that replaces it.

What happens in practice

Counties do not all handle a lapse the same way. According to the Legislative Analyst's Office (LAO), some counties end IHSS, and others leave the case in IHSS-Residual. To learn what applies in your case, ask your county.

The LAO also reports that if Medi-Cal is restored within 90 days of termination, the state can claim federal funds retroactively. This does not mean providers will be paid for the gap. Do not count on back pay for the weeks Medi-Cal was off. Ask your county what applies.

How to restore Medi-Cal and IHSS

• Step 1: Complete the Medi-Cal renewal or reconsideration. Contact the county Medi-Cal office and finish it as fast as you can, ideally within 90 days.
• Step 2: Tell the IHSS social worker. Do it as soon as the Medi-Cal step is done, and ask about reinstatement. The county decides the outcome.
• Step 3: If an IHSS termination notice arrives, request a state hearing before its effective date. Asking before that date lets aid continue while the hearing is pending. If you lose, you may have to repay that aid.

Under CDSS rules, you have 90 days from the date on the notice to request a state hearing. Do not wait until the end of that window. Requesting before the effective date is what keeps aid in place.

What is coming in 2027

Starting in January 2027, federal rules require renewals every 6 months for the ACA expansion group. The LAO says this raises the risk of a lapse. Watch for renewal mail and respond right away.

A state proposal in the 2026-27 budget would have ended IHSS automatically when Medi-Cal ends for noncompliance. The final 2026-27 budget did not adopt it (RCRC budget highlights; LA County budget summary).

Common questions

Will my provider be paid while Medi-Cal is off?We can't promise that. It depends on what your county does with the case. Ask your IHSS social worker.

Will IHSS be restored once Medi-Cal is back?We can't promise that either. Tell your social worker right away and ask about reinstatement. The county decides.

Where do I renew Medi-Cal? With the county Medi-Cal office. IHSS staff handle IHSS, not the Medi-Cal renewal.

Where can I learn how to apply for IHSS again? See the guide to applying for IHSS.

Sources

• Rule: CDSS All County Letter (ACL) 12-36, page 11, July 24, 2012. No later document that replaces it was found.
• Analysis, not a rule: Legislative Analyst's Office, 2026-27 budget brief on IHSS, March 2026, pages 13 to 14.
• Hearing information: CDSS, General Information Regarding a State Hearing.