Welfare and Institutions Code section 14006.4


(a)

The statement required by Section 14006.3 shall be in the following form:
If you or your spouse is in or is entering a nursing facility, read this important message!
You or your spouse do not have to use all your resources, such as savings, before Medi-Cal might help pay for all or some of the costs of a nursing facility.
You should be aware of the following to take advantage of these provisions of the law:
An unmarried resident is financially eligible for Medi-Cal benefits if they meet income requirements. Resources, including property and assets, are not considered in determining Medi-Cal eligibility.
If an unmarried resident is financially eligible for Medi-Cal reimbursement, they are allowed to keep from their monthly income a personal allowance of (insert amount of personal needs allowance) plus the amount of health insurance premiums paid monthly. The remainder of the monthly income is paid to the nursing facility as a monthly deductible called the “Medi-Cal share of cost.”
If one spouse lives in a nursing facility, and the other spouse does not live in a nursing facility, the Medi-Cal program will pay some or all of the nursing facility costs as long as the couple together meets income requirements. Resources, including property and assets, are not considered in determining Medi-Cal eligibility.
If a spouse is eligible for Medi-Cal payment of nursing facility costs, the spouse living at home is allowed to keep a monthly income of at least their individual monthly income or (insert amount of Minimum Monthly Maintenance Needs Allowance), whichever is greater. Of the couple’s remaining monthly income, the spouse in the nursing facility is allowed to keep a personal allowance of (insert amount of personal needs allowance) plus the amount of health insurance premiums paid monthly. The remaining money, if any, generally must be paid to the nursing facility as the Medi-Cal share of cost. The Medi-Cal program will pay remaining nursing facility costs.
Under certain circumstances, an at-home spouse can obtain an order from an administrative law judge that will allow the at-home spouse to retain additional income. That order may allow the at-home spouse to retain more than (insert amount of Monthly Maintenance Needs Allowance) in monthly income, if the extra income is necessary “due to exceptional circumstances resulting in significant financial duress.”
An at-home spouse also may obtain a court order to increase the amount of income that they are allowed to retain. You should contact a knowledgeable attorney for further information regarding court orders.
Note: For married couples, the income limit ((insert amount of Minimum Monthly Maintenance Needs Allowance) in (insert current year)) generally increase a slight amount on January 1 of every year.
This is only a brief description of the Medi-Cal eligibility rules, for more detailed information, you should call your county welfare department. You will probably want to consult with the local branch of the state long-term care ombudsman, an attorney, or a legal services program for seniors in your area.
I have read the above notice and have received a copy.
Dated: ______ Signature: _________”

(b)

The statement required by subdivision (a) shall be printed in at least 10-point type, shall be clearly separate from any other document or writing, and shall be signed by the person to be admitted and that person’s spouse, and legal representative, if any.

(c)

Any nursing facility that willfully fails to comply with this section shall be subject to a class “B” citation, as defined by Section 1424 of the Health and Safety Code.

(d)

The department may revise this statement as necessary to maintain its consistency with state and federal law.

(e)

This section shall become operative on the later of either January 1, 2024, or the date on which the determination of the Director of Health Care Services is communicated in writing to the Department of Finance pursuant to paragraph (2) of subdivision (b) of Section 14005.62, and subject to implementation of Section 14005.62 pursuant to subdivision (d) of that section, and shall remain operative for time periods in which the department has obtained the necessary federal approvals to implement paragraph (2) of subdivision (b) of Section 14005.62 for the applicable population.

Source: Section 14006.4, https://leginfo.­legislature.­ca.­gov/faces/codes_displaySection.­xhtml?lawCode=WIC§ionNum=14006.­4.­ (updated Jul. 10, 2023; accessed Jun. 30, 2025).

14000
14000.01
14000.1
14000.2
14000.3
14000.03
14000.4
14000.05
14000.5
14000.6
14000.7
14000.8
14001
14001.1
14001.11
14002
14002.5
14003
14004
14005
14005.1
14005.2
14005.3
14005.4
14005.5
14005.6
14005.7
14005.8
14005.9
14005.10
14005.11
14005.12
14005.13
14005.14
14005.15
14005.16
14005.17
14005.18
14005.19
14005.20
14005.21
14005.22
14005.23
14005.24
14005.25
14005.26
14005.27
14005.28
14005.29
14005.30
14005.31
14005.32
14005.33
14005.34
14005.35
14005.36
14005.37
14005.38
14005.39
14005.40
14005.41
14005.42
14005.50
14005.60
14005.61
14005.62
14005.63
14005.64
14005.65
14005.66
14005.67
14005.68
14005.70
14005.73
14005.75
14005.76
14005.84
14005.85
14005.88
14005.89
14005.95
14005.185
14005.255
14005.271
14005.275
14005.277
14005.285
14005.287
14005.288
14005.401
14006
14006.01
14006.1
14006.2
14006.3
14006.4
14006.5
14006.6
14006.7
14006.15
14006.41
14007
14007.1
14007.2
14007.4
14007.5
14007.6
14007.7
14007.8
14007.9
14007.15
14007.45
14007.65
14007.71
14007.95
14007.705
14008
14008.6
14008.7
14009
14009.5
14009.6
14009.7
14010
14011
14011.1
14011.2
14011.3
14011.4
14011.5
14011.6
14011.7
14011.8
14011.9
14011.10
14011.15
14011.25
14011.65
14011.65a
14011.65b
14011.66
14011.75
14011.78
14012
14012.5
14013
14013.3
14013.5
14014
14014.5
14015
14015.1
14015.2
14015.5
14015.7
14015.8
14015.12
14016
14016.1
14016.2
14016.3
14016.4
14016.5
14016.6
14016.7
14016.8
14016.9
14016.10
14016.51
14016.55
14017
14017.1
14017.5
14017.6
14017.7
14017.8
14018
14018.1
14018.2
14018.4
14018.5
14018.7
14019
14019.3
14019.4
14019.5
14019.6
14019.7
14020
14021
14021.2
14021.3
14021.4
14021.5
14021.6
14021.7
14021.8
14021.9
14021.30
14021.31
14021.33
14021.35
14021.51
14021.52
14021.53
14022
14022.1
14022.3
14022.4
14022.5
14023
14023.7
14024
14025
14026
14026.5
14027
14028
14029
14029.5
14029.8
14029.91
14029.92
14040
14040.1
14040.5
14041
14041.1
14041.5
14042
14042.1
14042.2
Green check means up to date. Up to date

Verified:
Jun. 30, 2025

§ 14006.4's source at ca​.gov