By CalNews360 Staff
August 20, 2026
Thousands of California families are facing uncertainty over assisted-living coverage after Health Net announced plans to discontinue benefits that currently help pay for assisted living for some Medi-Cal members.
The change could affect approximately 3,500 Medi-Cal patients, many of whom are older adults and people with cognitive conditions such as dementia, according to reporting by CalMatters.
For families already struggling to afford long-term care, the development raises a difficult question: What happens when an older family member’s assisted-living coverage disappears?
Why this matters to California families
Assisted living can be extremely expensive, particularly for older adults who need help with daily activities but may not require the level of medical care provided by a nursing facility.
For some Medi-Cal members, coverage can make the difference between remaining in an assisted-living community and having to find another living arrangement.
Health Net’s decision has therefore raised concerns among senior advocates and families who worry that some residents could lose their housing or be forced into less appropriate care settings.
Who could be affected?
The change involves members whose assisted-living services are currently covered through certain Medi-Cal arrangements involving Health Net.
CalMatters reported that Health Net, along with CalViva Health and Community Health Plan of Imperial Valley, has notified the state of plans to discontinue assisted-living benefits.
Many of the affected residents are older adults, and some have significant cognitive or care needs.
That makes the transition particularly complicated because finding another suitable place to live and receive care can take time.
Why is Health Net ending the benefit?
Health Net has told state regulators that changes in how members are using assisted-living services have contributed to the decision.
According to documents reported by CalMatters, the insurer said more members were moving directly from their homes into assisted living rather than moving from nursing facilities, changing the financial equation for the program.
The insurer has also pointed to changes in state program guidelines.
However, advocates for seniors have raised concerns about whether adequate protections are in place for people who could lose their current arrangements.
Families are worried about what happens next
The biggest concern is not simply losing a benefit.
It is what happens after the benefit ends.
Senior advocates and assisted-living providers have warned that some residents may have nowhere affordable to go if their coverage is terminated.
CalMatters reported that some facilities have already seen residents arrive at emergency departments after coverage problems, raising concerns about hospitals becoming a temporary destination for people who primarily need stable housing and supportive care.
That situation could create additional pressure on families, hospitals and long-term-care facilities.
What should families do?
Families who believe a loved one may be affected should not wait until coverage ends to start asking questions.
They should contact the health plan and assisted-living provider and ask:
- Is the resident’s current assisted-living benefit being terminated?
- What is the expected end date?
- Will the member receive written notice?
- What transition assistance is available?
- Can the family request an extension?
- What alternative care arrangements are available?
- What appeal or complaint options are available?
CalMatters reported that Health Net is required to provide members with at least 30 days’ notice before terminating the service.
Families should keep copies of notices, correspondence and medical documentation related to the resident’s care.
Why this is bigger than one insurance decision
California has millions of older residents, and the state is already facing growing demand for affordable long-term care and assisted-living services.
The dispute highlights a broader challenge: how to provide stable housing and appropriate care for older adults who cannot safely live independently but may not need a nursing home.
For families dealing with dementia or other conditions that require daily assistance, sudden changes in coverage can be especially difficult.
The bottom line
Health Net’s planned termination of assisted-living benefits for certain Medi-Cal members is creating uncertainty for thousands of California families.
The immediate priority for affected families is to find out whether their loved one is covered by the change and what alternatives or protections may be available.
The situation is still developing, and state officials, health plans, providers and advocates are expected to face increasing pressure to explain how affected residents will be protected during the transition.
Source: California Department of Health Care Services and reporting by CalMatters.
Image note: The image used with this article is AI-generated for illustrative purposes only and does not represent an actual resident, facility, patient, or event.