Paying for Senior Care When a Parent Is Not a US Citizen

Assisted living and board and care homes, licensed in California as residential care facilities for the elderly (RCFEs), are mostly paid for privately. The public programs that sometimes help, such as SSI, the Medi-Cal Assisted Living Waiver and CalAIM Community Supports, each have their own rules for people who are not US citizens.

Those rules changed in 2025 and 2026, and more changes are scheduled for 2027. This page states what the agencies' own pages say as of October 2026. It cannot tell you what applies to your parent. Status categories have exact legal meanings, and two parents who both say they have papers can be in very different positions.

Gather your parent's immigration documents, any letters from Social Security or Medi-Cal, and a list of income and savings before you speak with anyone. Then take the questions to the counselors and legal services listed below.

Most people pay no premium for Medicare Part A because they or a spouse paid enough into Social Security through work. CMS says premium-free Part A depends on earnings records, the worker's own or those of a spouse, parent or child. A parent who arrived late in life may not have that record.

A person without enough work credits can buy Part A and Part B, but CMS lists conditions. They must be 65 or older, live in the US, and be either a US citizen or a lawful permanent resident who has lived in the US for 5 continuous years before the month they apply. A parent who received a green card two years ago generally has to wait.

There is also a 2025 federal change. A CMS notice dated October 22, 2026 says section 71201 of Public Law 119-21 limits Medicare entitlement and enrollment to lawful permanent residents, Cuban and Haitian entrants, and people from the Compact of Free Association nations, and that terminations under the new categories will follow later. If your parent has Medicare as a refugee, asylee or parolee without a green card, ask HICAP how this may affect them.

Supplemental Security Income (SSI) is a monthly payment for people 65 or older, blind or disabled, with very low income and savings. In California it can be paid at a higher rate for someone living in a licensed care home, as our guide to SSI in board and care explains. For noncitizens, the Social Security Administration's 2026 spotlight lists these rules:

• Most noncitizens must be in a qualified alien category, such as lawful permanent resident, refugee or asylee, and also meet a condition that allows SSI.
• A permanent resident with 40 quarters of work may qualify, and a spouse's or parent's work can count toward the 40 for SSI.
• A person who entered on or after August 22, 1996 may be ineligible for the first 5 years as a permanent resident, even with 40 quarters.
• Refugees, asylees and some other groups may receive SSI for up to 7 years from the date their status was granted.
• If someone signed an affidavit of support as your parent's sponsor, Social Security generally counts the sponsor's income and resources as your parent's.

Social Security tells applicants to bring proof of status, such as Form I-94 or Form I-551. When SSI is closed only because of immigration status, California has a state program. The Department of Social Services says the Cash Assistance Program for Immigrants (CAPI) gives monthly cash to aged, blind or disabled noncitizens who are ineligible for SSI or SSP solely because of their immigration status. Applicants must be 65 or older, blind or disabled, live in California, meet income and resource limits and meet the program's immigration status rules. You apply through the county social services office, and CDSS says CAPI payment standards match SSI/SSP.

The Department of Health Care Services (DHCS) says that as of January 1, 2026, some adults can no longer sign up for full-scope Medi-Cal because of their immigration status. Its FAQ says adults 19 and older without satisfactory immigration status can no longer enroll in full Medi-Cal. Anyone who already had full Medi-Cal can keep it, as long as they renew on time and still meet the rules. If coverage ends, DHCS says there are three months to sign up again. After that, only restricted-scope Medi-Cal is available, which covers emergency care, pregnancy care and nursing home care.

DHCS's status chart, dated August 2026, shows other changes. Green card holders who have finished the 5-year waiting period keep full Medi-Cal in their health plan. People in the waiting period, people considered PRUCOL and undocumented members move from a health plan to Fee-for-Service Medi-Cal on January 1, 2027. DHCS says Community Supports, the CalAIM services some families use toward assisted living, will not continue in Fee-for-Service. Starting October 2026, some refugees, asylees and parolees move to state-funded coverage until June 30, 2027.

For older adults, DHCS says undocumented members aged 60 and over who had full Medi-Cal by January 1, 2026 can keep it and do not pay the premium planned for July 1, 2027. Since January 1, 2026, Medi-Cal's asset limit for people 65 and older has been $130,000 for one person, through June 30, 2027, according to DHCS. The Assisted Living Waiver guide explains how that Medi-Cal program works.

When benefits are closed or uncertain, most families combine the parent's own income and savings with help from adult children. Homes differ in what they include in the monthly rate, so ask each home for a written rate and what would raise it.

Public charge is a separate worry for many families. DHCS says some benefits, including Medi-Cal, may be considered if public charge applies to a person's case, and that neither DHCS nor county offices can advise on immigration or public charge. Talk with a qualified immigration attorney or a nonprofit legal service before applying if this concerns you.

Help is available. HICAP, run through the California Department of Aging, gives one-on-one counseling on Medicare and long-term care insurance, the Health Consumer Alliance gives free legal help with health coverage problems at 1-888-804-3536 (as listed by DHCS in 2026), and the county handles Medi-Cal and CAPI applications. Our guide to help with senior care costs lists more. Bring these to the first appointment:

• Every immigration document your parent has, with dates of entry and of any status change.
• Any affidavit of support and the sponsor's name.
• Social Security statements or work history in the US, and a spouse's if there is one.
• Current Medi-Cal, Medicare or SSI letters, including renewal dates.
• A list of income, bank accounts and property, here and abroad.

Hamssa Benrekia is a placement specialist in Torrance who helps families in the South Bay and Harbor area find licensed board and care homes and assisted living communities. She speaks English, Arabic and Spanish. She does not give immigration, legal or benefits advice, but she can talk through which homes may fit the budget you have. If your parent is newly arrived, see bringing a parent from abroad who needs care. To start, contact Hamssa. More topics are in the California Assisted Living Placement Guide.