How to get Medi-Cal to help pay for a ramp or other home changes

If you or someone you care for has Medi-Cal and needs a ramp, grab bars, a wider doorway or a roll-in shower to stay safely at home, Medi-Cal may help pay. The main path is a benefit your Medi-Cal health plan may offer called "Environmental Accessibility Adaptations" (home modifications). This guide explains, in plain steps, which programs can pay, who qualifies, how to ask, and what to do if the answer is no.

Which Medi-Cal programs can pay for home changes

In-Home Supportive Services (IHSS) doesn't pay for construction, but it can pay for help at home, such as personal care. Many people who need a ramp also qualify. See the CDSS IHSS page. Veterans should also look at the VA grants on our statewide page.

Who qualifies

• You need Medi-Cal. Community Supports come through Medi-Cal managed care plans. HCBA asks for full-scope Medi-Cal, or qualifying under a special rule called institutional deeming.
• The change has to keep you out of a nursing home. All of these programs are for people who would otherwise be at risk of needing nursing facility care. DHCS describes these changes as ones a person needs for health and safety, or to live more independently at home, without which they would need institutional care.
• The change has to be medical, not cosmetic. DHCS excludes purely aesthetic work and improvements that help the whole household in general. Additions that make the home bigger are excluded unless they're needed for the adaptation itself, such as a bathroom layout that fits a wheelchair.
• Your plan has to offer it. Community Supports are optional for plans. DHCS's June 2026 list shows that most plans offer home modifications, but not all. For example, it shows Partnership Health Plan of California not offering it in the northern counties it serves. Call your plan to confirm, because offerings can change.

How to ask, step by step

1. Check your plan offers it. Find your county and plan on DHCS's list of Community Supports by plan and county (PDF, June 2026). Look for an X in the "Environmental Accessibility Adaptations" column. You can also use the DHCS Community Supports search tool. If you don't know your plan, it's on your plan card, or check the DHCS directory of Medi-Cal managed care plans.
2. Call Member Services. Use the number on your plan ID card. You can say something like: "I'd like to request the Community Support called Environmental Accessibility Adaptations, or home modifications. I need a ramp at my front door so I can get in and out safely. What do you need from me and my doctor?" DHCS says plans must accept requests from members and from family, caregivers, care managers and community organizations on a member's behalf. If you have an Enhanced Care Management (ECM) care manager, ask them to help.
3. Get a doctor's order. DHCS says the plan needs a written order from your primary care doctor or another health professional that names the item or work you need, such as "grab bars at toilet and in shower." The plan also needs a short written explanation, specific to you, of how it meets your medical needs.
4. Expect a therapy evaluation and a home visit. Unless the plan decides it isn't needed, a physical or occupational therapist evaluates what you need, why what you have now doesn't work, and whether you or your caregiver can use the new item. DHCS says this should usually come from someone with no tie to the company doing the work. Someone also visits the home to check that the change fits.
5. Bids from licensed contractors. When possible, the plan looks for at least two itemized bids. DHCS requires physical changes to be done by a California-licensed contractor and to follow state and local building codes. See our guide on how to hire and verify a contractor.
6. Keep notes. Write down the date you asked, who you spoke with and any reference number. You'll need these if there's a delay or a denial.

What to expect: timelines, limits and wait lists

• About 90 days. DHCS says the assessment and approval should happen within 90 days of your request. It can take longer if the owner's permission is slow to arrive or if you ask for more time.
• A $7,500 lifetime limit for Community Supports home modifications. DHCS sets this total lifetime maximum. The only exceptions it names are if you move to a new home, or if your condition changes so much that more changes are needed. Some plans also limit what they cover. For example, Inland Empire Health Plan's July 2026 guideline (PDF) covers ramps, grab bars, stair lifts, door widening and emergency response systems, and no longer covers accessible bathroom and shower conversions. Call your plan to confirm what it covers.
• The changes are permanent. Before work starts, the plan must tell you and the owner in writing that the changes are permanent and that the State won't maintain, repair or remove them if you move out.
• HCBA has a wait list. DHCS says the waiver reached capacity and has used a wait list since July 12, 2023. Some groups get priority, including people under 21 and people who have lived in a health facility for at least 60 days. Apply anyway to hold your place.
• MSSP is only in counties with an MSSP site, and DHCS lists a statewide enrollment cap of 11,370 people. Call your local site to ask whether there's a wait.
• One waiver at a time. You can be enrolled in only one of these waiver programs at a time.

If you rent

You can still get help. DHCS says home modifications are available in a home you own, rent, lease or live in. If you don't own it, you need the owner's written permission for any change to the building or anything installed, such as grab bars or a stair lift. Ask your landlord early, since a slow reply is one of the reasons DHCS allows past the 90-day timeline. Other programs may ask for the same permission, so ask your care manager what form they use.

If you're told no

1. Get the decision in writing. A denial from your plan should come as a written notice (a Notice of Action). DHCS says members can file grievances and appeals when a Community Support they asked for is denied, and that Community Supports are covered by the State Hearing process.
2. Appeal to your plan within 60 days. CDSS says you generally have to appeal to your plan first, within 60 calendar days of the notice. Call Member Services or follow the steps in the notice. Include the doctor's order and therapy evaluation.
3. Ask for a State Hearing if the plan still says no. CDSS says you have 120 calendar days from the plan's appeal decision to ask. You can also ask if the plan hasn't decided your appeal within 30 days. Request one online or by mail through CDSS, or call the State Hearings Division at 1-800-743-8525. That number also takes requests for a faster (expedited) hearing.
4. Independent Medical Review. If your plan is licensed by the Department of Managed Health Care (DMHC) and denied the request as not medically necessary, you may be able to ask DMHC for a free review by independent doctors after your appeal. Call the DMHC Help Center at 1-888-466-2219 to ask whether your case qualifies. DMHC: frequently asked questions
5. Call the Ombudsman for help. The Medi-Cal Managed Care Ombudsman helps solve problems between members and their plans: 1-888-452-8609, Monday to Friday, 8 a.m. to 5 p.m. If you have both Medicare and Medi-Cal, DHCS also lists the Medicare and Medi-Cal Ombudsperson Program at 1-855-501-3077 (TTY 711).
6. For HCBA, complaints about your care team or services go to your Waiver Agency, and problems with how the agency coordinates your care go to DHCS. See the "HCBA Grievances" section of the DHCS HCBA page.

This page is general information, not legal or medical advice. Deadlines are counted from the date on your notice, so act quickly and keep copies of everything.

Free help

• Area Agency on Aging: 1-800-510-2020 connects you to your local office, which can point you to MSSP and other help. Each county's number is on our county list.
• Medi-Cal Managed Care Ombudsman: 1-888-452-8609.
• Your county page lists local plans, waiver agencies and other programs. Search by ZIP code or city on the home page.
• Other programs that don't require Medi-Cal, such as Rebuilding Together, city repair programs, VA grants and USDA rural repair grants, are on the statewide page.

Sources

All facts on this page come from these official sources, checked in October 2026:

• DHCS: Community Supports Policy Guide, Volume 1 (PDF, updated April 2025), the Environmental Accessibility Adaptations section and the grievances and appeals section
• DHCS: Summary of proposed July 2026 updates to the Policy Guide (PDF)
• DHCS: Community Supports offered by each plan and county (PDF, June 2026)
• DHCS: Home and Community-Based Alternatives Waiver and the waiver comparison flier (PDF)
• DHCS: Multipurpose Senior Services Program and California Department of Aging: MSSP
• CDSS: State Hearing Requests
• DHCS: Medi-Cal Managed Care Ombudsman and DHCS: Help for people with Medicare and Medi-Cal
• DMHC: Frequently Asked Questions

Last verified Oct 2026