Cost of medi cal

CANHR is a private, nonprofit 501(c)(3) Aged & Disabled ...

Martha is eligible for Medi–Cal at no Share of Cost through the A&D FPL program, because her countable monthly income is below the $1,271 eligibility threshold. Example 2: Married Applicants, Earned and Unearned Income SAM AND ROSE ARE MARRIED, and both of them are applying to Medi-Cal.

November 5th,2019

Share-of-Cost - California Department of Social Services

What is a Share-of-Cost? Most people receive IHSS as a part of their Medi-Cal benefits. Depending on the amount of income received, some people must agree to pay a certain amount each month toward their Medi-Cal expenses, before Medi-Cal will pay. The money that must be paid before Medi-Cal will pay is called a Share-of-Cost (SOC).

http://www.cdss.ca.gov/agedblinddisabled/res/FactSheets/IHSS_Share_of_Cost_Color.pdf

November 5th,2019

CANHR is a private, nonprofit 501(c)(3) Aged & Disabled ...

Martha is eligible for Medi–Cal at no Share of Cost through the A&D FPL program, because her countable monthly income is below the $1,271 eligibility threshold. Example 2: Married Applicants, Earned and Unearned Income SAM AND ROSE ARE MARRIED, and both of them are applying to Medi-Cal.

http://www.canhr.org/factsheets/medi-cal_fs/PDFs/FS_Community-Based-Medi-Cal-Programs.pdf

November 5th,2019

Share of Cost Medi-Cal

Overview of Share of Cost Medi-Cal Under share of cost Medi-Cal, beneficiaries must incur a predetermined amount of health care expenses each month (their “share of cost”) before Medi-Cal begins to offer assistance for that month. When the share of cost has been met, Medi-Cal will pay for any additional covered expenses for the month.

https://www.chcf.org/wp-content/uploads/2017/12/PDF-ShareOfCostMediCal2010.pdf

November 5th,2019

Medi-Cal Provider Training 2019

Medi-Cal services based upon potential third party liability. If the recipient elects to seek service not covered by Medi-Cal, Medi-Cal is not liable for the cost of those services. To establish Medi-Cal’s liability for a covered Medi-Cal service, the provider must obtain an acceptable denial letter from the OHC entity.

https://files.medi-cal.ca.gov/pubsdoco/outreach_education/workbooks/mcr_2019.pdf

November 5th,2019

Share of Cost (SOC) (soc bb) - Medi-Cal

Share of Cost Description Some Medi-Cal recipients must pay, or agree to be obligated to pay, a monthly dollar amount toward their medical expenses before they qualify for Medi-Cal benefits. This dollar amount is called Share of Cost (SOC). Example: A Medi-Cal recipient’s SOC is similar to a private insurance plan’s out-of-pocket deductible.

https://files.medi-cal.ca.gov/pubsdoco/outreach_education/workbooks/modules/bb/soc_bb.pdf

November 5th,2019

“medically needy.” CALIFORNIA MEDI-CAL SPEND DOWN

California Medi-Cal Spend Down www.schomerlawgroup.com 6 A single individual is allowed to have up to $2000 in cash and investments, as well as a primary residence, if they plan to return to it.

https://www.schomerlawgroup.com/wp-content/blogs.dir/201/files/2016/02/California-Medi-cal-Spend-Down.pdf

November 5th,2019

Medi-Cal Rx - Transitioning Medi-Cal Pharmacy Services ...

Medi-Cal Rx will not change: o The scope of the existing Medi-Cal pharmacy benefit o Provision of pharmacy services in an inpatient or long-term care setting, regardless of delivery system o Existing Medi-Cal managed care pharmacy carve-outs (e.g., blood factor, HIV/AIDS drugs, antipsychotics, or drugs used to treat substance use disorder)

https://www.dhcs.ca.gov/provgovpart/pharmacy/Documents/Pharmacy-Carve-Out-Advisory-Group-Presentation_FINAL-071819.pdf

November 5th,2019

Worksheets for Determining Eligibility under the Aged ...

premium of those who qualify for Medi-Cal under a program with no share of cost and also pays the Part B premium of those with a Medi-Cal share of cost of $500 or less. For share-of-cost people, Medi-Cal pays the Part B premium for months the share of cost is met but in the following month. “Return to Main Document” 4 Welf. & Inst.

https://www.disabilityrightsca.org/system/files/file-attachments/545001.pdf

November 5th,2019

What does “Share of Cost” mean? Medi-Cal Fact Sheet

• You should be getting free Medi-Cal, or • Your Share of Cost is too high, or • The county is not allowing you to use one of your bills to meet your Share of Cost. Example: Janet has a $100 Medi-Cal Share of Cost in the months she gets health care services. Last month, Janet’s doctor prescribed bandages and cough medicine for her.

https://www.sfdph.org/dph/files/CBHSdocs/BHISdocs/UserDoc/MediCalSOCFactSheet.pdf