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1. Share of Cost, Who pays for IHSS? Share of Cost, Who pays for IHSS?...
2. SOC, Who pays for IHSS? In-Home Supportive Services (IHSS) are financed by state, county, and federal funds. Depending on your countable income, you may have to pay for a portion of the cost of services. This is known as share of cost. If you work, you may qualify for no-cost IHSS even if you think you have to pay a […]...
3. Share of Cost, Understand Medicare’s requirements for post-hospital care. Share of Cost, Understand Medicare’s requirements for post-hospital care....
4. Share of Cost is calculated independently for CMSP and Medi-Cal SOC policy also applies to County Medical Services Program (CMSP) providers and subscribers. Share of Cost is calculated independently for CMSP and Medi-Cal, however, the same subscriber income is included in both calculations. Therefore, the same medical expenses may be used to clear SOC for both programs.  Providers may apply the same services used to […]...
5. California’s Anti-Psychotic Drug Collaboration Uncovers Disturbing Truth of Illegal Drugging in Nursing Homes California’s Anti-Psychotic Drug Collaboration Uncovers Disturbing Truth of Illegal Drugging in Nursing Homes...
6. Share of Cost Case Summary Your Medi-Cal case has been affected by a lawsuit called Sneede v. Kizer.  This lawsuit limits which family members may use medical expenses that are not billed to Medi-Cal to meet their family’s Share of Cost. If you are a spouse or a parent, you have the choice of listing your medical expenses in any […]...
7. Share of Cost in California What is Share of Cost? “Share of Cost” is the amount you agree to pay for health care before Medi-Cal starts to pay. This is called “meeting your share of cost.” Your Share of Cost is a set amount based on how much money you make. You only need to meet your Share of Cost […]...
8. How long before applying for Medi-Cal can a person transfer assets? The Medi-Cal “Look-Back” period in California is 30 months. “Transfer” means an outright gift or a “sale” made at less than “fair market value.” If a disqualifying transfer of property is made, Medi-Cal will calculate the period of ineligibility for nursing facility level of care. It will be the number of months resulting when the […]...
9. Roundup: In Oregon, New Gov. Kitzhaber Vows To Change State’s Health Care Delivery System; In Ariz., 2nd Person Denied Transplant Coverage Dies Roundup: In Oregon, New Gov. Kitzhaber Vows To Change State’s Health Care Delivery System; In Ariz., 2nd Person Denied Transplant Coverage Dies...
10. State of California Dental Insurance State of California Dental Insurance ...
11. Medi-Cal Claims: A frequent cause of claim denials by Medi-Cal is due to incorrect recipient admission A frequent cause of claim denials by Medi-Cal is due to incorrect recipient admission and discharge dates and/or incorrect patient status codes submitted by providers. Erroneous “from-through” dates or patient status billed by one provider and paid by Medi-Cal can result in the denial of correct claims billed by another provider. This often occurs between […]...
12. Where can I get more information on Medi-Cal Eligibility? You can find more information by downloading a copy of “Before You Buy,” found on the Partnership’s web site. This document, which provides an explanation of asset protection and Medi-Cal Eligibility rules, must be provided to consumers when long-term care presentations are made, in compliance with Partnership regulations. “Before You Buy” is updated annually with […]...
13. What property/assets are allowable for Medi-Cal? The Medi-Cal program determines eligibility for benefits on a “means” tested basis. If a Medi-Cal applicant’s property/assets are over the Medi-Cal property limit, the applicant will not be eligible for Medi-Cal unless they lower their property/assets according to the program rules. The Medi-Cal eligibility worker looks at how much an applicant and their family has […]...
14. Share of Cost, How do I Find out if I Qualify? Share of Cost, How do I Find out if I Qualify?...
15. Can a nursing home resident give away their income, or does it need to be spent on medically necessary care? Let us say a person is in a nursing home and wants to give their grandchild $50 for their birthday. Can they do that? There is currently no transfer of income penalty in California. However, a nursing home resident’s income must be used to meet their SOC, or Medi-Cal will pay for NO services during that month. The nursing home resident is allowed only $35 for personal needs. It is fine if he/she wants to give their $35 away, […]...