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1. If a person applies for Medi-Cal, can they have a principal residence in another state (outside of California) and still qualify for Medi-Cal? Yes, but the person has to distinguish between “principal residence” and “primary residence”. In other words, they can have a principal residence anywhere, as long as they eventually return to it to live. In order to qualify for Medi-Cal, a person must show that they are presently living in California with the intention to remain […]...
2. The U.S. Department of Housing and Urban Development and the Houston Housing Authority Settle Allegation of Discrimination for Refusing Deaf Resident’s Request for Interpreter The U.S. Department of Housing and Urban Development and the Houston Housing Authority Settle Allegation of Discrimination for Refusing Deaf Resident's Request for Interpreter...
3. Share of Cost Issues Question: What can I do if I have a problem with my share of cost? Reply: You can complain if you think that you have a problem with your share of cost: • If you should be getting free Medi-Cal• If your Share of Cost is too high• The county is not allowing you to […]...
4. SOC: What is a Eligibility Verification Confirmation (EVC) number for Share of Cost Once SOC has been certified, an Eligibility Verification Confirmation (EVC) number is displayed in the message returned by the Medi-Cal eligibility verification system.  Return of an EVC number does not guarantee that a subscriber qualifies for full-scope Medi-Cal or CMSP benefits.  It does, however, indicate that the subscriber qualifies for at least partial services.  Providers […]...
5. Share of Cost, Share of Cost Issues Share of Cost, Share of Cost Issues...
6. Share of Cost – Partnership Policy Covers Question: If a Partnership policy covers a patient’s stay in a private room in a nursing home until policy benefits are exhausted, and the patient transitions into Medi-Cal, with a Share of Cost (SOC), do they have to spend the SOC for services specifically pertinent to the nursing home? Reply: No, the patient can spend […]...
7. Share of Cost – Partnership policy Question: If a Partnership policy covers a patient’s stay in a private room in the nursing home until policy benefits are exhausted, and the patient transitions into Medi-Cal, with a SOC, and the nursing facility intends to transfer them out of their private room and into a semi-private room, can the patient use their SOC […]...
8. 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 […]...
9. If a Medi-Cal applicant’s spouse transfers assets, will that result in any period of ineligibility for nursing home care? Generally, California will not impose any period of ineligibility for nursing home care on the applicant if his or her spouse previously transferred assets. The exception is if the asset/resource transferred originally belonged to the applicant. In that case, a disqualification period will be imposed if the spouse received the assets from the applicant before […]...
10. How to find out if a subscriber must pay a SOC Providers access the Medi-Cal eligibility verification system to determine if a subscriber must pay an SOC.  The message returned by the eligibility verification system includes the SOC dollar amount the subscriber must pay.  The eligibility verification system is accessed through the Point of Service (POS) device, Automated Eligibility Verification System (AEVS), state-approved vendor software and […]...
11. Share of Cost, How Much Is My Share of Cost. Share of Cost, How Much Is My Share of Cost....
12. Share of Cost Clearance Transaction To clear a subscriber’s SOC, the provider accesses the Medi-Cal eligibility verification system, enters a provider number, Provider Identification Number (PIN), subscriber identification number, BIC issue date, billing code and service charge.  The SOC information is updated and a response is displayed on the screen or relayed over the telephone. Several clearance transactions may be […]...
13. How Much Is My Share of Cost. Question: How much will my Share of Cost be? Reply: The more money you make, the higher your Share of Cost is. You can complain if you think there is a mistake and your share of cost is too high. If you can not figure out how much your Share of Cost is, you would […]...
14. 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 […]...
15. Share of Cost, Medical Eligibility Requirements for IHSS? Share of Cost, Medical Eligibility Requirements for IHSS?...