The more money you make, the higher your Medi-Cal Share of Cost is. Some tips on meeting your Share of Cost more easily? 

• Plan to get all non-urgent medical and dental appointments in the same month. Medi-Cal pays for all your care for the rest of that month after you meet your Share of Cost. 
• Ask your doctor to prescribe two to three months’ worth of medicine at a time. Medi-Cal pays for all the medicine after you meet your Share of Cost.
• Use receipts for health items to meet your Share of Cost. You can apply what you have already paid for health items toward your SOC, even if Medi-Cal does not cover what you bought. For example, someone with diabetes might buy alcohol and cotton balls to help inject prescription insulin. This person could apply the cost of the alcohol and cotton balls toward her SOC. Save your receipts and show them to your county Medi-Cal worker. You can only use receipts to meet your share of cost in the month you paid the bills. 

Another Use Full Tip

• Use unpaid medical bills to meet your Share of Cost. These bills can be for health care services you or your family members receive. You will need to prove to Medi-Cal that you have been charged by Asking your doctor or pharmacist to contact Medi-Cal for you or Showing your unpaid bills to your county Medi-Cal worker. Your unpaid bill may be higher than your Share of Cost. If so, you can apply the extra amount to your Share of Cost in a future month. Only unpaid bills can be used for the coming months.

It’s important to note that your Share of Cost resets every month. So, you’ll need to meet it again the following month before Medi-Cal starts paying for your care. Additionally, some services, such as emergency care, family planning, and preventive care, are exempt from the Share of Cost.

As a Medi-Cal member, you might wonder if you have a Share of Cost (SOC). The answer is no; not all Medi-Cal members will have a Share of the Cost. The Share of Cost is a certain amount of money you must pay before Medi-Cal begins to pay for your healthcare services. 

Some Medi-Cal members receive free Medi-Cal and do not have a SOC. To be eligible for free Medi-Cal, you must meet specific income requirements. If you make too much money to qualify for free Medi-Cal, you will have to pay a Share of Cost. 

However, some free Medi-Cal programs do not require paying a SOC. If you are still determining whether you are eligible for free Medi-Cal, you can always check with your county worker. They can provide more information on these programs and help determine your eligibility.

If you have children who need healthcare coverage, they might be eligible for Healthy Families. This low-cost health insurance program is specifically designed for children with a Share of Cost. While it covers fewer services than Medi-Cal, it can be a great option for families who need affordable healthcare coverage. 

If you have any questions about Healthy Families or want to learn more, ask your county Medi-Cal worker for more information. They can help you determine your children’s eligibility for this program and walk you through the application process.

Remember that it’s important to understand your healthcare coverage options and requirements to ensure you receive the care you need. Contact your county worker or our member service line for assistance.

Contact our member service line at 310-534-3444 M-F 8 am-4 pm if you are trying to qualify for a zero share of cost. Our team of experts will be happy to help you understand each plan’s different options and benefits.

Share of Cost: Share of Cost is a program designed to help Californians. Californians with low income and resources pay for their medical expenses. The program is a part of Medi-Cal, California’s Medicaid program. The Share of Cost program requires recipients to pay a certain amount out of pocket for their monthly medical expenses before Medi-Cal begins to pay.

This amount is called “meeting your Share of Cost.” Your Share of Cost is calculated based on your income and expenses, a set amount you agree to pay monthly. Once you meet your Share of Cost for the month, Medi-Cal will pay for the rest of your medical expenses.

It is important to note that you only need to meet your Share of Cost in the months that you receive medical care. If you don’t receive medical care in a month, you won’t have to pay anything towards your Share of Cost.

The Share of Cost program can significantly help those who need medical care but can’t afford it. It allows them to get the care they need without worrying about the high medical expenses. If you are eligible for Medi-Cal, consider enrolling in the Share of Cost program to help manage your medical expenses.

What is a Dental Sealant?

A dental sealant is a thin, plastic coating that is applied to the chewing surfaces of the back teeth, where decay is most likely to occur. The sealant acts as a barrier, protecting the enamel from plaque and acids. It is a safe and effective way to prevent cavities in kids. Dental sealants are usually applied to permanent molars when they come in, around age 6 for the first molars and age 12 for the second molars.

By going to a dentist, a dentist would be able to put on dental sealants to help protect your children’s teeth. However, even knowing this, only about one-third of children ages 6 – 19 have sealants. Cost can be a factor; dental insurance can help control the cost of dental sealants. Many dental insurance plans cover sealants as part of preventive care. You may not have to pay anything out of pocket for the procedure. Without insurance, the cost of dental sealants can vary depending on the dentist and the region where you live. However, the cost of sealants is generally much less than that of treating a cavity. So, having dental insurance and a plan that covers sealants can help many people and their families afford this preventive dental treatment.

Although Gastroesophageal reflux disease (GERD) isn’t directly linked to cancer, it may lead to a more severe condition called Barrett’s esophagus, which may raise your risk of developing esophageal adenocarcinoma.

Research has found people who have more frequent symptoms tend to have a higher risk. But GERD is ubiquitous, so it’s essential to keep in mind that most people who have it don’t develop esophageal cancer, which is very rare—accounting for about 1 percent of all cancers diagnosed in the United States, according to the National Cancer Institute. It’s still a good idea to seek care to be sure your GERD doesn’t develop into Barrett’s esophagus.

How Gastroesophageal Reflux Disease Affects Your Dental Health

Gastroesophageal reflux disease (GERD) can significantly impact your dental health. The acid from the stomach that comes up during an episode of reflux can cause erosion of the enamel on your teeth, leading to tooth sensitivity, discoloration, and even decay. In addition, the acid can also cause inflammation of the gums and increase the risk of gum disease. If you suffer from GERD, talking to your dentist about protecting your teeth and gums, such as using fluoride toothpaste and mouthwash and avoiding acidic foods and drinks, is essential.

Long-term care involves the assistance or supervision you may need when you cannot do some of the basic “activities of daily living” (ADLs), generally eating, continence, bathing, dressing, or moving from a bed to a chair. You might need assistance with ADLs if you suffer from an injury like a broken hip, an illness, a stroke, or from advanced age and frailty. Other people may need long-term care because of mental deterioration, called “cognitive impairment,” which can be caused by Alzheimer’s Disease, other mental illnesses, or brain disorders.

Long-term care is sometimes called “custodial care” or “personal care.” Formal long-term care (the kind of care you must pay for) is provided by skilled and unskilled workers. Unskilled workers are sometimes supervised by qualified medical personnel such as registered nurses. Unpaid family members and friends frequently provide informal long-term care.

Long-term care services can be provided in your home, in a community program like an Adult Day Care Center, in an assisted living facility licensed as a Residential Care Facility (RCF) or a Residential Care Facility for the Elderly (RCFE), or in a nursing home.

Long-term care is not necessarily “long-term.” Some people only need long-term care for a few months, for example, while recovering at home from a broken hip, while others may need care for the rest of their lives.
Source: CA Dept of Ins

What is a Dental Cavity? A dental cavity is a small hole or opening in a tooth due to tooth decay. Tooth decay is caused by bacteria that produce acid, which eats away at the tooth’s enamel and dentin. If left untreated, cavities can lead to more serious dental problems, such as infection or tooth loss. That’s why visiting a dentist regularly and addressing cavities is essential.

No one wants to have a cavity, but they do happen. To treat a cavity, the first step is to remove the decayed part of the tooth. A dentist can offer three choices for decay removal: the “drill,” microabrasion, and laser treatment. This post will address the more traditional method of drill. The handpiece drill remains the technique of choice for removing tooth decay. High-speed handpieces make dental treatment quicker and more comfortable than in the past; however, with the handpiece, you may feel vibrations during the dental treatment.

Why Have Dental Insurance: Having dental insurance before treating a dental cavity can benefit you in several ways. First, dental insurance can help you save money on the cost of the treatment. Without insurance, the price of treating a cavity is high, especially if the cavity requires more extensive treatment, such as a root canal or crown. Second, dental insurance can encourage you to seek regular dental care, which can help prevent cavities from developing in the first place. Finally, having dental insurance can provide peace of mind, knowing that you are covered in a dental emergency or unexpected dental problem.

Limitations and exclusions are terms used in dental insurance policies to describe the specific services that are not covered or are limited under the plan. Limitations are restrictions placed on services covered but with certain conditions or requirements, while exclusions are services not covered by the plan at all. It’s essential to read your dental plan’s limitations and exclusions to fully understand what services are covered, what services are not, and what services may have limitations or requirements. By understanding your dental plan’s limitations and exclusions, you can better plan for your dental care expenses and avoid unexpected costs. Additionally, you can work with your dentist to make the most of your coverage and ensure you receive the dental care you need.

• Medicare may pay for skilled care in a nursing home for a very short period but no longer than 100 days and only when the patient meets all the Medicare requirements for daily professional care. While people get personal care services simultaneously, Medicare will not pay unless there is a need for daily skilled services that only a nurse or therapist can provide. Medicare may pay for some personal care services at home, but again, only if you also need skilled care daily that only a licensed person can provide. For more details, see the Medicare benefits book available from your Social Security office or call the Social Security Administration toll-free at 800-772-1213.
• Medi-Cal (called Medicaid outside California) pays for necessary health care that Medicare does not cover, but only if you meet federal and state poverty guidelines. You can get the most current information about Medi-Cal from your local county Department of Social Services, legal services Program, or an elder law attorney.
• Most people commonly use Personal Resources to pay for long-term care expenses. These funds come from personal income and resources. When family members and friends at home provide care, necessary skilled care such as equipment, transportation, and other costs not paid by Medicare are also produced from the patient’s income or savings. People who use up their assets paying for long-term care are “spending down” and may become eligible for Medi-Cal.
• Long-Term Care Insurance is designed to pay or reimburse covered long-term care costs. Understanding the coverage provided and how benefits will be paid/refunded before you purchase a Long-Term Care Policy is critical. Long-term care insurance is available from insurance companies selling in California and may be cost-effective for you if you have sufficient available income to pay the premiums.
• Source CA Dept of Ins

Question: I am looking for cheap dental insurance in California. All I need is my twice-a-year cleaning and check-ups, and I am looking for an affordable dental insurance plan that will save me money on my preventive dental care.

Reply: I suggest reviewing an HMO dental insurance plan, which runs from $7.95 to $18.95 monthly, depending on the plan. HMO dental insurance plans are generally more affordable, and most provide free preventive dental care.

What is a Dental HMO Insurance Plan?

A Dental Health Maintenance Organization (HMO) insurance plan is a type of dental insurance plan that typically requires you to choose a primary care dentist. This dentist will serve as your primary point of contact for all dental needs and will refer you to specialists within the HMO network if necessary. HMO dental insurance plans usually have lower monthly premiums than PPO (Preferred Provider Organization), but they may have more limited options for dental care providers. It’s essential to review the plan details and network of providers to ensure you can get the care you need at a price that works for you.

Call our office at 310-534-3444. We are happy to review our HMO dental insurance plan options with you.

Want an individual dental insurance plan to help you with the cost of your dental care needs? If you’re looking for a dental insurance plan to assist you with the price of your dental care needs, we can help you find the right one. Many options are available in the market, so we can explore them together and find the one that suits your needs and budget.

How Does Dental Insurance Help You With Your Dental Care Cost?

Dental insurance can help you save money on your dental care costs by covering all or a portion of the expenses associated with routine checkups, cleanings, X-rays, and other preventive services. Depending on your specific dental insurance plan, it may also cover a portion of the cost of therapeutic services, such as fillings, crowns, bridges, and orthodontic treatment. By reducing your out-of-pocket expenses, dental insurance can make it easier for you to maintain good oral health and seek necessary dental care when you need it.

Having Dental Insurance Helps You Visit the Dentist Regularly

Having dental insurance can encourage you to visit the dentist regularly because most dental insurance plans cover the cost of preventive care, such as routine checkups, cleanings, and X-rays. By taking advantage of these covered services, you can maintain good oral health and address any potential issues before they become more severe and costly. Additionally, many dental insurance plans offer incentives for regular checkups and cleanings, such as lower copays or deductibles, which can further encourage you to prioritize your dental health. Overall, having dental insurance can help make dental care more affordable and accessible, making it easier for you to care for your teeth and gums.