How to Reduce the Medi-Cal Share of Cost

Medi-Cal is California's public health care for low income families and adults. It is equivalent to the federal government's Medicaid program. Medi-Cal recipients may have a share of cost depending upon their income and household size. A share of cost is a monthly deductible that the individual must meet before Medi-Cal will pay. It is not a premium. Your share of cost may be reduced when you begin paying health insurance premiums or when your income changes.

Instructions

Family with Earnings

• 1

  Write a note to your representative explaining that your income has changed.

• 2

  Give your representative a recent pay stub that has the lowest gross income. Do not turn in two or more pay stubs, as your average paycheck will be determined by the sum of all checks received. Medi-Cal regulations only require one pay stub. If your income has ceased, you will need to turn in proof that it has ended and that you have applied for unemployment.

• 3

  Wait for a notice of action from your representative stating your new share of cost. Call if you need your share cost reduced immediately.

• 4

  Apply for Healthy Families for children under the age of 18 that have a share of cost. Healthy Families offers affordable low-cost health insurance for children that are below 250 percent of the federal poverty level.

Elderly and Disabled Individuals

• 5

  Ask your representative the amount that you are over-income for the Aged and Disabled (A&D) Medi-Cal Program. This is a special program which gives individuals and couples a zero share of cost if their countable income is less than 100 percent of the federal poverty level.

• 6

  Add the amount you are paying for Medicare Part B. Once your share of cost is reduced to zero, the state will begin paying this premium.

• 7

  Purchase a Medicare supplement or other health, dental or vision insurance. The premium needs to be the sum total of the amount that you are over-income, the Medicare premium plus a $10. cushion.

• 8

  Provide proof of the health insurance premiums you are now paying so that your representative can recalculate your benefits. Note that this process can be tricky. You will need to weigh your individual circumstances to see if it is worth it to you to purchase a Medicare premium or other health insurance.