A share of cost is the monthly amount you have to pay for health care before Medi-Cal starts to pay. This is called “meeting your share of cost.” Your share of cost is calculated based on how much money you make. You don’t ever need to meet your share of cost if you do not receive any medical care. If you did receive medical care during the month, you must meet your share of cost before Medi-Cal will pay on your claim.
Not everyone on Medi-Cal has a share of cost. Some people qualify for free Medi-Cal. You can ask your worker if you qualify for any free Medi-Cal programs. You should also talk to your worker if you think your share of cost is too high. You can request a fair hearing if you think your share of cost is wrong.
There are several ways to meet or reduce your share of cost.
• You can plan to get all your health care needs taken care of in the same month, that way you have more chance of meeting your share of cost and having Medi-Cal pay for some of your care.
• You can ask your doctor to prescribe you several months of medication at a time, that way you only pay the cost in one month, and Medi-Cal will pay for any cost of medication over you share of cost.
• You can use receipts of health care you or family members have received and paid for in the month you paid for it, you can do this whether it is a service Medi-Cal would pay for or not.
• You can use unpaid receipts any month to meet your share of cost, but you can use each receipt only once.
• If you are on Medi-Cal because you are over 65 or disabled you can use any premiums you pay for health insurance, such as a Medicare advantage plan or a dental insurance plan, to reduce your share of cost.
For more information about how to meet you share of cost, read HCA’s Meeting Your Share of Cost fact sheet.