How to use Medical Expenses to lower Countable income for Medi Cal Share of Cost
Medical Expenses can be used to lower Share of Cost!
To lower your Medi-Cal Share of Cost (SOC), you can use payments for medically necessary services, supplies, and equipment, even if they aren’t covered by Medi-Cal or are from non-participating providers, including doctor visits, prescriptions, dental care, hospital stays, prosthetics, transportation, and sometimes IHSS/in-home care, by submitting detailed receipts and physician orders to your county worker. [1, 2, 3, 4, 5] This is also known as “spend down.” To get to the Medi Cal limit (income chart)
What Counts (Examples)
- Services: Doctor/dentist visits, hospitalizations, mental health, rehab (PT/OT), acupuncture, chiropractic, specialist care, lab tests.
- Medications: Prescription drugs, certain prescribed over-the-counter meds (like insulin, vitamins), but not nutritional supplements.
- Supplies & Equipment: Wheelchairs, oxygen, hearing aids, dentures, eyeglasses, incontinence supplies, special phones for disabilities, medical equipment. our webpage on DME
- Insurance Costs: Your Medicare premiums, visit our webpage health insurance premiums, co-pays, and deductibles (if not covered by Medi-Cal). visit our webpage on Dental premiums.
- Care-Related Costs:
- Transportation: Reasonable costs for travel to medical appointments.
- Lodging: Needed to get medical treatment.
- In-Home Care: IHSS or prescribed home care services beyond standard hours.
- Service Animals: Costs for specially trained animals for the disabled.
- Unpaid Bills: Past, unpaid medical bills can count for future months, and you can get retroactive coverage if your SOC was met in prior months. [1, 2, 3, 5, 6, 7, 8]
- Get much more detail on the Cal Fresh website
How to Get Expenses Applied
- Pay the Provider: Pay for the medically necessary service or item.
- Get Proof: Keep detailed receipts and, if possible, a doctor’s order or prescription.
- Contact Your County: Submit these documents to your county Medi-Cal worker so they can be applied to your Share of Cost. [3, 5, 7]
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Our webpage on How to Upload Medical Expense Proof to BenefitsCal.com
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AI responses may include mistakes.
[1] https://canhr.org/understanding-the-share-of-cost-for-medi-cal/
[2] https://calfresh.guide/medical-expense-deductions/
[3] https://www.chcf.org/wp-content/uploads/2017/12/PDF-ShareOfCostMediCal2010.pdf
[4] https://mcweb.apps.prd.cammis.medi-cal.ca.gov/file/manual?fn=share.pdf
[5] https://dpss.lacounty.gov/content/dam/dpss/documents/en/medical/Share%20of%20Cost%20Flyer.pdf
[6] https://www.dhcs.ca.gov/Get-Medi-Cal/Pages/coverage-for-all.aspx
[8] https://cahealthadvocates.org/low-income-help/medi-cal-for-people-with-medicare/
- California Welfare & Institutions Code §14005.37
- California Code of Regulations, Title 22, §50555
- California Department of Health Care Services (DHCS) – Medi-Cal Eligibility Manual
- BenefitsCal User Guide – Document Upload Instructions
- DHCS All County Welfare Directors Letters (ACWDLs) on Share of Cost
Dental Coverage designed to lower Income for Share of Cost Medi Cal
Visit our main webpage on lowering Share of Cost to ZERO!
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- Main Email to Get a hold of Medi Cal --- [email protected]
- All inquiries related to Medi-Cal, including questions about terminating Medi-Cal coverage, must be referred to the beneficiary’s local county Social Services office.
- • Department of Health Care Services County Listings:
- • Covered California’s Medi-Cal page:.
- • Covered CA Toolkit Medi-Cal Reminders and When to Contact County Social Services:
- guide outlining information that certified enrollers can use when assisting Medi-Cal beneficiaries who may be eligible for and wish to enroll into a Covered California plan.
- dhcs.ca.gov/medi-cal/Contacts
- health care options.dhcs.ca.gov/contact-us
- Medi-Cal Rx Customer Service Center
- Department of Health Care Services Contacts
- [email protected] regarding general Medi-Cal eligibility.
- If the question contains specific details the county or the district office that handles your case must answer.
- Benefits Cal - Enrollment Website
- • Assisting Medi-Cal Eligible Consumers FAQ:
- frequently asked questions and glossary terms to understand the Medi-Cal enrollment process and learn how to seek help for various scenarios.
- California Department of Health Care Services 1-844-253-0883
- How-to Videos
Watch How-to Videos on setting up your account, uploading documents, submitting reports, and more. Benefits Cal.com - Non MAGI Medi Cal 1.916.345.8675
- [email protected] Ms. Leslie Benson
- IHSS In Home Supportive Services
- Ombudsman Webpage
- Phone: 1-888-452-8609
- Email: [email protected]
- The Office of Ombudsman cannot approve/terminate/reinstate Medi-Cal eligibility; alter aid codes, change/update addresses, change/update name or initiate inter-county transfers.
- Complex Questions Assistance
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- Health Consumer Alliance at 1-888-804-3536.
- Disability Rights California at 1-800-776-5746.
- HICAP – Health Insurance Counseling & Advocacy Program
- CA Health Care Advocates – 1-800-434-0222 Volunteer counselors can help you understand your specific rights and health care options
- CA Health Care Advocates – 1-800-434-0222 Volunteer counselors can help you understand your specific rights and health care options
- Medi Cal Consulting Services
- National Center on Law & Elder Rights
- VITA Volunteers Income Tax Assistance
- Bet Zdedek Legal Services
- Medi Cal - Technical Comprehensive Reference Materials
- Our webpage on education, research & tutoring for a fee
- aging.ca.gov/Medicare_& Medi Cal Counseling
- Elder Care locator
- medi helper.com
- Pdf Brochure - I was told their fee is $3k
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Medi Cal - #County Office Lookup
See our Main Webpage on Medi Cal contact information
Non MAGI Medi Cal
- dhcs.ca.gov/ Non MAGI Medi Cal
- Western Poverty Law - Non MAGI Medi Cal
- Benefits Cal How to report a change
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- • Department of Health Care Services County Listings:
IRS Publication 502 pdf * html
Medical & Dental #Expenses
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- Aetna Listing of HSA allowable expense
- Topic no. 502, Medical and dental expenses IRS.Gov
- expenses exceed 7.5% of your adjusted gross income for the year may be deductiblexxx
- Medical Necessity? Our webpage
- The Tax Definition of "Medical Care:" Repository Law.com
- Medical expenses also include amounts paid for qualified long-term care services and limited amounts paid for any qualified long-term care insurance contract.
- Turbo Tax
- Schedule A 1040 Itemized Deductions