Medi-Cal Share of Cost and Premium Reduction Calculator
Estimate your monthly Share of Cost and how much insurance premium may reduce it to $0.
Enter 0 if the client is not paying Part B.
Dental, vision, Medigap, Medicare Advantage premium, and similar coverage.
Optional.
Advanced Settings
Monthly Health #Premium - Spenddown Needed
- $1–$84 per month:
Get quotes and enroll dental or vision plan
. - $85–$425 per month: Complete the
- AmFirst Maximum Care Application AmFirst offers premium choices within from $85 to $425
- Applications are processed quickly, and proof of coverage can usually be provided within 24 hours after you submit your application.
- Then you can easily upload (instructions) to BenefitsCal.com
- Just complete the one page application and email [email protected] to us.
- $426–$600 per month:
- A combination of the AmFirst Maximum Care application
- and another qualifying dental or vision premium
- $601 or more: The situation should be reviewed individually before applying. Send us the information below
- Medi-Gap premiums
- The monthly notice of action Share of Cost shown by your county.
- Your county and ZIP code.
- Whether you have Medicare Parts A and B and the premium amounts
- Any premiums you already pay for Medicare Part B, Part D, Medicare Advantage, Medi-Gap, dental or vision.
- Whether the problem concerns future months or previous months.
- Your Notice of Action Sample from the county
- Email Steve Your Share of Cost Information
- Our email is encrypted by PauBox
- Secure Upload
- Email Steve Your Share of Cost Information
Introduction to using Health Premiums to eliminated
Medi Cal Share of Cost
- Medi Cal imposes a share of cost (deductible) for those who get Medi Cal, but earn more than 138% of Federal Poverty Level, $1,836 in 2026 for a one person household.
- Thus, there is a complicated formula for how much you are over the income limit and how much you pay in Share of Cost the amount you pay, before Medi Cal pays anything that month, like a deductible. It's a REAL PROBLEM if you need an IHSS caregiver!
- The easiest way to figure out your share of cost, is to look at your notice of action then double check and find out with our CALCULATOR the share of cost and the amount of extra health coverage you need to eliminate it.
- your county Notice of Action
- Once you know the amount of coverage that you need, scroll down to get your coverage.
- If you have any questions or what more information:
- Email us [email protected]
- Set a Zoom meeting.
- We pride ourselves on not guessing as anything and having references for anything we say.
-
- Aged & Disabled and Medically Needy Medi-Cal Programs pdf Canhr 7/20/2026
- Are you able to work?
- Check out working disabled program 250%
- Medi-Cal Share of Cost 2026: What Changed (and What Didn't) Video Cookman Law
- 00:59 How Share of Cost works
- 04:17 Option 1: Dental, Vision, Medi Gap supplemental insurance
- FAQ's
- View our one page summary for professionals, social workers, attorneys, etc.
FAQ’s
- If you don’t pay Part B Medicare – can you still put that # in the calculator?
- Yes.
- Effective December 1, 2020, counties must disregard income equal to the amount of the individual’s Medicare Part B premium when determining eligibility for the ABD FPL program, regardless of the state’s payment of the premium.
- Chat GBT
- Yes.
- More FAQ’s
References & Citations
- California Medi-Cal rules provide for the deduction of health-insurance premiums in applicable Medically Needy income calculations.
- California Code of Regulations, Title 22, §50555.2
- DHCS Non-MAGI Medi-Cal Guide
- Center for Health Care Rights Plain English How to Eliminated Share of Cost
- CANHR Fact Sheet on Share of Cost
- FAQ’s
- Your county eligibility worker makes the final determination for your individual case.
- California Code of Regulations, Title 22, §50555.2
Optional Deeper Details Below
The practical explanation is above. The section below includes supporting documents, background material, citations, examples, and technical details for readers who want more.
Estimate First — County Verification Controls
This calculator provides an estimate for educational and planning purposes. Medi-Cal eligibility can be affected by household size, earned versus unearned income, spousal rules, allowable deductions, program category and information in the county case file. The county Medi-Cal eligibility worker makes the final determination and should issue a written Notice of Action.
Calculate Share of Cost → Select Premium → Request Verification
Use the calculator to find the monthly premium that may reduce your Medi-Cal Share of Cost to $0.
- 1. Calculate
- Enter the person’s gross monthly income, Medicare Part B premium and any other health-insurance premiums already being paid. Then select Calculate.
- 2. Select Premium
- Use the green amount labeled “Amount needed in premiums to reach $0 Share of Cost.” That is the number to compare with the premium choices below.
- 3. Request Verification
- Before applying, send Steve the calculator results and the Share of Cost shown on your county Notice of Action.
- Better yet, send a copy of the county Notice of Action
- Steve can review the proposed premium amount and explain what proof may need to be submitted to Medi-Cal.
- Before applying, send Steve the calculator results and the Share of Cost shown on your county Notice of Action.
Which Calculator Number Should You Use?
The calculator may show two very different numbers. They answer two different questions.
- The green number — “Amount needed in premiums to reach $0 Share of Cost”
- Use this number when reviewing the insurance-premium choices below. It estimates the additional monthly premium that may reduce countable income to the applicable ABD-FPL limit.
- The blue number — “Estimated monthly Share of Cost”
- This estimates the traditional Medically Needy Share of Cost calculation. A person whose countable income is within the ABD-FPL limit may qualify for $0 Share of Cost even though this larger traditional calculation is also displayed.
Important: Do not purchase insurance based solely on the blue Share of Cost number. Compare the premium choices with the green amount, and request verification before applying.
Step 3 — Request Verification From Steve
Before applying, send Steve enough information to compare the calculator result with your county paperwork and the available premium choices.
Please include:
- The green “Amount needed in premiums to reach $0 Share of Cost.”
- The monthly Share of Cost shown on your county Notice of Action.
- Your county and ZIP code.
- Whether you have Medicare Parts A and B.
- Your Medicare Part B premium and any other insurance premiums you already pay.
- Whether the issue concerns future months, previous months or both.
- A copy of the relevant county Notice of Action, when available.
- Center for Health Care Rights – How to eliminate Share of Cost
For your protection: Do not email your Social Security number, bank-account number or credit-card information.
Email Steve for Share of Cost Verification
Email is the best way to reach Steve.