Medi Cal Share of Cost Calculator

• Hi,   Most people that we help have been given an amount that they need to spend from their Medi Cal Social worker.  The information on this webpage will give you an understanding of how the number came about or how to double check the number.
• CHCF explanation SOC Share of Cost Rev December 2017
  • Includes cost calculation worksheets  It’s the most Plain English explanation I’ve found!
  • CANHR understanding share of cost for Medi Cal
  • IHSS explanation
• Is the amount in Step 13 equal to or less than $1,801 effective 4/1/2025 ^Canhr * ^{Covered CA Income Chart}     That amount is 138% of the FPL.
  • If yes, then you qualify for Medi-Cal with no share of cost.
• Covered CA Chart for 138%  & 250% FPL
  • A few years ago, California state officials agreed to change the $600-a-month allocation for other needs to match 138% of the federal poverty level.
• Aged & Disabled Federal Poverty Level Medi-Cal (A&D FPL).
  If you are aged or disabled, and are not eligible for SSI, you may be able to get Medi-Cal through the Aged & Disabled Federal Poverty Level (A&D FPL) program. You must:
  • Be either aged (65+), or disabled (meet Social Security’s definition of disability, even if your disability is blindness)
  • Have less than xxx  in countable monthly income for an individual ($xxx  for a couple).
    • canhr.org/aged-disabled-medi-cal-program/
    • Our webpage on Aged & Disabled
• If you are single and live on your own, follow the steps above to figure out if your countable income makes you eligible for A&D FPL Medi-Cal. If you live with others, you should use DB101’s Benefits and Work Estimator.
• Find your total countable income using Social Security’s rules.  ^{DB 101}

How much  do  I have to spend to eliminate share of Cost?

• • Yeah, it’s very confusing.  Please scroll down and read everything.  Send us your paperwork and we can review, [email protected]
  • Log into Benefits Cal.org and see if you can find the information there.
  • Check with your Medi Cal Social Worker
    • Bet Tzedek Free Legal Aid
  • See the worksheets below
  • Send us your  NOTICE OF ACTION, all documents, etc. from Medi Cal
  • Understanding the Shared Monthly Cost for Medi-Cal  CANHR
    • The most common way to reduce or avoid a shared monthly cost is to purchase supplemental health insurance policies to lower countable income, such as supplemental dental, vision, or a Medicare Part D prescription drug plan.
    • See above for more. It’s important to note that not everyone can purchase these plans. The monthly cost of these health insurance plans lower your countable income, which may help you qualify for Medi-Cal with no shared monthly cost.
    • 

Footnotes * ^Wikipedia * ^Investopedia *  ^{Merriam – Webster} *  ^{Things to know about Share of Cost} * ^HICAP *

Share of Cost: “A person’s or family’s net income in excess of their maintenance need that must be paid or obligated toward the cost of health care services before the person or family may be certified and receive Medi-Cal.” ^{22 CCR § 50090  * Western Poverty Law *}