Calculate Insurance needed to
Eliminate Your Medi-Cal Share of Cost

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
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• 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.
  • • What is Share of Cost & 2 ways to eliminate it Center for Health Care Rights SHIP 4/2025
    •  canhr.org/understanding-the-share-of-cost-for-medi-cal  
    • Medi-Cal Share of Cost Calculator 
  • • 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
• View our one page summary for professionals, social workers, attorneys, etc.

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.
    • Secure Upload
• $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
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  • Email Steve Your Share of Cost Information
    • Our email is encrypted by PauBox
    • Secure Upload

After Enrollment:

Send Proof to the County

After approved enrollment, the county may request a proof-of-coverage letter, premium invoice, effective date and evidence that the premium was paid. Keep copies of everything submitted and follow up with your county worker.

See the complete  proof and BenefitsCal document-upload instructions
.

Sample Proof of Dental Insurance for BenefitsCal

• See Proof and BenefitsCal Upload Instructions
  
• View the AmFirst Application and Current Premium Choices

Share of Cost Testimonials

• “Medi-Cal reviewed my Mom’s case and eliminated her Share of Cost effective February 1. My family is very grateful that this issue was resolved in a very timely manner.” — Don V.
• “Eliminating her Share of Cost will allow her to stay living at our home longer, so it’s very wonderful.” — Mary
• “You are a wealth of knowledge, and I am so grateful to connect with you.” — Carie C.

• See additional  Share of Cost comments and testimonials.
• See  general client testimonials
  
• See this  Reddit discussion about Share of Cost

References & Citations 

• See California Code of Regulations, Title 22, §50555.2
  
  • Determination of Medi-Cal Eligibility and Share of Cost Cornel Law
• 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
  • Aged & Disabled and Medically Needy Medi-Cal Programs
• What happens if you have two or more health or dental policies?  Our webpage
• Videos 
  • Med-Cal FAQ: What Is Share Of Cost?
    • Can I Eliminate It?
  • How Can I Avoid a Medi-Cal Share of Cost?
  • Changes to Medi-Cal Share of Cost Laws in 2025: Good News!
• Bet Tzedek legal aid
• Your county eligibility worker makes the final determination for your individual case.
• More details on AmFirst Plan
  • EOC Evidence of Coverage
    • Chat GBT on Definition of UCR Usual Reasonable & Customary 

Resources 

• ADL Activities of Daily Living
• Long Term Care Nursing & Home Health Care
• Assisted Living Waiver – Long Term Care