By Shannin Prather
Some consumers of In-Home Supportive Services (IHSS) have a Share of Cost (SOC) for their services. This means the consumer is responsible for paying their provider(s) out-of-pocket for some of the hours they work.
Those with an SOC have a higher income than most individuals receiving Social Security Income (SSI)/Medi-Cal. Depending on the amount of income being received, you may be required to pay a certain amount each month before Medi-Cal will pay for services like IHSS.
The SOC allows people with higher monthly incomes to receive IHSS, if a part of their medical costs are paid by them directly. An SOC is like a private health plan’s monthly deductible. The SOC is usually paid to whichever Medi-Cal approved services are used first during the month. For example, you may need to pay out-of-pocket for your first medical appointment or prescription before Medi-Cal begins to pay for the rest.
Once your IHSS provider(s) has submitted their timesheet, the IHSS program will send a notice letting you know how much of your SOC has been met for the month and how much you will need to pay your IHSS provider(s) as part of your SOC. Once Medi-Cal has determined that the SOC has been met for the month, IHSS will issue your provider a paycheck for the remaining amount owed to them along with a notice of how much you are expected to pay them out-of-pocket.
If you have an SOC and believe it is too high, there are several Medi-Cal programs that can assist you in lowering or removing your SOC. To find out if you qualify for any of these programs, contact your Medi-Cal Eligibility Worker at 1 (877) 962-3633 or email BACClericalPhoneSupport@ssa.sccgov.org.