By IHSS Staff
October 2017 | 2017 Fall Newsletter
Some consumers of In-Home Supportive Services (IHSS) have a Share of Cost (SOC) for their services. Those with an SOC have a higher income than most individuals receiving SSI/Medi-Cal and, as a result, need to spend some of their monthly income for medical services before SSI/Medi-Cal benefits will pay.
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 the cost is paid by them directly. An SOC is similar to a private health plan’s monthly deductible; the SOC is Medi-Cal’s out of pocket deductible.
The SOC is usually paid to whichever Medi-Cal approved services are used first during the month. For example, if you have an SOC, you may need to pay out of pocket for your first medical appointment or the pharmacy before Medi-Cal begins to pay for the rest. Once your IHSS provider 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 as part of your SOC. Once Medi-Cal has determined that the SOC has been met for the month, the IHSS program (at the State level) will issue your IHSS provider a paycheck for the remaining amount owed.
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, such as:
- 250% Working Disabled Program
- The Medi-Cal 1619b waiver
- 250% Working Disabled Program
- the Medi-Cal Pickle Program
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.