Medi-Cal programs are deprivation, age, and income-based eligibility programs and may have a share of cost involved. Low income households are likely to qualify for zero share of cost Medi-Cal or CMSP programs.  Varying levels of age and income may result in different levels of Share of Cost for individuals, families, and among different household members.  In some families the parent or teenager may have a share of cost while the younger children have none.  A child with both parents in the home may have a share of cost unlike the zero share of cost for a child with an under-employed, absent, deceased, blind, or disabled parent.  

 

Share of Cost is not a monthly premium nor is it a co-pay.  It is the portion that you are responsible to pay first before Medi-Cal or CMSP will begin paying. If you have no medical expenses there is no share of cost and you pay nothing. Share of Cost is monthly and reoccurs each month. 

 

Your Medi-Cal card must be presented to your provider in order to get your paid expenses credited to your Share of Cost.  Once you have met your Share of Cost in a month, Medi-Cal or CMSP will cover the balance.   For example, if your Share of Cost is $50 a month that is all you will have to pay.  If your medical bill is $2550 you will only be responsible to pay that first $50.  Your card will cover the $2,500 remaining balance.  

 

 

NOTE: Medi-Cal and CMSP are good only for approved medical expenses and only where the cards are accepted.  Not all services, procedures, or medicines may be covered. Check with medical providers to be sure they accept the cards and that the services are a covered expense.

 

  

For families who all have a Share of Cost, it is often one shared between them all. One family member or several may have medical expenses, which meet the Share of cost in a month. It is recommended that prescriptions, medical procedures, and appointments all be scheduled early in the same month so that the Share of Cost will be met quicker and only once.  When your Share of cost has been met you could then consider your cards as being free cards for the balance of that month. You could then seek other medical care in that same month and pay nothing more.

 

Share of cost may change as you report changes to family income and circumstances.   Some families or individuals may be over income and may not qualify for Medi-Cal or CMSP.   Higher levels of income may result in a very high Share of Cost ranging from several hundred to several thousand dollars.  In such instances high Share of Cost medical coverage is useful only for major medical expenses.

  

Because Share of Cost reoccurs each month, you must make a Share of Cost payment for each month of medical service.  Until you meet your Share of Cost or make a payment arrangement to do so you will be billed and held responsible for the entire bill.   

 

 

NOTE: For account information, bill balances, and payment arrangements please contact

Sutter Coast Hospital Business Services at 707-464-8894 Monday-Friday 9:00 AM - 4:00 PM