Do I have to pay for Medi-Cal?

It depends if the following apply:

  • If your income is less than Medi-Cal limits for your family size, you will receive Medi-Cal services at no cost to you.
  • If your income is more than Medi-Cal limits for your family size, you will have to pay a certain amount only in the month you have medical expenses. The amount that you pay is called your share of cost (SOC). When you pay or promise to pay that amount, we say that you have met your SOC. Once you have met your SOC, Medi-Cal will pay the rest of your covered medical bills for that month. For example, if your SOC is $50, you must first pay or obligate (obtain your providers agreement to make payments on the SOC) $50. Your provider will enter the amount you paid or obligated into the Department’s database. Your case will certify when the amounts you paid or obligated equal the amount of your share of cost. Once your share of cost is certified; providers checking your eligibility will advised that you are eligible and covered services may now be billed to the Medi-Cal program. Please note, expenses incurred by ineligible members of your family may be used to meet the share of cost of eligible members.
  • Add-If your income is more than Medi-Cal limits for you family size, you will be referred to Covered CA to select a health insurance plan.

If one spouse lives in a nursing home, Medi-Cal allows the spouse remaining in the home to keep all of the income he/she receives in his/her name regardless of the amount. You can find more information on the Medi-Cal Information Notice 007 (English) and 007 (Spanish). 

Show All Answers

1. How do I apply for Medi-Cal?
2. How long does the Medi-Cal application process take?
3. Do I have to pay for Medi-Cal?
4. What benefits does Medi-Cal provide?
5. I have Medicare. Can I apply for Medi-Cal also?
6. Can I get help from Medi-Cal with Medicare costs?
7. What services does Medi-Cal cover?
8. Is there a special program for children and pregnant women?
9. What is the Child Health and Disability Prevention (CHDP) Program?
10. What is the Medi-Cal Access Program (MCAP)?
11. What is the Women, Infants and Children Supplemental Nutritional Program (WIC)?
12. What is the Family Planning Services Program?
13. Are there county-operated health care programs?
14. What is the California Children Services (CCS)?
15. What is In-Home Supportive Services?
16. More Program Information and Telephone Numbers