Share of Cost Medi-Cal
Fact Sheet No. 4
August 1998
Contrary to common misperception, many Medi-Cal recipients are not on welfare. In addition to covering individuals who receive cash assistance from the government, Medi-Cal offers health care coverage to individuals and families who have incomes too high to qualify for welfare, but too low to cover health care costs. Medi-Cal requires some of these recipients to contribute to their health care by paying a share of the cost of the services they receive.
Share of cost is a term that refers to the amount of health care expenses a recipient must accumulate each month before Medi-Cal begins to offer assistance. Once a recipient's health care expenses reach a predetermined amount, Medi-Cal will pay for any additional covered expenses for that month. Share of cost is an amount that is owed to the provider of health care services, not to the state.
Share of cost is not the same as cost sharing. Cost sharing requires a recipient to pay a set amount or percentage of each health care service received, while share of cost requires recipients to take full responsibility for health care expenses up to a predetermined amount. Share of cost is also not a premium; it is an amount that a recipient is responsible for only during a month in which Medi-Cal's assistance with health care expenses is needed.
The complete fact sheet is available under Document Downloads.