Share-of-Cost: When your client pays for IHSS partially out-of-pocket

Most IHSS recipients receive their home care as part of their Medi-Cal benefits. Some people’s income is too high for them to qualify for full coverage of their hours, so they agree to pay a certain amount each month toward their Medi-Cal expenses before Medi-Cal will pay. That amount is called Share-of-Cost (SOC). The SOC may be paid to the IHSS provider, a pharmacy, doctor’s office, or when purchasing other medically necessary goods or services.

How it works

Your client receives an “Explanation of Share-of-Cost” letter the California Department of Social Services that tells them how much SOC they need to pay out of their own pocket during that pay period. It will also appear on your timesheet under “Share-of-Cost” liability. The amount may change from pay period to pay period based on whether your client paid any SOC on other medical expenses. Their SOC liability is what they own you as their IHSS provider.

How to protect yourself from non-payment of SOC

The best way to avoid problems is to know ahead of time if your client has a SOC. It is your right to ask your client if they have a SOC. If they have a SOC they will owe you money directly out of their pocket each pay period for services you provide.

If your client does not pay the wages they owe you, which is their SOC, the Public Authority will not intervene to collect the money and the only way you may be able to get it is by pursuing action in small claims court.

When it comes to SOC, knowledge is power. Always know who is paying you—or not paying you—before you find out the hard way!

 

 

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