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Joseph, Lawyer
Category: California Employment Law
Satisfied Customers: 5299
Experience:  Extensive experience representing employees and management
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Medi-Cal and PensIon

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My household partner of 18 years is 85 years old, has Dementia/Alzheimers and has been diagnosed as permanently disabled and in need of 24-hour Protective Supervision. We have 4 caregivers taking care of him through 24 hours, paid for by the County as he is low income and on Medi-Cal. I am going to have to notiify Social Services of his increase of $980. each month added to his Soc. Sec. of $1,283. will raise his income too high. But, is his Pension considered income? I understand we don't pay taxes and don't receive a 1099 form. Can the county take away his Medi-Cal? Do you have any suggestions? Thank you..

Hello and welcome to JustAnswer.

I'm very sorry to hear about your partner's situation and hope I can help.

No, a pension payment of $980 added to your partner's social security income of $1,283 will not cause his Medical benefits to stop, but he may have to contribute a nominal amount of money (called his Share of Costs or "SOC" for short) due to his income being above $2,000 a month.

See the information from the DHCS's webpage on the topic here:

  • If your income is less than Medi-Cal limits for your family size, you will receive Medi-Cal services at no cost to you. (Refer to All County Welfare Directors Letter (ACWDL) 11-16 to view the Income Limit Chart.)
  • 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.
  • 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. If that amount is below $2,541per month, then the spouse in the nursing home can give income to the spouse at home to bring the spouse at home up to $2,541 per month. Be sure to ask your county social service agency for an MC Information Notice 007 for more information on income.

The pension amount is still considered income, but it is 'unearned' income, which is why there are no tax forms asssociated with receiving it, such as a 1099 form. Only a portion of it will typically be applied to determine whether your partner will have to pay a nominal amount for Medical services or not.

I hope the above information is helpful to you.

Please let me know if you have any additional questions.

If you're satisfied with my answer, please remember to rate me positively so I get credit for my work!

Thanks and best of luck!

Joseph, Lawyer
Satisfied Customers: 5299
Experience: Extensive experience representing employees and management
Joseph and other California Employment Law Specialists are ready to help you
Customer: replied 3 years ago.

Hello Joseph,

What Medical Benefits? Do you mean IHSS?

What do you mean by contribute a nominal amount of money?

When you mention i.e.g. re $50.00 SOC (you must pay OR obligate (obtain providers agreement to make payments) Can I actually negotiate this?

Is the Provider IHSS and not the caregiver?

When you speak of expenses incurred by ineligible members of family, your talking about me. I have had some expensive dental bills these last 3 years. Can these be used if he gets a SOC?

Hello Joy,

I was actually referencing MediCal about his medical benefits, but the same applies for benefits from IHSS.

The nominal amount of money I was referncing is the "SOC," which would be the nominal amount, which is normally $50 a month, but may be even lower in your partner's case since he'd be barley above an income of $2,000 a month, and some of the pension income may even be discounted.

You may be able to negotiate the payments if they are even required. I was only stating that it is a possibility, but he won't necessarily have to make any contributions (or you won't have to make any contributions) to his own care.

Yes, if he's required to pay an SOC, you can use your financial circumstances to minimize or eliminate payments, including the expensive costs of dental bills that you've had in the past three years.
Customer: replied 3 years ago.

Joseph, thanks for The information. Where do you get your information about SOC NORMALLY being $50.00? I would be extatic if this was true however, I've already been charged $648. for one month a few months ago when Mel was getting disability of $932. a month before it expired and then he got his Pension.

They deducted $648, from 2 caregivers one month and told them to collect it from me which they did. Then, for some lucky reason, they said it was a mistake and I was given papers to apply for re-imbursement of the money which I did but haven't gotten yet.

Can you explain why some of the Pension money might be discounted?

Hello Joy,

It's because 'passive income,' such as pension payments are generally not counted against people for receiving it in governmental programs.

It definitely seems that $648 would be a substantial amount to pay, so it does seem like that would be a mistake, so that should go through once they process your application.

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