The above is a famous court case in California. It is important to every person who is now or may be receiving Medi-Cal (MC) to pay for nursing home care. It deals with SOC which stands for “share of cost”. Let me give you an example.
Fred is in a nursing home. He is married to Wilma. He receives Medi-Cal to help pay for his nursing home (SNF) stay. In many cases Medi-Cal does not pay for the entire cost of the SNF. In my example, Fred has a $2,000 SOC. Every month, Wilma writes a check to the SNF for that amount. She does that needlessly.
Because of this court case, Wilma could use her SOC to pay for other needed medical care that would make Fred’s life better. She could use the money for prescriptions, physical therapy, medical equipment, incontinence supplies, specialized medical equipment and much more. The only requirement is that it has to be part of Fred’s care plan and prescribed by Fred’s doctor.
In other words, it does not have to go to the SNF. It can in fact be used to improve his life. Most people simply do not know this can be done, and, in my experience, the SNF never makes this known to the family.
This is why you should ALWAYS use someone who specializes in applying for Medi-Cal and maintaining eligibility. Don’t take no for an answer. For more information contact me for help.