Medicare, Medicaid, Life and Health Insurance/Medicaid share of cost program
Mimo wrote at 2008-10-15 00:10:05
Not true at all! My spouse has Medicaid share of cost for a year now. Here is how it suppose to work, income lets say $1000.00 a month, share of cost $700.00
if you visit 4 doctors in one month and the total exceeds $700.00 medicaid will pay. If your total was $699.00
you pay! If you make any payments out of pocket medicaid will not reimburse your money back. Lets say you had one doctor's visit $200.00 and you paid it, now you have to come up with additional $700.00 share of cost. Lets say you visited 2 more doctors and your bill was $600.00 if you had not paid the $200.00 you had already met your share of cost.But lets say because you paid $200.00 cash to the first doctor you still have
to charge $100.00 to meet the share of cost for that month.
All I can tell you it's a big gimmick we had the same problem. There are some doctors that do accept Medicaid. You have to be careful from Dr. Offices that ask for cash, never pay them cause I did it and I got robbed! I had met the share of cost and they had promised to give me my money back after they receive the money from medicaid, they got their money and kept mine as well!
The only ones that benefit from this system are the Hospitals! It's like goes out of the right pocket in to the left pocket but the penitent never gets the help and the meds they need. But guess what? They call it(HELP)
It is discrimination if you ask me!
You can try take her to Shand's as out penitent they do take that card so called (Medicaid)
I never knew all the years we were paying taxes this was the help they were bragging about.
My God bless you both and keep you safe!
Mike wrote at 2008-12-03 15:08:39
He said it correctly. No Doctors wil accept the share of cost medicaid. We are having the same problem, My wife called the whole phone book and nothing. What is the point of having this insurance if no one will accept it.
JEN wrote at 2009-03-06 00:21:34
I UNDERSTAND HOW THE SHARE OF COST WORKS BUT THERE STILL NEEDS TO BE A DR. THAT ACCEPTS MEDICAID BEFORE YOU EVEN ATTEMPT TO TAKE THE SHARE OF COST FORM IN TO SCHEDULE THE APPT.
WHAT DERMATOLOGISTS ACCEPT MEDICAID??? I HAVE BEEN TRYING TO GET THIS INFO FOR MONTHS NOBODY EVER SENDS IT IN THE MAIL LIKE THEY SAY THEY WILL.
OH AND THE HOSPITALS ALWAYS ACCEPT YOUR MEDICAID SHARE OF COST SO IN 911 GO TO HOSPITAL AND ADVISE THEM OF THE MEDICAID U HAVE...HOSPITAL BILL IS ALWAYS HIGH ENOUGH TO COVER YOUR PART
Ang wrote at 2009-03-23 13:31:22
The share of cost is not an out of pocket expense. It just means you need to accumulate the amount of share of cost (i.e., $500) before the bills are paid. FYI - get a printout of the cost BEFORE you get treatment and take it to the main office for approval THEN go get the work done. Nothing should come out of your pocket. As for providers...still checking on that. Hope this helps.
Sherry wrote at 2009-06-27 13:18:51
there are doctors on a list that medicaid has!! You are correct when you said that you have to pay the amount of cost before medicaid kicks in but the lady needs a doctor that will take this
you have to call medicaid options 18883676554 they should give you a list. That is what I was told yesterday June 26th 2009 that is why i am on here today to see if the list is posted!!!
JOHN DOE wrote at 2009-10-14 19:15:59
Well the MEDICAID "SHARE OF COST IS A BUNCH OF BULL SH*T" I have found that of you go to the HOSPITAL EVERY MONTH and run up that bill really high that it covers your share of cost as long as the hospital bill exceeds your share of cost. Then you will have MEDICAID for the rest of the month but only when they decide to process your HOSPITAL BILL which can take week's "MORE BULL SH*T" after all that, you have no co pays or don't have to pay for med's but the DR's still wont take you B/C of the "SHARE OF COST" that they see on their computers that you don't have an HMO. I think the "SHARE OF COST" is a bunch of bull sh*t again. "POINTLESS" What medicaid doesn't do is take in consideration that you do have bill'S to pay and food to buy...etc...They just go off of your income, more bull sh*t. The medicaid share of cost needs to be vanished and people who need health insurance should have full medicaid with an HMO and "NOT A SHARE OF COST" Maby the DCF workers should try living with a "SHARE OF COST" they wouldn't get no medical help at all. Or would have to debate on paying rent, mortgage,bills,food or just pay medical. Which one is it. Loose your home so you can have Medical help. More bull sh*t. Something need's to happen and that "SHARE OF COST NEEDS TO BE LOWERED OR TAKEN OFF"
elle wrote at 2009-12-28 04:55:00
i also have share of cost..i went to the hospital to the e.r from the advice of my own dr. he stated that they cant refuse and your share of cost will be covered since your stay will almost always cover the share of cost. my share is 2100. the bills was 7000 and 8 months later, i am getting lawyers calling that medicaid still hadnt paid the bill, i a starting to believe that its a sham. there is no such thing when it comes to share of cost. i am also very sick and can not afford a doctor. what to do? im not sure. possibly go to a clinic? im sorry, i feel your fristration.
charistine wrote at 2010-01-05 15:26:47
I have been on Medicaid share of cost in Florida for almost two years, and amazed at how many people do not understand how it works, including those working at the Dr's office or the hosptial. You do NOT have to pay the share of cost out of your own pocket if you meet or exceed the share of cost amount in one bill. The term share of cost does sound misleading as it is NOT like a deductable where you have to pay a certain amount to get benefits. My share of cost is 957.00. If I were to incur a bill for less than that amount before meeting share of cost then yes I would have to pay it. If I acquire a bill equal to or over the 957, then I do not as I have met share of cost. There are ways around this and you have to be proactive. If I were to pay for my monthly prescription meds out of pocket they would cost me about 3,000.00, so on the 1st day on the month I go to Walmart and have them print out a list of all my medications and the actual cost. I then fax the list with the total to my local DCF/Medicaid office showing that the bill from Walmart would exceed my share of cost of 957.00. I also write on the paper share of cost met on such and such date and my case number. Within one business day Medicaid opens up my coverage from that date through the end of the month. Every month I see an internist, a pulmonary dr, an ortho dr, a pain specialist, go to physical therapy, have labs, get meds, have surgery or procedures, etc., and I have NEVER paid a cent for any of it in almost two years. Medicaid will not hold your hand, you have to make sure you meet or exceed your share of cost in ONE bill to get coverage for the rest of the month. If you are not lucky enough to have prescription meds that exceed your share of cost like I do, then there is another way to meet your share of cost and get your medicaid started. If you are ill or in pain, etc go to the ER. Your bill will far exceed your share of cost. Say that you go the er on the 1st of the month for severe back pain or whatever, it will take the hospital about 3-5 days to itemize your bill in the system. Go to the hospitals billing department after they have entered your bill and ask for a copy of the bill. Fax that bill to Medicaid YOURSELF and you will get your coverage opened from the date you were at the hospital through the end of that month. It really is not hard, the problem comes from people NOT understanding what shre of cost means, and assuming it means it is like a deductable that you have to pay. IT is NOT.
jstar1219 wrote at 2010-01-14 01:35:52
Share of cost is not where you pay anything out of pocket it is where if your share of cost is say $90.00 and your bill is $90.01 or more then you are covered by insurance. The hospitals will give you every which way runaround on this though. You have to keep fighting it out.
D wrote at 2010-01-22 20:29:16
The answer above seems to be correct. I myself just moved my family to FL from PA. I worked in NJ for Johnson & Johnson and was laid off, I have never had to worry about medical insurance before either, but now in FL, it proving hard to find work and even harder to find medical insurance for my child, husband and I. We were approved for Medicaid "Share of Cost" which was over $1900/month. I was just shocked. I have called the ACCESS office so many times and spoke to many different people and was not understanding the Share of Cost program until just today. I feel really sorry for anyone moving to FL and needing to use Medicaid. It simply doesn't help families at all.
I Collado wrote at 2010-02-19 19:25:40
He is correct, because I'm in the same position. There is a list of Providers but when you call, nobody take the "share of cost" plan. I have medical necesity too, because I have breast lumps in both breast and I can't find help. I have no job at this time and I need to pay $398 monthly first.
superstar wrote at 2010-04-07 06:52:24
share of cost is a joke, it helps no one and if the government agrees that the children get full medicaid b/c of income, it should only make sense that the parents do seeing they have to work and take care of the children. i hate share of cost bs
JOAN wrote at 2010-04-12 22:51:48
ABOUT SHARE OF COST WITH MEDICAID. IT IS CALLED THE MEDICALLY NEEDY PROGRAM. UNDER DCF MEDICALLY NEEDY ON AOL SEARCH, IT WILL COME UP WITH A PAGE THAT GIVES AN EXPLANATION OF "SHARE OF COST". YOU CAN TAKE YOUR $6000 BILL PAID OR NOT AND FAX IT TO MEDICAID AND YOUR SHARE OF COST IS COVERED. YOU CAN GO BACK THREE MONTHS WITH PAID OR UNPAID BILLS AND FAX THEM TO THEM. FAX NUMBER IS 866-735-2469. ALWAYS PUT YOUR CASE NUMBER ON THE TOP OF EACH SHEET.
ONCE THE BILL IS OVER YOUR SHARE OF COST, YOU DON'T HAVE TO PAY ANYTHING. ALWAYS SCHEDULE YOUR OPERATIONS OR ANYTHING OVER OR NEAR YOUR SHARE OF COST AT THE BEGINNING OF THE MONTH. AFFORDABLE DENTURES ACCEPTS MEDICAID. THEY ARE ALL OVER THE STATE. HEARX ACCEPTS MEDICAID. OSLER MEDICAL CENTER ACCEPTS MEDICAID. BUT LIKE I SAID DO THE BIGGEST EXPENSIVE THINGS FIRST. IF YOUR SHARE OF COST IS $50 AND THE BILL IS 51 DOLLARS THEN THEY PAY THE WHOLE THING. IF IT IS 49 DOLLARS THEN YOU PAY. JUST AN EXAMPLE. GO TO THIS WEB SITE AND GET THE INFO. GOOD LUCK AS I AM GOING THROUGH THIS RIGHT NOW. I WAS TOLD I HAD TO COME UP WITH THE FIRST $1000 AND THEN THEY WOULD PAY THE BALANCE. THIS WAS WRONG AND REALLY MEDICAID FRAUD. A LOT OF PEOPLE HAVE PAID UP FRONT AND THEN THE MEDICAID PAYS THE WHOLE BILL ANYWAY AND THE PATIENT IS OUT HIS SHARE OF COST.
melissa wrote at 2010-05-17 11:26:39
i totally understand were you are coming from.i am on the same thing and my share of cost is 27 dollars ,but that is not the problem,no doctor will see u if you are in the share of cost program. even if you meet your share of cost , they still will not see you! so i am having the same problems trying to find a doctor who takes share of cost.. this has gone so far that i will be righting a letter to the govener to see if i can get any answers!
Eileen wrote at 2010-06-21 13:59:40
I have had the same problem as Erik. i have called several doctors and although they accept straight medicaid they do not participate in the share of cost program. Apparently, these insurances are two seperate programs.
SimplyMe wrote at 2010-07-08 16:06:28
I have the share of cost too and my portion that I am responsible for is $o....which means I am ALWAYS supposed to be covered. The medicaid office has said to tell the docs to run it as straight medicaid but as long as it says share of cost when they run my card (which it does), NO ONE will see me. I've been turned away soooo many times. It's been well over a year since I've been outta my meds and have not found a doctor to see me. It's really very frustrating. I wish you the best of luck!
help wrote at 2010-07-09 02:18:51
call the governers office i did three weeks ago even they are having a hard time finding a doctor to help my husband find a doctor he could be parellized permanetly if he moves the wrong way we have been living with this for four months pain pain pain a piece of bone is stuck in the middle of his siatic nerve pain meds cant block the pain i have been told 27 times that they stop taking share of cost in the last 2-5 months cause of the (new health care plan!!!!!) thank you oboma we were tax payers now on food stamps fix my husband so he can work agin or suport us for the rest of our lifes!!!?
medical billing wrote at 2010-07-09 13:00:59
this is true, however because of the ignorance and misunderstanding of how share of cost works most practices will not accept it even after the share of cost has been met and the medicaid is activated.
Michelle wrote at 2010-07-21 15:16:39
no that is incorrect I have callled medicaid so many times i practically can work there, basically you have to go to the doctor as many times as you can, try to go to the hospital they charge more so you can reach your share of cost if you go over they will cover 100% if you do not go over then your responsible.
Dennis S. wrote at 2010-07-31 16:54:09
I've been on this program for three years and it is difficult to find any doctors accepting "new"medicaid patients.Some of my experience is the docyor or emergency room has to accept or call medicaid to find out if your with the program . Usually it comes back not activated.When i go to the emergency room they take my medicaid card and id and process this info. My understanding is that once my bills hav exceeded my share of cost,medicaid pays for ALL of my bills for that month.I"m not sure but if i pay any thing out of pocket ,it wont be reimbursed.
Fed up with share of cost wrote at 2010-08-26 20:11:13
As a person that works with Medicaid share of cost program for some of our patients, the answer above is incorrect. If you are seen by a physician, be it the primary care or an ER, all you have to do is show medical debt for that month that meets or exceeds your share of cost amount. Take any bills that you have accrued for that month and send them to DCFS via mail for tracking. If a bill that you send this month does not meet the share of cost, it will carry over to the next month until you have met that share of cost. We are still learning new things about this program on a daily basis, but for now I am hoping that this information is helpful to whomever reads this, including the doctors offices that do not understand just how this system works!!
ShareOfCost - A Cancer Survivor wrote at 2010-09-23 16:15:50
I have Share of Cost and I also had problems finding a Dr to accept me at first. In the beginning I also didn't understand how share of cost worked. I was very upset because I needed medical attention and my share of cost was over $400, which I knew I didn't have that kind of money. Then I went to Bayfront Hospital in St Petersburg, FL. They explained that I go to my Dr visits and once my Dr bills for that month reaches my Share of Cost ($400) then Medicaid kicks in for that month and pays all of my medical expenses, including prescriptions covered by Medicaid. I was seeing an Oncologist OB/GYN so ofcourse my Dr visits were always high. This was a blessing in my case because my Medicaid always kicked in right away. Also being that my Dr office was within the hospital I am sure that my visits costs a little more than they would have else where. Luckily I never had to pay anything out of pocket. If you are unsure of what to do, I suggest seeing the person in charge of Finances at your hospital. If it isn't likely that your monthly Dr bills will meet your Share of Cost then a hospital normally has some type of Sliding Scale for low income patients. My first visit with one of the hospitals clinics was on a sliding scale. I as charged 30% of my first visit which came out to $45.00.
abrokedad wrote at 2010-10-01 20:31:39
i have share of cost and my cost amount is 200 and no doctors will accept me however if i walk into an emergency room i get all the medical help i need and pay nothing..meds, hospital stay, follow ups every thing is paid for cause the emergency room costs more than my 200 limit so if i need a doctor, dentist, or eye doctor i go there then they will refer me to a dentist or eye doctor and i still pay nothing
Redcajun wrote at 2010-10-21 03:00:44
Ridiculous! Medicaid is paying for unnecessary ER visits just so people can have their share of cost met to activate Mediciad. I wonder who's brilliant idea this was. Seems pretty expensive for the tax payers!
jaysharks wrote at 2010-11-07 16:58:16
charistines reply on 1/5/2010 sums it all up, the
misfits in our government I think they could have made
the SOC cheaper though.I pay 897.97 just enough for two nice family premium so hopefully more can
learn from your blog.
onetruth wrote at 2010-11-12 16:36:13
I have a share of cost for $214, since I was taken off of Medicaid a month ago. I was really confused about how it worked (and you'll see that it works differently in different states). I have gone a month without much needed medication, and have nearly gone to the ER a few times. However, I decided to try my regular doctor. Because my share of cost was low enough, they worked with me to raise the bill so that it covered my share of cost. I did need breathing treatments and things like that, so it was mostly justified. I was given several prescriptions which more than exceed my share of cost. The pharmacy faxed the information in for me on Tuesday, but it still hasn't been processed by billing, and it is now Friday. Having Veterans Day in there didn't help. I may have to go another weekend without medicine, and I may end up taking a trip to the ER for another breathing treatment. Once I figure out this month, I am hoping that I will be okay for subsequent months. Like charistine, my prescriptions exceed my share of cost. But it's taking much longer than a day to get approval, and my pharmacy is re-faxing the information every day, just in case.
christal wrote at 2010-11-24 13:47:53
I was told that Shhare of cost only means that if your bills for the month are less than your share you pay. if you meet and exceed the share then they pay everything for the month.
Amy wrote at 2010-12-06 19:34:22
this is incorrect, i also thought this was the right information about "share of cost" but you do NOT have to pay the share of cost, you only have to incur a bill that is equal or greater than your share of cost and then medicaid will pick it up. My share of cost is 208 bucks a month, i go to the er for something on the 1st of the month, incur the bill, get the actual bill the next day and send it to medicaid and normally by the 10th of the month i have medicaid for the month, but the medicaid is actually good from the day you incur the bill til the end of the month, also, dr's don't like share of cost bc they take forever and a day to pay the bill (the state does). once your share of cost is met, you only need to find a doctor who takes medicaid, don't say anything about share of cost.
Adam wrote at 2011-03-07 15:19:15
Share of cost works this way. You go to a doctor, let them bill you or ask if they do. When you receive the bill you forward it to your case worker and depending what your share of cost is, what ever amount the bill is Medicaid will pay and you then meet the requirements of cost of share. After you meet it through outstanding bills then you medicaid goes into 100% active for that month. Any other bills will be paid. Every other month on medicaid works the same way. So if you go see a doctor today and the bill is $500. and your share of cost is $500. you tell the doctors to bill you for the $500. when it comes in the mail you forward it or fax it to the case worker and after that share of cost is met, you get full medicaid for the remaining of the month. I have been on share cost and that how it works. Getting billed is the ticket and answer.
Kim wrote at 2011-03-10 17:07:51
I want to say thank you for all these post, for someone that is new this is great. My mother is on share of costs and can not longer take care of herself so I'm now going to be coordinating this. From what I see it will be some work. Medicade brochure states that "Any family member whose income is counted can be used to meet the share of costs. Dad is a vet so he goes to the VA for all his care so I'm not sure if that counts or how that would work. Has anyone ever experienced this?
hyperhydrosis wrote at 2011-03-26 04:54:13
I have two children and get $900 a month in there childsupport money and no property or bank accounts i own.I have a share of cost of $200.I asked for a dermitoligist list because I have been getting botox treatment for hyperhydrosis which is a severe sweating disorder it cost 1,200.00 every six months but none out of the five dermitoligist exept the share of cost I am so fustrated because i need the treatments.I just got a new job as an esthetician and have to be in peoples faces all the time how emarassing I dont know what to do.
Flarotagilla wrote at 2011-07-26 06:00:10
Share of Cost - My wife and I have SS income of $1735.00@ mo. Our SOC is $1351.00@ mo. That's $2702.00@ mo. The person at DCF told me today that I should be greatful for this FREE insurance. Please; at 64 years old I have paid enough taxes. We earned it. If I could talk my wife into it I would move to Costa Rica. They are ranked medically at #36 out of 191 countries and the US is #37. You can get health insurance there for about $60.00@ mo. and not have to put up with this ridiculous state of Fla. By the way our great politicians voted this to become law for the entire state WITHOUT any FINANCIAL INFO. Real smart arn't they?
Ben Franklin once said that if the government fails the people that "We the People" should forcefully remove it and replace it. (Or something to that effect)
mona wrote at 2011-08-15 17:47:36
I was told to just call doctor offices and ask if they take medicaid, however that to become a night mare because as the conversation goes and they ask you other questions, some offices say they don't take share of cost, even though they accept medicaid. Apparently share of cost uses a different code and if they are not enrolled it will not work. I have spent three days calling doctors inquiring about this insurance, and no one accepts it. No sure why the state approves such program if they can't even provide an accurate list of available doctors.
Julie wrote at 2011-10-17 02:00:54
I know this question was years ago but since i know that people still google these things and these type of answers is what they rely on i am going to clarify this. if you have share of cost you dont have to pay anything!!!!!!! you just have to go to the children and family website print out your share of cost letter (every month) and go to any place that accepts the medicaid and tell them that u have share of cost and they have to fax the papers too medicaid. once they do this and the bill adds up to the amount of share of cost they awarded you then you have full medicaid for the rest of that month until next month.
hlight84 wrote at 2011-11-09 19:07:33
That is not correct at all. You never have to pay out of pocket with share of cost. If you have prescriptions, hospital visits, etc. that total altogether for instance my share of cost is 388 so by me getting a print out from pharmacy and a copy of bill from er visit and turning it into my local office, i meet my share of cost, never have to pay out of pocket. I just have to repeat this every month.
mommy of 2 princess wrote at 2011-11-15 01:17:51
this is really not an answer but i couldnt find a comment button.. this helped me greatly. i am anti-coagulant dependent at 22.. telling them that works perfectly. thanks- mommy of 2 princess
a person on share of cost wrote at 2012-01-10 21:00:54
no that isnt right about share of cost if you go lets say to the er and your share of cost is 500 as long as your bill is more than that medicaid pays that and you are straight medicaid the rest of the month it paid in. as long as that first bill is more than your share of cost amount you pay nothing out of pocket. Now lets say your bill was 400 and your share of cost was 500 and had not been met yet then you pay the 400. The problem is actually finding a doctor in seminole county that actually takes it is a different story.
Victoria Haris wrote at 2012-01-20 19:09:15
Bring your wife to the emergency room, if they take Medicate they will charge you more from the amount the share cost wants from you as a down payment. This is a solution to pay nothing. The only thing is that you will call the hospital people to be sure that they notified the children and family department for the charge and then you can see any doctor you want. Do this the first of the month and try in the next week to see if the right department was notified for the charges of the emergency room. I did the same the months I needed to go to the doctors and to get medications.Sincerely Victoria
chelle wrote at 2012-02-21 04:39:50
Actually... if your share of cost is 500... your medical bills of that month need to exceed that amount before it is considered just regular medicaid.
Kyneatria wrote at 2012-04-02 13:59:02
I just asked the same thing to my case worker and he explained that if you contact a doctor that accepts Medcaid advise them you have share of cost. If they take it and you make an appointment, if the services you receive is over your share of cost, the doctors office then forward the bill to Mediaid (which the will have the fax # to send it to) Medicaid will pick up the bill and you will have Medicaid for the rest of that month. If its under your share of cost then you are responsible to pay it but they still should forward the bill to Medicaid because your share of cost is not per visit, it's an overall total therefore each bill will be deducted from your share of cost. If you use it all before the end of the month, again you will have Medicaid for the rest of that month to go to dentist, hospitals, etc.
Connie wrote at 2012-04-05 17:41:28
I totally understand where everyone is so frustrated with the "share of cost" I make $742. a month from social sec disability. I have "share of cost" of $542, in order to even get that I had to apply for Medicare Part B. Which I could not afford in the beginning. So, I pay a penalty for not having part B, and It cost $150 a month. That covers my total income. And yes you do have to find a doctor that takes Medicaid but not just medicaid, It has to be the share of cost program, and I haven't found one yet. I think this is just a system to make the government able to say they are helping. However, non of them live or have tried to live off this program. It has never been tested by anyone that does not need medical help. The program is worthless!!!!!!!!!!!
Connie wrote at 2012-04-05 17:48:24
Oh and Joan affordable dentures takes Medicaid, yes. But they no longer take "Share of cost" Medicaid. I called them today. I had started going to them, paying out of pocket. So I was already a patient, when I called to tell them now I have share of cost,they said they no longer take patients with that coverage. Only Full cover Medicaid.
anxley wrote at 2012-04-26 19:36:51
I completely understand your frustration. I have been taking care of a patient who just started getting some child support payments from years ago, and they changed her to share of cost. there is one neurologist about sixty five minutes from her home, the rest of her specialists, other than oncologists don't take share of cost. I have contacted every agency I can find, and there is not a thing I can do about it, except move to another country, it appears.
Kris help with medicare wrote at 2012-06-11 18:40:18
every time My daughter makes an appointment and goes to a doctor , with her share of cost Medicare,( after telling them over the phone what she carries ) the office people send her away , Stating they do not take share of cost. I have asked my own doctors office , they say no , Something needs to be done for families that can not get insurance coverage, because of cost , or fix this share of cost thing so people can get medical help. My daughter has a female problem and a gall bladder that needs to be removed. we can't get any help. Sad world this is.
AJ wrote at 2012-06-20 02:38:03
I Hope this helps. You can visit www.dcf.state.fl.us/ess/
"What is the Medically Needy Program?
A Medicaid program for people who have too much income or assets are over the limits for Medicaid, Some people call it the “share of cost” program. The Department of Children & Families (DCF) determines eligibility for the Medically Needy Program.
What is a “share of cost”?
A share of cost is the amount of medical bills that you must owe or have paid before Medicaid can pay any of your current unpaid medical bills. Your share of cost is based on your family’s monthly income.
If we estimate your share of cost based on your statement of your monthly income, the income must be verified before Medicaid can pay any bills. The share of cost may change when your income changes.
How does the “share of cost” work?
Each month certain medical expenses you owe or have paid in the last 3 months are counted toward your share of cost. When your allowable medical expenses are equal to your share of cost, you are eligible for Medicaid for the rest of that month.
Here is an example: Your share of cost is $800. You go to the hospital on May 10 and send us the bill for $1000. You have met the share of cost and are Medicaid eligible from May 10ththrough May 31. Medicaid will pay the $1000 medical bill. This is only an example.
Some examples of medical expenses that can be used to meet the “share of cost”
Unpaid medical bills you owe that have not
been used to meet your share of cost before.
Medical bills you paid within the last 3
Medical bills that will not be paid by
health insurance or any other source.
Health insurance premiums.
Co-payments for medical bills.
Medical services prescribed by a doctor.
Transportation by ambulance, bus or taxi to
get medical care.
Some examples of medical expenses that cannotbe used to meet the “share of cost”
Premiums for insurance policies that pay
you money when you are in the hospital or
the payment is not intended to pay for
First aid supplies and over the counter
supplies such as adhesive bandages,
alcohol, cold remedies, etc.
Whose medical expenses can be used to meet the “share of cost”?
Any family member whose income is counted, even if the person is not eligible for Medicaid.
More information about the “share of cost”
If you have questions about the Medically Needy Program, want to see a list of our service centers, fax numbers or to apply for benefits, visit our website: www.dcf.state.fl.us/ess/
What to do when you meet the “share of cost”
Provide proof of medical expenses to a DCF ACCESS office by fax, mail or in person.
Your name and case number
The amount of the expense
The date the expense was incurred and
The date and amount of any payments
that you have made for the expense.
Examples of proof you can provide:
Medical bills you have received
Receipts for paid medical bills and
Cancelled checks for paid medical bills.
What services are covered by Medicaid?
The Agency for Health Care Administration (AHCA) can provide more information on what services Medicaid will cover, as well as the doctors, pharmacists and hospitals that accept Medicaid.
Contact the local AHCA Area Office or visit their website at www.fdhc.state.fl.us.
Some Medical providers do not accept Medicaid and some do not accept the Medically Needy Program. Even after you contact AHCA for information about doctors and services, remember to tell your provider before you make an appointment that you are on the Medically Needy Program.
twylla wrote at 2012-07-12 18:38:35
medicaid only pays for the fee that exhausted my S.O.C for the month. basically whateva was the last bill that made it meet or pass ur S.O.C is the only thing that will be paid for by medicaid. If ur share of cost is $200 and u go to the doctor and its $150 you have to pay for that. Lets say you go again and its $100. Your S.O.C has been exceeded and that last doctor bill is the only thing that they will pay for (or reimburse you). That first bill is on you! Then for the rest of the month medicaid pays for everything else!
Mystically wrote at 2012-12-11 19:58:24
Thats not correct, if any doctor bill (s) in any given month equal or exceed your share of cost you don't pay anything, and you are on full medicaid from the time your share of cost is met. For example: Your share of cost is 1,000. You have a doctor appt on nov 3rd and total charges are for 500.00. On nov. 7th you have a ER visit and total charges are 2000.00, your share of cost is met and medicaid pays for BOTH bills, you pay nothing out of pocket.
PLAY ALONG wrote at 2013-03-10 06:37:25
JUST GO TO HOSPITAL 1ST OF EVERY MONTH PERIOD! END OF DISCUSION!!! THEN EVERYTHING IS COVERED.THATS WHAT I DO!WHY DO YOU THINK THE HOSPITAL IS FULL OF THE GHETTO EVERY MONTH! PEOPLE THINK! USE YOUR HEAD!!!
LynnC wrote at 2013-03-22 11:25:10
The main problem with Share of Cost is finding a doctor who accepts it. There are NO ENT doctors here in Broward who will accept it-NONE! Try living with tinitus for over 6 months,24 hours a day & then get on the medically needy program only to search for weeks on end for a doctor who will accept it. It took me literally a month just to find a primary physician & forget it if they send you to a specialist because NONE of them take it. Now I'm trying to find a cardiologist & dermatologist for my husband as well as an ENT for me. I've a feeling I'm out of luck & will have to deal with the insane buzzing in my head for a really long time.
It's a broken system that NEEDS fixing!
deathisbetter stor wrote at 2013-03-25 22:38:24
I used to give myself too much insulin on the 1st of everymonth and call the ambulane so that my $1004.00 share of cost would be met, but now they are saying you can only use the er towards share of cost 6 times per year. I have not found a dr that will take share of cost within a 5 hour drive of me. I had a kidney transplant and have to see a doctor every 3 months and I am on an insulin pump and have to see a doctor every 3 months to get prescriptions refilled. I have decided as of this month to stop the anti-rejection meds and let the kidney fail which will put me back on dialysis which I will eventtually die. My check is $1162.00 when I pay $1004 every month to cover my share of cost because none of the doctors will accept it, that leaves me with about $150.00 a month to live on. I need my care to live in, so I have to have car insurance, I steel food when I can and but food from the dollar store but I am so tired and sick and I have been living in my car for the past two months and can not do it anymore. I hope someone comes up with an answer although I can not get on the computer often. I would rather be dead than feel like this with no help.
KATCORK wrote at 2013-04-06 05:04:20
i went to the hospital at the beginning of march due to having pneumonia, my bill was suppose to be 2085.00 my share of cost is 1977.00, however the bill the hospital sent me has a non insured deduction and not its 1400. NOT COVERED, looks like the hospital has learned to work the system. The funny part was I have had medicaid and they put me on medically needy when my ex lost his job and couldn't pay his child support, the reason was I had a decrease in unearned income. THAT MAKES NO FREAKING SENSE
henry wrote at 2013-04-19 18:24:18
this share of cost program is just a scam. this isn't helping people, it's making it worse and costing more money. how about this, give the poor (who have it bad enough as it is) full medicaid and make it mandatory that they schedule regular checkups, getting the poor the help they need and preventing more serious and COSTLY medical conditions from beginning in the first place. for example, joe schmoe is overweight and has high cholesterol, works for min. wage and is poor, barely surviving with HIGH levels of stress b/c of this. but he doesn't go to the doctors because he can't afford it and the appointment doesn't meet his "share of cost" so he doesn't go. he's on the program for 2 years without seeing a doctor because he's too poor to go in the first place. suddenly joe has a heart attack, is in the hospital for an extended period of time, has surgery and now he's on oxygen and a whole host of medications. he can't work b/c of his heart cond. and is now subsidized by the govt. and goes to the doctors regularly.
proposed cost: cost for doct. appt. w/diag. and prescribed (preventative) medication ~$1000/yr.
real cost b/c of share of cost:
money saved by not helping joe: ~$1000/year
money spent by not helping joe in the first place:
heart attack, emerg. surgery, er and hosp stay ~$30,000 (yeah right, conservative enough number for you?)
new medications ~$5000/yr
food stamps (can't work now) ~$6000/yr
neg. impact due to lack of taxes and contributions to local and small businesses ~$3000/yr
Quality of life = UN-quantifiable = much much much worse
what makes more sense to you?
Elizabeth Davis, RN wrote at 2013-06-07 15:51:53
Florida Medicaid Share of Cost is a really confusing program and a lot of it's recipients don't understand how to use if. So many healthcare providers don't understand how it works that it's really hard to find a doctor that accepts it. It doesn't help that the medically needy program brochure describes the share of cost as "like a deductible" which it isn't. If it were a deductible, you would have to pay it. Instead, with share of cost, you just have to OWE it, not pay it.
About.com has an online article called "Florida Medicaid Share of Cost--How Does It Work" that explains how it works, fives tips on how to use it effectively, what to do and what to avoid. You can access the article here: http://healthinsurance.about.com/od/medicaid/a/Florida-Medicaid-Share-Of-Cost-Ho
If the forum filters out the link, just copy and past the name of the article (inside the quotation marks above) into your Google search engine bar, and choose the Google search result from About.com
Martha wrote at 2014-11-21 02:26:58
I am currently walking around with a broken collar bone since May the doctor that saw me while I was in the hospital takes it but because I live in a different county and that took me to a trauma center in a different county I'm pretty much screwed I just get to walk around with a broken collar bone and pain cause these doctors don't really care
regena wrote at 2015-03-06 13:29:55
My share of cost is 1900 a month. It is really pointless unless you have an emergency visit every month.
If your share of cost is 800.00 and you went to the doctor and spent out of pocket 100.00 save your receipt. Because if you actually go a few days later to the er for something simple and say your amount is 700.00 but you didn't pay. You can take your bill to medicaid and your recipt and you have met your share of cost. Also after you meet your share of cost that then shows up as full medicaid. The thing is you must keep up with the hospital to get that bill because they will sit in it. I actually went to the hospital website after going to the er and the very next day they had the bill on the computer. I printed it out along with the barcode paper and sent it to my local area 6 medicaid office plus I also uploaded the bills on myaccessfl online account. Then I called hours later to see if they got it and they did. The only thing I don't understand is why they wait 10 days to put the information in. That is what screws soc recipients. So mine is from the 4 so I have to wait till the 17th to have my medicaid but I have made a ton of appointments for the end of the month.
I hope this help you understand a little.
Dee wrote at 2015-04-19 02:37:24
I have recently became disabled. I get a monthly check in the amount of $1192. a month. I was told my share would be $938. a month. I would love to know how I am supposed to take care of my condition and pay my rent,electric,water bills. I had surgery on Monday when I went to pick up my prescriptions I was told they would be $698. dollars. I said the $938 had to have been met since I had just has surgery and was in the hospital for4 days. The reply was yes it wS met but it has not been approved yet so you will have to wait for your meds after all its Friday and their offices are closed for the weekend. I went back into the ER and said I meed to be admitted. I don't know how I am suppoaed to pay over 95% of my disability money to health care and live. There is no compassion in this communist country.
Jangell wrote at 2015-06-04 18:57:29
All info above is just being repeated. But the true problem is not being able to find Doctors willing to accept SOC and sit on bills until you meet the SOC.. or even accept SOC at all. It's pretty much a catastrophic insurance.
This explains our share of cost coverage well. http://healthinsurance.about.com/od/medicaid/a/Florida-Medicaid-Share-Of-Cost-Ho
BeachGirl wrote at 2015-07-15 20:28:35
I agree with all the above, Florida Medicaid share of cost is too high, hard to understand, no providers know how it works, and no doctors will accept it.
I was told that teaching Hospitals - usually attached to Universities - will take Florida share of cost and/or do sliding scale fee. The University of Florida Gainsville confirms this information on their website. Of course this isn't an option for everyone, but if you are within driving distance and/or have a hard to treat or hard to diagnosis condition, it may help you. They have a neurodiagnostic center, and "orphan disease" center for autoimmune diseases, rheumatology, etc.
Carleigh wrote at 2015-11-28 13:16:30
I just read on the Medically Needy brochure from Access Florida that a Insurance Premium can be used as your share of cost. Has anyone tried this and how did it work for you? If your cost of insurance is over your share of cost then you would have it every month.