Last Updated: September 1, 2026
What Is Medi-Cal Share of Cost? 2026 California SOC Guide
If your Medi-Cal Notice of Action says you have a Share of Cost (SOC), you may be wondering what it means and when Medi-Cal will begin paying for your medical care.
A Medi-Cal Share of Cost is the amount of medical or dental expenses you must pay or become responsible for paying before Medi-Cal begins paying for covered services for that month.
Share of Cost is similar to a monthly deductible, but it is not an insurance premium. You only need to meet it in a month when you use medical or dental services. Once your SOC is met, Medi-Cal can begin paying for covered services for the rest of that month.
1. What Is a Medi-Cal Share of Cost?
Some Non-MAGI Medi-Cal programs require members to have a Share of Cost.
Your County Medi-Cal Office calculates the amount and sends you a Notice of Action showing whether you have an SOC and how much it is.
The SOC amount is not a monthly bill that you send to Medi-Cal or to the State of California.
Instead, it represents the amount of health or dental expenses that you must pay or agree to pay to health care providers before Medi-Cal begins paying for covered services for that month.
2. Is Share of Cost the Same as a Deductible?
It is often described as being similar to a monthly insurance deductible, because you must meet a certain amount of medical expenses before Medi-Cal begins paying.
However, there are important differences.
- Your SOC resets each month.
- You do not pay the SOC directly to Medi-Cal.
- You generally only need to meet it in months when you receive health or dental care.
- You may be able to meet it by paying or becoming responsible for qualifying medical expenses.
A Share of Cost is not a monthly premium. If you do not receive medical or dental services during a month, you generally do not have to pay an SOC simply because the month passed.
3. Example: How Share of Cost Works
Your monthly Share of Cost is $600.
During July, you receive medical services that create $600 in expenses that can be applied toward your SOC.
Once you have paid or become responsible for enough qualifying expenses to meet the $600 SOC, your Share of Cost for July is satisfied.
Medi-Cal can then begin paying for covered services for the remainder of July, subject to normal Medi-Cal coverage rules.
On August 1, the monthly Share of Cost starts over.
The exact way a provider records or certifies your SOC can depend on the service and Medi-Cal billing system.
4. Do I Have to Actually Pay the Entire SOC First?
Not necessarily.
DHCS explains that your SOC is the amount you must pay or promise to pay for health or dental care before Medi-Cal begins paying.
This means that in some situations, you do not have to hand over the entire SOC amount in cash before the expense can count.
A provider may allow you to pay an amount later. You may still remain personally responsible for the portion of the bill used to meet your SOC.
Meeting your Share of Cost does not mean Medi-Cal pays the portion of the bill that you used to satisfy the SOC. That amount may remain your responsibility.
5. Why Do Some People Have a Share of Cost?
Share of Cost is most commonly associated with certain Non-MAGI Medi-Cal eligibility categories.
For example, some people who are age 65 or older, blind, disabled, or eligible under a Medically Needy Medi-Cal category may have an SOC depending on their income and eligibility rules.
A person may have income above the level for Medi-Cal without a Share of Cost but still qualify for another Medi-Cal category with an SOC.
Most adults who qualify for regular MAGI Medi-Cal based on income do not use the traditional Share of Cost system. SOC is primarily associated with certain Non-MAGI and Medically Needy programs.
6. How Is My Share of Cost Calculated?
Your County Medi-Cal Office calculates your Share of Cost according to the rules of the Medi-Cal program under which you qualify.
The calculation can involve:
- Your monthly income
- Which income is countable or exempt
- Allowable income deductions
- Your household or Medi-Cal Budget Unit
- The applicable maintenance need amount
- The specific Medi-Cal eligibility category
The maintenance need is an amount established under Medi-Cal rules that is deducted when calculating the SOC for certain programs. It is not necessarily the same as your actual monthly rent, food, utilities, or other living expenses.
Your Notice of Action should show how the County calculated your eligibility and Share of Cost.
7. What Medical Expenses Can Help Meet My SOC?
Qualifying health care expenses can potentially be used toward your Share of Cost.
Examples may include:
- Doctor visits
- Hospital services
- Prescription medications
- Dental services
- Laboratory tests
- X-rays and diagnostic services
- Medical equipment
- Other allowable health care expenses
Whether a particular expense can be applied toward your SOC can depend on Medi-Cal rules and your individual case.
8. Can Expenses From a Provider Who Does Not Accept Medi-Cal Count?
Sometimes.
DHCS says that if you pay for health care services from a provider who does not accept Medi-Cal, those payments may be counted toward your Share of Cost.
You may need to take receipts or other documentation to your local County Medi-Cal Office so the County can determine whether the expenses qualify and credit them toward your SOC.
9. Can Old Unpaid Medical Bills Reduce My Share of Cost?
Possibly.
DHCS states that certain unpaid medical bills from prior months may be used to lower a current or future month's Share of Cost.
The bill must meet applicable rules and generally cannot have already been used to satisfy another month's SOC.
Because these rules can be detailed, take your unpaid medical bills to your County Medi-Cal Office and ask whether they can be applied.
Using an old unpaid bill toward your SOC does not mean Medi-Cal will automatically pay that old bill. It may instead be used as a credit toward your current or future Share of Cost.
10. Does My Share of Cost Reset Every Month?
Yes. The normal Share of Cost amount resets each month.
For example, if your SOC is $600 and you meet it in July, that does not automatically satisfy August's Share of Cost.
If you need medical care again in August, you may need to meet the SOC again before Medi-Cal begins paying for covered services that month.
11. What If I Do Not Need Medical Care That Month?
You generally do not have to pay your Share of Cost simply because you have one.
If you do not receive health or dental care during a month, there may be no SOC amount for you to pay to a provider that month.
This is one of the major differences between Share of Cost and a regular monthly insurance premium.
12. Can I Be in a Medi-Cal Managed Care Plan With a Share of Cost?
It depends on your Medi-Cal eligibility category and where you live.
DHCS notes that in some situations, people with an SOC may not enroll in managed care until the SOC is met.
However, there are important exceptions. For example, certain members receiving long-term care services can have a Share of Cost and still be enrolled in Medi-Cal managed care.
Therefore, having an SOC does not automatically tell you whether you will be in Fee-for-Service or managed care Medi-Cal.
13. How Do I Know If I Have a Share of Cost?
The best place to check is your Medi-Cal Notice of Action.
The notice should tell you:
- Whether you have a Share of Cost
- Your monthly SOC amount
- How your eligibility was calculated
- When the decision becomes effective
You can also contact your County Medi-Cal Office if you do not understand the calculation.
BenefitsCal may also show information about your Medi-Cal case, depending on the information available in your account.
For questions about the amount of your Share of Cost or how it was calculated, your County Medi-Cal Office is usually the best place to start.
14. Can I Reduce or Eliminate My Share of Cost?
Possibly. Your Share of Cost may change if your financial or eligibility circumstances change.
For example, your SOC may decrease or disappear if:
- Your countable income decreases
- Your household situation changes
- You become eligible for a different Medi-Cal category without an SOC
- You qualify for additional allowable income deductions
- Certain qualifying unpaid medical bills can be applied toward future SOC amounts
Ask your County Medi-Cal Office to review your case if your income or circumstances have changed.
15. What If I Think My Share of Cost Is Wrong?
First, review the calculation on your Notice of Action and contact your County Medi-Cal Office.
Ask the County to explain:
- Which income was counted
- Which deductions were applied
- Which household members were included
- Which Medi-Cal eligibility category was used
If you disagree with a Medi-Cal eligibility decision or a change to your Share of Cost, you may also have the right to request a State Fair Hearing.
Check the hearing rights and deadline printed on your Notice of Action.
Frequently Asked Questions
Is Share of Cost a monthly Medi-Cal premium?
No. Share of Cost is not a premium that you pay every month simply to keep Medi-Cal. It applies when you have qualifying medical or dental expenses and need to meet your monthly SOC.
Do I send my Share of Cost payment to Medi-Cal?
No. DHCS explains that the SOC is owed to the health or dental care provider, not to Medi-Cal or the State of California.
Do I have to meet my SOC every month?
Only when you need to use services and want Medi-Cal to begin paying after the SOC is satisfied. The SOC amount resets each month.
Can unpaid medical bills count toward my SOC?
Certain unpaid medical bills may qualify to reduce a current or future SOC. Ask your County Medi-Cal Office to review the bills.
Who decides my Share of Cost amount?
Your County Medi-Cal Office calculates the SOC based on the eligibility rules that apply to your case and sends the decision in your Notice of Action.
Official Resources
- DHCS — Medi-Cal Help and Share of Cost
- DHCS — Medi-Cal Eligibility Procedures Manual
- BenefitsCal
- DHCS — State Fair Hearing Information
California Benefits Guide is an independent informational website and is not affiliated with or endorsed by the State of California, the California Department of Health Care Services (DHCS), Medi-Cal, any county agency, or any Medi-Cal health plan. This article is for general educational and informational purposes only and is not legal, financial, medical, or official Medi-Cal eligibility advice. Share of Cost calculations and eligibility rules can vary by program and individual circumstances and may change. Always verify your SOC amount with your County Medi-Cal Office and review your official Notice of Action.