Florida’s Medically Needy Share of Cost Program: What it Means for You

Introduction

Health insurance coverage is crucial for accessing medical care, but it can be confusing to navigate the different options available. One program that provides coverage for low-income individuals and families is Medicaid. However, there are certain aspects of Medicaid, such as the Medically Needy Share of Cost (MN-SOC) program, that may not be fully understood. In this blog, we will delve into the MN-SOC program, explaining what it is, how it impacts Medicaid eligibility, and what steps to take if you receive coverage under this program.

What is the Medically Needy Share of Cost Program?

The MN-SOC program is a Medicaid program that provides health insurance coverage to low-income individuals and families who have high medical expenses. Under this program, individuals are required to pay a monthly share of their medical costs before their Medicaid coverage begins. This share of cost is based on a percentage of your income and assets.

How Does the MN-SOC Program Impact Medicaid Eligibility?

In order to be eligible for the MN-SOC program, you must meet the following criteria:

• Be a Florida resident

• Be a U.S. citizen or qualified non-citizen

• Have a low income (below 138% of the Federal Poverty Level (FPL))

• Have high medical expenses that are expected to exceed a certain amount each month

What if I Receive Coverage Under the MN-SOC Program?

If you receive coverage under the MN-SOC program, you will be required to pay a monthly share of your medical costs. This share of cost will be based on your income and assets. You can pay your share of cost in a variety of ways, including:

• Deducting the share of cost from your monthly income

• Paying the share of cost directly to the Florida Agency for Health Care Administration (AHCA)

• Using a Health Savings Account (HSA) or Flexible Spending Account (FSA)

What if I Can’t Afford My Share of Cost?

If you can’t afford to pay your share of cost, you may qualify for a hardship waiver. A hardship waiver is a reduction or elimination of your share of cost due to financial hardship. To apply for a hardship waiver, you must contact your local AHCA office.

What if I Have Questions or Need Help?

If you have any questions about the MN-SOC program or need help applying for coverage, you should contact your local AHCA office. You can also get help from a licensed agent who specializes in health insurance.