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 Do
I qualify?
You may qualify for the Stanislaus County Medical
Indigent Program (MIA) if you are:
- Non-disabled
- Between the ages of 21 through 64
- A verifiable resident of Stanislaus County
- Have no Medi-Cal or major health coverage
- Able to meet financial and other requirements for MIA eligibility
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What kind of benefits do I get?
Healthcare expenses are covered when provided at an approved Health Services
Agency (HSA) facility, which includes:
Not all healthcare services are covered benefits. A list of exclusions
is available upon request.
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Do I qualify for benefits if I am an unqualified
alien?
No. Benefits for non-federally qualified aliens are not available. However,
you can still seek services at HSA clinics as personal pay.
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Can I get benefits if I am disabled?
Yes, if you are physically unable to work for more than 12 months and
meet the requirements of the Disability Evaluation Division (DED) coverage,
you may be eligible for benefits.
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What if I am traveling out of the County? Are
my benefits good there?
If you are traveling out of the County, the benefits offered by the
Stanislaus County Indigent Health Program are not accessible to you.
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What Services Require Prior Authorization?
- All outside services and certain HSA services require written authorization.
This is called TAR, which must be approved BEFORE services are rendered
so payment to the provider can be made.
- Any services that CAN be done at HSA MUST be done at the HSA facilities.
MIA covers most medical services, but services that are not a covered
benefit will be your responsibility.
- A summary of program benefits and exclusions will be provided upon
request.
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What
am I responsible for?
Written Application
- You must submit a written application to be considered for benefits.
- You may be required to provide certain documentation.
- If the HSA Eligibility department approves your application, you
will be given a proof of eligibility card with a range of dates in which
you are eligible.
- Take your eligibility card with you each time you see a doctor or
fill a prescription.
- You must complete a new application to have the card renewed past
the eligibility dates. This can be done by scheduling an appointment
at least 45 days in advance of the expiration date.
- If your application is denied, you will receive a Notice of Action
and the HSA eligibility worker will explain the appeals process.
Medical Lien
- A resolution adopted by the Stanislaus County Board of Supervisors
requires that you sign a Stanislaus County Medical Lien.
- A lien is a charge against any real property you have at the present
time as security for the payment of medical care provided to you by
the County.
- The lien document is recorded by the Stanislaus County Clerk Recorder’s
Office and applies only to real estate.
- If you refuse to sign the lien, your application will be considered
incomplete and cannot be processed.
- PLEASE NOTE: Property cannot be transferred to someone else in order
to qualify for the program. If the property is transferred during the
application process, you could be barred from the program for up to
2 years from the date of transfer.
Inability to Work
- If you believe that you are unable to work for 12 months or more when
you apply for the program, you must report this to the HSA eligibility
department.
Medi-Cal
- If you are referred to Medi-Cal to complete a medical disability
application, you must cooperate by completing the Medi-Cal process or
your MIA benefits will be denied.
- Take your eligibility card with you each time you see a doctor or
fill a prescription.
Reporting
- You are required to contact the HSA eligibility department within
10 calendar days if you have a change in income, property, and number
of persons in your family, or your living situation.
- If you need surgery and will become temporarily disabled as a result,
you need to report this as a change. You may call and leave a message
at 209-558-7232.
- Failure to report correctly and timely may result in loss of your
MIA benefits and/or prosecution for fraud.
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Where
do I apply?
- Applications are taken by appointment only.
- To make an appointment, call 209-558-7393.
- The Eligibility Department is located at HSA.
Family Practice Center, 830 Scenic Drive, Suite A, Modesto, CA.
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What
do I bring to my interview with with the Eligibility Department??
Driver’s license or California I.D.
- Birth Certificate, Resident Card, Green Card, Passport, or Visa.
- Proof of Residency (e.g. current utility bills in applicant’s
name, voter registration)
- Social Security Card
- Current Checking and/or Savings Account statement /pass book (with
current interest posted)
- Income verification (last 4 – 5 check stubs) or Employers Statement
broken-down by pay period with a name and telephone number or payroll
clerk. If self-employed, bring last year’s Federal Income Tax
Return and quarterly statements for each quarter thus far this year.
- Unemployment Ins. Benefits (UIB) or State Disability Income (SDI)
Verification
- Vehicle Registration (car, truck, boat)
- Naturalized Citizenship
- Life Insurance Policies
- Trust Deeds, Trust Funds, Notes on Loans/Property
- Stocks, Bonds, or IRAs
- Court-ordered Child Support (Include proof of current child support
paid)
- Legal Separation or Divorce Forms
- Veterans Benefits
- Current Property Tax
- Other financial documents as required to determine eligibility
Insurance, Workman’s Compensation and Third Party Liability Information
- Employer Name, Business Name, Third Party Coverage Name and Phone
Number
- Insurance, Workman’s Compensation, Third Party Liability Address
and Policy Number
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What
is a lien?
- You have a financial responsibility for the medical services you seek.
- The Health Services Agency has a responsibility to the County to collect
for services rendered.
- A resolution adopted by the Board of Supervisors requires it.
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Why
do I have to sign a lien?
- You have a financial responsibility for the medical services you seek
- The Health Services Agency has a responsibility to the County to
collect for services rendered
- A resolution adopted by the Board of Supervisors requires it.
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What
is share of cost?
- If your monthly income is greater than the basic IHCP income standard,
you will be responsible for a portion of you medical bills. This is
called a “Share of Cost” and works much like an insurance
co-payment.
- You will owe the monthly share of cost only if you receive services
in that month. Your share of cost is based on your income, not on the
amount of your medical bill. In some months, you may have medical bills
higher than your share of cost; in other months you may have medical
bills lower than your share of cost. When the medical bills is higher
than your share of cost, you will be responsible only for the share
of cost (co-pay) assigned to you.
- Examples: (1) You have bills for $160, but your share of cost is $100.
You will be responsible for the first $100; the program will pay the
additional $60. (2) You have a medical bill for $160 for the month,
but the share of cost assigned to you for that month is $200. You will
pay $160; the program will pay $0.
- Share of cost must always be paid at HSA even if you are having your
services at Doctors Medical Center or other community providers. You
should keep all receipts.
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Do
I need to renew my indigent health care program eligibility?
You have 2 options:
- You may request a mail-in application (please call at least 30 days
prior to the expiration date on your card to avoid any lapse of eligibility)
by calling 209-558-2777 or toll free 1-800-962-4468.
--OR--
- You may make an appointment with the Eligibility Department by calling
209-558-7393.
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Where
can I use my MIA card?
The MIA Eligibility card is to be used only for
medical treatment at the HSA medical offices and pharmacy and at Doctors
Medical Center. Any treatment not available at HSA, requires a Treatment
Authorization Request (TAR), pre-approved by the IHCP Utilization Management
Department.
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I am a sponsored immigrant. Can I apply for benefits?
Yes, sponsored immigrants who enter the United States with an I-864 or
I-864A Affidavit of Support are processed for IHCP eligibility in accordance
with Federal Immigration and Welfare Reform laws. The Indigent Health
Care Program will consider (deem) the income and property of the sponsor
and the sponsor’s spouse to be the income and property of the applicant.
The sponsored immigrant must meet all other IHCP eligibility requirements.
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Do I need to complete a dental authorization
to see a dentist?
No, if you are currently on the MIA program and need dental care, you
need only call a participating dentist and make an appointment. Click
here for a list of dental providers.
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Who
do I contact?
Heath Services Agency (HSA)
Indigent Health Care Program
830 Scenic Drive
P.O. Box 3007
Modesto, CA 95353
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