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Dear Advocate…


Dear Advocate:

My father lives in a nursing home and recently developed a rash requiring the attention of a dermatologist who prescribed a medicated cream that is not covered by Medi-Cal. The prescription exceeds his 35 dollar personal needs allowance. How will he be able to afford his medication? 

Sincerely,

Concerned in Concord

Dear Concerned in Concord:

Yes, you must pay out-of-pocket for prescriptions not covered by Medi-Cal. However, the charges can be deducted from the Share of Cost before you pay the nursing home. Under the Johnson v. Rank judgement effective October 1, 1989, all Medi-Cal recipients must have the opportunity to use their Share of Cost to purchase medically necessary or remedial care, supplies and/or equipment not paid for by the Medi-Cal program, as long as it is prescribed by a physician. Provide the receipt, and a copy of the prescription, to the facility and deduct the cost of the prescription from that month’s Share of Cost. Although you will have to initially pay for the prescription at the pharmacy, you can deduct the amount paid from you father’s Share of Cost for that month.

Page Last Modified: June 21, 2018