Share of Cost Considerations/NOAs

Multiple Shares of Cost

Under Sneede, it is possible that a case can have multiple Shares of Cost for a single month.

Some MBUs may have zero SOC, while others have a SOC.
Each MBU may have a different SOC.

The system will show that each person in the individual “MBU” has met his/her SOC.

Example Example Parents are not MC eligible until the SOC in their own MBU is met, and they are not required to wait until their child with income (in his own separate MBU) meets his SOC.

If Sneede procedures result in a higher SOC for some individuals, the family does not have the option of remaining together in one MFBU.

Responsible Relative's Medical Expenses

Parent(s) are included in the MBUs as responsible relatives (RR) of their eligible children who are in a separate MBU. Their medical expenses may be used to meet the children’s SOC.

Medical expenses of a responsible relative can be split up and used to meet:

The SOC in his/her own MBU, or
The SOC in his/her child's MBU, or
The SOC in both.

However, a medical expense, or portion of a medical expense, cannot be used more than once.

Children's Medical Expenses

A child's medical expenses can only be applied to the SOC of the MBU which includes the child. His/her medical expenses cannot be applied to the parent(s)' SOC unless the parent(s) are in the same MBU as the child.

Required Informing

When Sneede is applied and at least one MBU has a SOC, the client must be informed of the option to apply medical expenses:

When the initial SOC is determined, and
At redetermination.

Example of Medical Expenses

The MFBU has a SOC and includes a married couple and the wife's separate child. Her husband has no linkage. The wife and her child need Medi-Cal. Each MBU has a SOC.

MBU “A”	MBU “B”
Wife (Aid Code 37)	Child (Aid Code 37)
Husband (I.E.)	Mother (RR)

In this example, mother may apply her medical expenses to MBU A, MBU B, or a portion of her medical expenses to both MBUs. Her child's medical expenses can only be used to meet the child's SOC. The stepfather's medical expenses, if any, can be applied to his wife's SOC.

Hunt v Kizer

If an MFBU with a Sneede class member has a SOC, old unpaid medical expenses must be deducted after Sneede procedures are applied to the case. Then, if any of the MBUs have a SOC, the old unpaid medical bills may be used to reduce the SOC.

A responsible relative's (RR) old unpaid medical bills can be applied to:

His/her own MBU,
His/her child(ren)'s MBU,
Or to both.

Reminder: A medical expense (or portion of a medical expense) can only be used once to reduce a SOC.

Note: A caretaker relative's old unpaid medical expenses can only be applied to his/her own SOC, as there is no financial responsibility for the children.

Adjusting the SOC

When income or other changes are reported which affect an MBU's SOC, adjustments are to be made based on whether or not the change is reported timely, within 10 calendar days following the date that the change occurred. If a SOC is retroactively reduced and an MBU requests a future SOC adjustment, the reduction may be applied to the future SOC of the MBUs as follows:

Situation 1

Change in income reduces the entire MFBU's SOC to zero:

When an MFBU no longer has a SOC, discontinue the Sneede MBUs and establish a regular MFBU.

Apply the reduction to the future SOC of any MBU which contains a member of the MFBU, even if the MBU compositions are no longer the same.

Situation 2

Change in income reduces an MBU's SOC, but Sneede procedures still apply because the MFBU has a SOC:

Apply the SOC adjustment to any MBU which includes a member of the original MBU for which the SOC is being adjusted.

Sneede NOAs

Sneede approval notices of action will be generated for each MBU based on relationships and person specific income entered.

Issue only one notice of action when denying or discontinuing the entire family.