CMS Frequently Asked Questions
Frequently Asked Questions
| Q: | What is County Medical Services (CMS)? |
| A: | CMS is not health insurance; it is a program of
last resort for eligible adults, which covers only necessary
medical services. CMS uses a network of Community Health
Centers, private physicians and local hospitals to provide the
services. A listing of CMS providers can be found in the CMS
Patient Handbook. You can find the CMS Patient Handbook by
selecting "CMS Handbooks" in the drop down menu. |
Applying For CMS
| Q: | How do I apply for CMS? |
| A: | Call 1-800-587-8118 to schedule an eligibility
appointment with a County CMS worker at a designated Public
Health Center or community clinic at a location convenient for
you. |
| | |
| Q: | Can I apply for CMS online? |
| A: | No, you must call (800) 587-8118 to make your CMS
appointment for an interview with a County CMS worker. |
| | |
| Q: | Can I make an appointment online for CMS? |
| A: | No, you must call (800) 587-8118 to make your CMS
appointment for an interview with a County CMS worker. |
| | |
| Q: | Do I have to make an appointment to go in and
apply? |
| A: | Yes, all applications are taken in person by
appointment only. |
| | |
| Q: | What do I need to bring with me when I apply? |
| A: | You will need to bring identification, proof of US
citizenship or legal alien status, proof of residency (such as a
rental agreement), verification of income you received (such as
pay stubs), and verification of property you own (such as bank
statements). Your CMS worker will advise you if additional
verifications are needed. |
| | |
| Q: | What if I don't have everything for the eligibility
appointment? |
| A: | You should still go to your CMS eligibility
appointment. Your CMS worker will review your application and
give you a complete list of items necessary to complete the
eligibility process. Your CMS worker will give you a specific
timeframe in which to provide outstanding items. |
| | |
| Q: | I lost my CMS Handbook, how can I receive another
one? |
| A: | The CMS Patient Handbook is available online. You
can find the CMS Patient Handbook by selecting "CMS
Handbooks" from the drop down menu on the CMS home
page. |
| | |
Requirements For CMS
| Q: | What are the Requirements For CMS? |
| A: | Minimum Eligibility Criteria: - Have an
immediate or long-term medical need
- Be 21 through
64 years of age
- Be a U.S. citizen or an eligible
alien, and be able to provide documentation of U.S.
citizenship or legal alien status.
- Be a resident of
San Diego County
- Sign lien forms for services
covered by CMS
- Meet CMS financial requirements or
receive General Relief
|
| | |
| Q: | What are the income guidelines for CMS? |
| A: | The income guidelines vary depending upon the
number of people in your family. If your family income is
between 0-165% of the Federal Poverty Level (FPL), then you may
be eligible for CMS at no cost. If your family income is more
than 165% of FPL, you may apply for a CMS Hardship and you may
be eligible for CMS with or without a Share of Cost. |
| | |
| Q: | What is acceptable CMS verifications for
citizenship? |
| A: | Examples of acceptable verification include:
- U.S. Passport issued without limitations
- Certificate of Naturalization (N-550 or N-570)
- Certificate of U.S. Citizenship (N-560 or N-561)
- U.S. Birth Certificate issued by the State,
Commonwealth, Territory or local Jurisdiction
|
| | |
CMS Coverage
| Q: | I have CMS, can I use it with any doctor? |
| A: | No, when you were certified for CMS you were asked
to choose one of the community health centers as your primary
care provider. You should go to the community health center you
selected for your care. |
| | |
| Q: | Does County Medical Services cover
medications? |
| A: | CMS covers medications that are on the CMS approved
list. If your medication is not on the approved list, your
primary care physician may submit a treatment authorization
request (TAR) to CMS for review. |
| | |
| Q: | What if it is not a CMS covered prescription? |
| A: | If your physician prescribes a medication that is
not covered by CMS, your primary care physician may submit a
Treatment Authorization Request (TAR) to CMS for review. |
| | |
| Q: | Where can I get my prescriptions filled? |
| A: | Prescriptions must be filled by a CMS contracted
pharmacy or by your primary care provider. If you fill your
prescription at a pharmacy that does not contract with CMS or
you fill a prescription that CMS did not approve, you are
responsible for paying for the medication yourself. A list of
CMS Pharmacies can be found in your CMS Patient Handbook. You
can also find the CMS Patient Handbook by selecting "CMS
Handbooks" in the drop down menu. |
| | |
| Q: | Does CMS cover dental services? |
| A: | CMS covers emergency dental care ONLY at a CMS
dental clinic. CMS does not provide complete dental care such as
routine check-ups, cleaning, or dentures. |
| | |
| Q: | Where can I see a dentist? |
| A: | A complete list of authorized dentists is listed in
your CMS Patient Handbook. You can also find the CMS Patient
Handbook by selecting "CMS Handbooks" in the drop down
menu. |
| | |
Share of Cost (SOC)
(applies only to those who have applied for the CMS Hardship)
| Q: | What is Share of Cost (SOC)? |
| A: | SOC is the amount that you must pay or be obligated
to pay toward the cost of CMS covered health care services
(including CMS approved prescriptions) each month you receive
CMS services. This is different from the Reimbursement Agreement
and Lien described below, which might not be collected until
some time in the future. |
| | |
| Q: | How much will my SOC bill be? |
| A: | Your worker will determine the amount of your
monthly SOC, and you will be notified of this amount and how it
was calculated. |
| | |
| Q: | Am I required to pay my SOC every month? |
| A: | Only if you receive CMS services every month. You
will not be responsible for paying your SOC in months you do not
receive CMS services. Please do not send payments to CMS until
you receive a statement. |
| | |
| Q: | How do I pay my SOC? |
| A: | You will be billed the amount of your SOC or the
amount of CMS services, whichever is less. You will not be
billed for any months in which you do not receive CMS services.
The billing statement will include the address where to send the
monthly payments. Do not send payments to CMS until you receive
a billing statement. Do not send cash. The County will not
accept cash payments. |
| | |
| Q: | Is interest added on to what I owe? |
| A: | No |
| | |
| Q: | When will I be required to make payments? |
| A: | When you receive a bill from the County it is due.
If you have questions regarding SOC billing and collection, you
can call our SOC bill representative at 1-877-702-6508. |
| | |
| Q: | I just saw my physician, when will I receive a
statement? |
| A: | Once all claims are received from your health care
provider. - If your Share of Cost has been satisfied for
the month, a monthly statement will be sent.
- If
your Share of Cost is not satisfied for the month, a
quarterly statement will be sent.
|
| | |
| Q: | Can I pay the SOC with credit cards? |
| A: | Yes, the County accepts Master Card, Visa, and
Discover. You may also make payments with personal checks,
cashiers checks or money orders. The County does not accept cash
payments. |
| | |
| Q: | Why did I receive a statement? |
| A: | Based on your recent CMS and CMS Hardship
applications, you were approved CMS with a Share of Cost. You
received a statement because you received CMS services and are
responsible for paying your Share of Cost. |
| | |
Reimbursement Agreement
(applies only to those who have applied for the CMS hardship)
| Q: | What is the purpose of the Reimbursement
Agreement? |
| A: | It allows the County to seek reimbursement from you
for: - Your monthly SOC obligation for those months
which you received CMS services, and/or
- Any health
care related costs CMS paid on your behalf.
|
| | |
| Q: | When can I be required to make payments to the
County? |
| A: | While you are eligible for CMS you will receive a
bill from the County for your SOC for each month you receive CMS
services. You are obligated to pay the SOC when you receive a
bill. After you are no longer eligible for CMS, you will receive
a bill from the County for the balance due on your account for
all amounts paid by CMS on your behalf stating that payments are
due. |
| | |
| Q: | If I sign the Reimbursement Agreement do I still
have to sign the Lien? |
| A: | If you are applying for a CMS Hardship, then yes,
you must sign both documents. |
| | |
| Q: | What is the difference between the Lien and the
Reimbursement Agreement? |
| A: | - The Lien attaches to real property to
secure the amounts owed to the County for payments made by
CMS on your behalf.
- Reimbursement Agreement--Once
you are no longer eligible for CMS, the County may bill you
for the balance due on your account and seek reimbursement
from your assets or surplus income.
|
| | |
| Q: | Can you take my inheritance and/or lottery winnings
with the Reimbursement Agreement? |
| A: | Yes, if you have surplus money from these sources
after meeting your support needs and those of your family. If
part of what you inherit is a home that you, your spouse, your
minor children, or any dependent child of any age who is
incapable of self-support because of a mental or physical
disability lives in, the County cannot foreclose on that
home. |
| | |
| Q: | When do I have to reimburse the County? |
| A: | When you stop getting CMS or when you die. The
County can collect reimbursement from those assets you obtained
after you applied for CMS, if there is surplus after meeting the
support needs of yourself and your family. |
| | |
| Q: | How will signing the Reimbursement Agreement with
the County affect my credit? |
| A: | Signing the Reimbursement Agreement will not affect
your credit. It is not a recordable document. |
| | |
| Q: | Will my wages be garnished? |
| A: | No, unless the county obtains a judgment and you
fail to pay the judgment. Even then, the County may only garnish
your wages if you have surplus money after meeting the support
needs of yourself and your family. |
| | |
| Q: | How long does a Reimbursement Agreement last? |
| A: | Until you have fully repaid the amount you owe the
County. |
| | |
| Q: | Does the Reimbursement Agreement include my
children's assets (property, lottery winnings...)? |
| A: | No. |
| | |
| Q: | Can my children be held responsible for repaying
the County? |
| A: | No. |
| | |
| Q: | Do I have to repay the County just because I get a
new job? |
| A: | No. |
| | |
| Q: | Is interest added on to what I owe? |
| A: | No, unless the County obtains a judgment. |
| | |
| Q: | Can I pay what I owe the County with credit
cards? |
| A: | Yes, the County accepts Master Card, Visa, and
Discover. You may also make payments with personal checks,
cashiers checks or money orders. The County does not accept cash
payments.
|
| | |
| Q: | Why am I receiving a bill from the County? |
| A: | When you applied for CMS benefits, you signed the
form CMS-106 Agreement to Reimburse the County of San
Diego. By signing the form, you agreed to repay all the
money paid by CMS on your behalf for your care. The bill is the
amount you now owe the County.
|
| | |
| Q: | Can I make payment arrangements? |
| A: | Yes, you can make arrangements by contacting:
County of San Diego
Office of Revenue
Recovery
P.O. Box 129037
San Diego, CA
92112
(619) 515-6200
|
| | |
| Q: | Can I get a copy of the reimbursement agreement I
signed? |
| A: | Yes, you can request a copy of the signed
reimbursement agreement by sending your signed request to:
County Medical Services
P.O. Box 85222 MS
0557E
San Diego, CA 92186
|
Liens
| Q: | Do I have to sign a Lien agreement? |
| A: | Yes, Everyone who applies for CMS starting April
11, 2008, is required to sign a Lien. If you applied for CMS
before April 11, 2008, you do not have to sign a Lien. If you
are confined to the hospital for tuberculosis ("TB"),
you may not have to sign the Lien. If you are confined to the
hospital for TB and you are also receiving services not related
to TB, you may not have to sign the Lien. If you are in the
hospital for other reasons, but not confined to the hospital for
TB, the fact that you have TB does not exempt you from signing
the lien. |
| | |
| Q: | What is the purpose of the Lien? |
| A: | It attaches to real property to secure the amounts
you owe the County for amounts paid by CMS on your behalf. It
allows the County to seek reimbursement for such amounts from
your real property. |
| | |
| Q: | If I sign the Lien, will I be forced to move out of
my home? |
| A: | No. |
| | |
| Q: | If I sign the Lien, do I have to sell my home? |
| A: | No. |
| | |
| Q: | I am a renter and own no real property. Do I have
to sign the Lien? |
| A: | Yes. The Lien will attach to real property you may
own on the future. |
| | |
| Q: | Can you take my inheritance and /or lottery
winnings with the Lien? |
| A: | No, the Lien is effective only against your real
property. |
| | |
| Q: | Will my wages be garnished? |
| A: | No. |
| | |
| Q: | Can the County foreclose on the lien on my home
while my family lives in our home? |
| A: | No. The County cannot foreclose on your home during
your lifetime or your spouse's lifetime. The county also cannot
foreclose on your home while your minor children live in your
home or during the lifetime of any dependent child of any age
who lives in the home who is incapable of self-support because
of a mental or physical disability. |
| | |
| Q: | Can I sell my home and buy another one? |
| A: | Yes, you can sell your home and buy another one as
long as the County's Lien is transferred to the new home. The
County will release the Lien on the original home and transfer
it to the new home, provided that it finds its security will not
be impaired. |
| | |
| Q: | Can I refinance my home? |
| A: | Yes, as long as the County's Lien is not
compromised, you can refinance. You can also use your home for
security to borrow money for the purpose of making improvements
on your home as long as the County finds that its security will
not be impaired. |
| | |
| Q: | How will signing the Lien affect my credit? |
| A: | The recording of a Lien is a matter of public
record, and will appear on credit reports the same way mortgage
or other loan is listed. |
| | |
| Q: | How long does the Lien last? |
| A: | Until you have repaid the amount owed to the
County. |
| | |
| Q: | If I sign the Lien, does it prevent me from buying
real property in the future? |
| A: | No, but the Lien would attach to any real property
you buy in the future. |
| | |
| Q: | Does the Lien include my children's real
property? |
| A: | No. |
| | |
| Q: | What if I own my home with someone else? |
| A: | The Lien will not attach to the other person's
interest in the home. |
| | |
| Q: | When will I be required to make payments on the
Lien? |
| A: | After you are no longer eligible for CMS you may be
required to make payments to the County. Such payments would
reduce the amount secured by the Lien. The County cannot
require you to use equity in your home to pay the Lien. If you
sell your home and do not buy a new one that you, your spouse,
your minor children, or any dependent child of any age who is
incapable of self-support because of a mental or physical
disability lives in, or if you refinance your home the lender or
the County may require you to pay all or a portion of the
amounts owed the County. Also, if real property is purchased
after the Lien is signed, the Lien will have priority (based on
recording date) over a Deed of Trust issued by the lender. A
lender may require that the Lien be satisfied before making the
loan. |
| | |
| Q: | Do I have to repay CMS if I get a new job? |
| A: | No. |
| | |
| Q: | Is interest added on to what I owe? |
| A: | No. |
| | |
| Q: | For married couples, do both spouses have to sign
the Lien? |
| A: | Yes, the applicant and spouse both have to
sign the lien in front of either a Deputy County Clerk or
Notary Public so that the form can be properly witnessed. If
you are no longer residing with your spouse and are unable to
obtain your spouse's signature notify your worker. Your
worker will advise you of alternate documentation that CMS may
accept. |
| | |
| Q: | For married couples who are separated or divorced,
do both spouses have to sign the Lien? |
| A: | No. Only the applicant needs to sign the Lien,
but legal documentation regarding the separation or divorce
must be provided. If you are unable to provide legal
documentation, notify your worker. Your worker will advise
you of alternate documentation that CMS may accept. |
| | |
| Q: | If an unmarried couple owns a home together, do
both owners have to sign the Lien or just the applicant? |
| A: | Just the applicant. |
| | |
| Q: | If my spouse is deceased, is documentation
required? |
| A: | Yes, a copy of a death certificate or some other
evidence of the death must be provided. If you are unable to
provide legal documentation, notify your worker. Your worker
will advise you of alternate documentation that CMS may
accept. |
| | |
| Q: | Can I pay the Lien with credit cards? |
| A: | No, payments to clear a Lien must be made by
certified funds. |
| | |
| Q: | If a married couple applies for CMS on separate
occasions, do the lien forms need to be signed again by both
applicant and spouse? |
| A: | Yes. |
For more information call us at 1-800-587-8118
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