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Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

Immigration Sponsor Liable for Medi-Cal Debts?

By on | 6 Comments

Question: Will an immigration sponsor be responsible for Medi-Cal bills of the immigrant who is holding a permanent green card?

Answer: No. To our knowledge, no government agency in California has sought reimbursement from a sponsor up to now.


The answer to the original question: “There is no direct liability for the sponsor to repay the Medi-Cal expenses of the sponsored persons” does not match the information on the CDPH’s website: “..Form I-864.. is a binding contract by the sponsor for support of the immigrant, and for repayment of certain benefits received by the immigrant such as CalWORKs … and non-emergency Medi-Cal.”

Is this document obsolete? have the rules changed?

Source: https://www.cdph.ca.gov/HealthInfo/healthyliving/childfamily/Documents/MO-CPSP-STT-Psychosocial-NewImmigrant.pdf

Don, in-patient hospital stays are not the same long-term care. LTC usually takes place in a nursing home or assisted living facility and involves stays of 90 days or more.

would 5 weeks in-patient care, 4 surgeries, and follow up dr visits and therapy due to being struck by a car in a cross walk count as long term or institutional care in terms of triggering asset recovery?


Miles …

As I have previously posted, the rules are complex and each case is determined separately from another. You can look here for some information concerning other state-based resources which are paid for with federal dollars http://hhsa-pg.sdcounty.ca.gov/FoodStamps/63-150/63-157SponsoredNon-Citizens/63-157SponsoredNon-Citizens.htm

At that San Diego County website, you may see the following information applicable to all federal-state partnership programs inluding Medi-Cal:


A sponsored noncitizen is not subject to the sponsorship provisions if she/he: · Achieves U.S. citizenship through naturalization; or · Has 40 qualifying quarters as specified in 63-154.9; or · Leaves the U.S. permanently; or · Dies (or the non-citizen’s sponsor dies); or · Meets one of the exceptions listed below.


A sponsored noncitizen will be exempt from the sponsorship provisions when the noncitizen: · Was sponsored prior to December 19, 1997; or

· Is a victim of human trafficking, domestic violence, or other serious crimes (The exemption applies for twelve months as explained in 63-157.4 and 63-155.1); or

· Is participating in the same CalFresh household as the sponsor; or

· Is sponsored by an organization or group who are not required to sign an I-864 Affidavit of Support. Included in this group are refugees, asylees, people granted withholding of deportation, Amerasians, and Cuban or Haitian entrants; or

· Is under 18 years of age

o Individuals who are exempt from sponsor deeming while under eighteen years of age, will have their eligibility reviewed at the next recertification after they turn eighteen.

If none of the above exceptions applies, then the worker will explain three options for participation in the program. Workers must explain to the client and document their choice in case comments:

  1. Indigence

  2. Provide sponsor’s information

  3. “Opt out”

Where could a concerned immigrant (such as myself) obtain confirmation that their enrollment in Covered California healthcare would not result in their sponsor being sued by the agency for recovery of benefits? I currently qualify for Medical (as I’m between jobs and can’t prove an income) but really don’t want to take Medical as I think it might be more likely that my sponsor (my ex wife’s father) will become liable to pay…something I desperately want to avoid. I’ve been searching online and asking Covered CA agents for weeks now and nobody can give me a definitive answer. Any advice would be greatly appreciated.

The concern is that of becoming a “public charge” under USCIS regulations. A “public charge” is a person who generally requires financial assistance for their daily living expenses. As Phil commented, under the new rules for Medi-Cal/Medicaid effective January 1, 2014, the essential program is no longer means-tested for adults age 19-64 who do not require assistance with the cost of “institutional” care.

However, if an adult requires Medi-Cal to pay some or all of the cost of institutional/long-term care, that could trigger the “public charge” status for a permanent resident alien. If the alien becomes a citizen, the sponsor is released from all obligations.

It should be noted that all Medi-Cal expenses paid on behalf of adults age 55 and older (as well as younger persons who receive Medi-Cal for institutional expenses) will be accumulated and are subject to “asset recovery” rules following that person’s death. A home is the single largest asset which may be available for “recovery” — but not until a surviving spouse or minor child is no longer living in the residence. A family is always permitted to repay the benefit amount to the state as a lump sum.

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