Medi-Cal What it Means to You - San Francisco Public Schools

28. WHAT IF I HAVE BEEN HURT BY ANOTHER PERSON OR HURTAT WORK?If you are hurt by another person or hurt at work, you may use your BICto get services. You must report the accident or injury to your countyeligibility worker so that the MEDI-CAL program can be paid back by theresponsible party.Also, send or fax the information OR You may call:listed below to: (916) 650-0490Dept. of Health Care ServicesRecovery Personal Injury UnitP.O. Box 997425, MS 4720Sacramento, CA 95899-7425FAX (916) 650-65811. Your name, address, and phone number.2. Your BIC number, and Social Security Number.3. The date you were hurt and what happened.4. The name, address, and phone number of your attorney, if you hired one.5. The name, address, and phone number of the person who hurt you.6. The name, address and phone number of the liable insurance company;also add the policy number.7. If you were hurt at work, the name, address and phone number of youremployer.29. WILL MEDI-CAL BILL A DECEASED MEDI-CAL BENEFICIARY’SESTATE?MEDI-CAL may claim against the estate of a MEDI-CAL beneficiary who hasdied after October 1, 1993, only if:• MEDI-CAL paid for certain medical services after the beneficiary’s 55 thbirthday, and the deceased MEDI-CAL beneficiary had no survivingspouse, minor, or totally disabled child(ren), and• the MEDI-CAL claim against the estate does not create a substantialhardship on the heirs of the deceased MEDI-CAL beneficiary.MEDI-CAL shall impose a lien upon the equity interest in the home or otherproperty of an institutionalized MEDI-CAL beneficiary if certain conditionsare met. Such claims and liens may be reduced if it can be demonstratedthat a substantial hardship is created on the survivors or heirs of thedeceased MEDI-CAL beneficiary.- 21 -