Medically Indigent Services Program (MISP)

You may be eligible for MISP if:

• You are a resident of Fresno County lawfully living and with the intent of continued living in Fresno County.
• You provide documentation showing that they are a U.S. Citizen or a Lawful Permanent Resident (LPR) of the United States.
• You are 19 - 64 years old.
• You have income up to 224% of the 2014 FPG (Federal Poverty Guidelines) and limited assets (cash and property). See the Share of Cost Determination and Asset Schedule below.
• You have a current medical need that MISP covers.
• You are not eligible for and have no other sources of health coverage available
  • AND you have applied for and been denied Medi-Cal
  • AND Covered California Bronze Insurance Plan premium will be greater than 8% of their yearly income. 

Income, Share of Cost and Assets

*Program maximum for household size

Share of Cost

Share of cost is the monthly amount you may have to pay to the provider towards your health care costs before MISP will pay the remainder. See the Share of Cost Fact sheet for more information.

• Share of Cost Fact Sheet- English(PDF, 107KB)
• Share of Cost Fact Sheet- Español(PDF, 100KB)
• Share of Cost Fact Sheet- Hmong(PDF, 98KB)
• Share of Cost Fact Sheet- Lao(PDF, 579KB)
• Share of Cost Fact Sheet- Khmer(PDF, 601KB)

Financial Hardship Waiver

You may apply for a Financial Hardship Waiver if your income is above the no share-of-cost amount or above 224% of the 2014 FPG or top limit. If you make court ordered payments, payments on a past medical debt pursuant to a payment plan, or payments on past due federal or state taxes, you may be able to deduct the amount of those payments from the month’s income in which you made the payments which could lower your share of cost or could allow you into the program if your income is above 224% of the FPG. In order to be allowable, the payment(s) require documentation.

MISP Approval and Denial Information

Duration of Eligibility

MISP provides short-term assistance to help clients pay for a specific medical need. Once approved, clients are granted either one month or three months eligibility, depending on whether or not you have the required documentation and whether your income and assets change from month to month or if your income is steady month after month. You will need to reapply if you continue to have a medical need at the end of your eligibility period.

Documents

If you do not have the necessary documentation to fully assess your application when you bring your completed application to the MISP Unit Office, you will be given a list of the documents required and you will have ten (10) County working days to bring those documents back to the MISP Unit Office. If you do not bring the necessary documentation within the ten (10) County working day limit, your application will be denied. If you are approved for MISP, your MISP will not start until you have submitted the complete application, including required documentation.

Documents should not be mailed as there is no guarantee that the MISP Unit Office will receive them within the time limit as the mailed documents could be misdirected or be lost in the mail nor will the MISP Unit Office be responsible for returning any documents to you if we receive them in the mail.

Eligibility Determination

You will be given a MISP Eligibility Determination Certification and/or a Notice of Action informing you of the MISP determination (approved for MISP or denied MISP). If your MISP application is denied because you do not meet all of the eligibility requirements, you may reapply for MISP at any time.

If you are denied MISP, you may be eligible to appeal the decision. Call the MISP Ombudsman at (559) 600-7069 for further information.

Where and How MISP Services are Provided

Medical Provider

Medical services are provided at Community Regional Medical Center (CRMC) by a Central California Faculty Medical Group (CCFMG) medical provider (e.g., doctor, nurse practitioner, physician assistant). All services with the exception of emergency room services require prior authorization from MISP. Services provided at other hospitals or by other providers are not covered by MISP.

Medical Referral

If your primary care physician believes you need services that he/she can’t provide, but are services provided by MISP, he/she can refer you to CRMC for those services. Your doctor would ask MISP for prior authorization for those services and, if approved by MISP, he/she would arrange for the necessary medical care at CRMC.

If you require primary care services, you may be able to receive those services from the Federally Qualified Health Centers (FQHCs) that are located in Fresno County. See the FQHC-RHC link below for location, phone number, and hours. FQHCs provide primary care, basic laboratory and X-ray services, case management, and preventative healthcare on a sliding fee scale. Alternatively, if you require primary care services, you would call CRMC at (559) 459-6000 and request a primary care appointment and they will transfer you to the correct clinic. You would let the scheduler know that you are either MISP approved or will be applying for MISP before your appointment at least fifteen (15) County working days before your appointment. The CRMC clinic will ask MISP for authorization prior to your appointment date. 

What Does MISP Cover?

Emergency Services

MISP covers emergency services at the CRMC emergency room for an emergency medical condition or emergency symptoms. Non-emergency follow-up care that is provided in the emergency room is not an MISP covered service.

Covered Services

MISP covered services include adult primary care, specialty care (e.g., cardiology, obstetrics and gynecology, neurology, etc.), inpatient hospitalization, outpatient surgery, X-rays, CT scans, MRIs, laboratory services, home health, pharmacy services, physical and occupational therapy.

Excluded Services

Services not covered by MISP include any service that is not covered by Medi-Cal, non-emergency dental, vision, and behavioral health care services, organ transplants, chiropractic and acupuncture, fertility treatments and reversals, family planning services, impotency services, abortion, skilled nursing and long-term care facilities, methadone maintenance, drug and alcohol treatment, allergy testing, allergy injections or treatment, sexual reassignment surgery, gastric bypass or other weight loss surgery or weight loss/control services, adult day health services, and non-emergency Hepatitis C treatment.

Complaints

To file a complaint about MISP or MISP medical services or if you need further information, call the MISP Ombudsman at (559) 600-7069. The MISP Ombudsman can assist you by trying to resolve your complaint.

Locate Federally Qualified Health Centers and Rural Health Clinics located in Fresno County.