Regional Center and Copayment Assistance

Article
Nov. 19, 2021Updated Oct. 17, 2022

Regional Center will assist with copays for services that are required to meet the goals in an Individualized Program Plan — including therapies — for families with income under 400% of the federal poverty level (FPL). Limited exceptions may apply in cases of extenuating circumstances or significant unreimbursed medical expenses for the child (read more on this below).

To see whether you may be eligible, multiply the figure in the chart below by 4 based on your household size:

Do not include income from in-home supportive services (IHSS) in your calculation if you are a parent provider for your child.

In some limited circumstances, Regional Center may provide copayment assistance for families who are above 400% FPL, typically when there are extenuating circumstances or extraordinary medical expenses. Regional Center may agree to consider your extenuating circumstances before issuing a decision, or you may need to file a request for hearing if you have already received a denial based on excess income.

Families who have secondary or “straight” Medi-Cal coverage may need to demonstrate to Regional Center that the provider does not accept Medi-Cal, as Medi-Cal can also assist with copayments when the provider is a contracted Medi-Cal provider under the recipient’s specific plan or program type.

You can read more about the requirements here.

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