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Outpatient Reduced-Cost Simplified Application (ORSA) Plan
 
What services are offered?
ORSA covers outpatient medical care and medicines at Department of Health Services (DHS) health facilities. You cannot use ORSA for inpatient medical care.

Who can be covered?
Los Angeles County residents not eligible to full-coverage Medi-Cal may qualify for ORSA.  Effective July 1, 2009, Los Angeles County residents receiving full-coverage Medi-Cal may qualify for ORSA for those benefits that Medi-Cal will no longer cover.  These changes affect only the Multi-Service Ambulatory Care Centers (MACC), Comprehensive Health Care Center (CHC) and Health Centers (HC).

Persons receiving restricted Medi-Cal may qualify for ORSA for non-emergency and non-pregnancy related services.  Persons who are potentially eligible for Medi-Cal must apply for and cooperate with the Medi-Cal application process before they can be considered for ORSA.

Is there an income limit?
Patient and patient's responsible relatives with total countable net income of less than or equal to 133 1/3% of Federal Poverty Level (FPL) would have no ($0) liability. Patients with total countable net income greater than 133 1/3% of FPL would have their liability established using the same calculation as outpatient ATP.  (Total net income minus allowable income deductions).

Is there a property limit?
No, only certain resources, (i.e., cash on hand, stocks, bonds and checking/savings accounts, etc.) are included to determine liability if net income is greater than 133 1/3% FPL.

Can an individual receive ORSA if she/he has other health insurance?
No.  Patients eligible for third-party coverage (e.g., Medi-Cal [full scope], Medicare, Healthy Families, private/group health insurance, CCS, TRICARE, Family PACT, Cancer Detection Programs: Every Woman Counts, etc.) would be ineligible for ORSA.

Effective July 1, 2009, Los Angeles County residents receiving full-coverage Medi-Cal may qualify for ORSA for those benefits that Medi-Cal will no longer cover. These changes affect only the Multi-Service Ambulatory Care Centers (MACC), Comprehensive Health Care Center (CHC) and Health Centers (HC).

Is citizenship or legal residency required?
No, but they must be a Los Angeles County resident and provide acceptable proof of address. Persons with unexpired "visitors" visas and certain categories or work permits are ineligible.

How to file an application?
Apply at any Los Angeles County DHS health facility.  Mail-in renewals are also available or call the toll-free information line 1(800)378-9919.  To locate the nearest Los Angeles County DHS Health facility, Click Here.

Last Updated: May 2012

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