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Medically Indigent Services Program (MISP)

Who can use this service?

You may qualify for MISP if:

  • You are 19–64 years old
  • You have income over 138% and up to 250% of the federal poverty level (FPL).
  • You have limited assets (cash and property)
  • You have a current medical need that MISP covers   
  • You have no other source of health coverage available
  • You are not eligible for Medi-Cal or any other public health coverage
  • You are a resident of SLO County and a legal resident of the U.S.
  • You have a qualified hardship (see list below) exemption from the tax penalty for not having minimum essential health coverage. A qualified hardship, or exemption, is the reason or cause that prevented you from obtaining health insurance. Click here for more information about the federal law, tax penalty, and the exemption.

List of MSIP Qualified Hardships:

  • Coverage is unaffordable: The lowest-priced coverage available (the Bronze Plan), including any premium assistance, would cost more than 8 percent of household income
  • Became homeless
  • Evicted in the past six months, or facing eviction or foreclosure
  • Received a shut-off notice from a utility company
  • Recently experienced domestic violence
  • Recently experienced the death of a close family member
  • Recently experienced a fire, flood, or other natural or human-caused disaster that resulted in substantial damage to one’s property
  • Filed for bankruptcy in the last six months
  • Incurred unreimbursed medical expenses in the last 24 months that resulted in substantial debt
  • Experienced unexpected increases in essential expenses due to caring for an ill, disabled, or aging family member
  • Other hardship in obtaining health insurance

What is the process?

Step 1: Find out if you qualify for other coverage.

Before you apply for MISP, find out if you qualify for Medi-Cal. MISP can help you with this step, or you can get information and apply for Medi-Cal at Covered California. If you're eligible for Medi-Cal, then you're not eligible for MISP. Medi-Cal provides long-term and full-scope health coverage. MISP provides short-term and very limited coverage.

If your income is too high for Medi-Cal, then find out if you qualify for financial assistance, or subsidies, towards purchasing a private insurance plan at Covered California. Unlike MISP, private insurance plans provide long-term and full-scope health coverage.

Step 2: Call for an appointment

Call MISP at (805) 781-4838 to start the application process. If a representative is not available, please leave your name, phone number and best time to call you back.
The MISP representative is available to talk with you about eligibility and to schedule an appointment with you to apply in person for MISP. The MISP representative may also help you to apply for Medi-Cal or insurance through Covered California.  

Step 3: Bring required information to application appointment.

Bring the following documentation with you to your MISP application appointment.

  • Government issued photo ID with date of birth. Any one of the following:
    • Social Security Card
    • U.S. Birth Certificate
    • U.S. Passport Naturalization Certificate
    • Alien Registration (Green Card)
  • Any one of the following to show your current address is in SLO County:
    • Current California Driver’s License or ID card
    • Most recent filed tax return
    • Rent receipt, bank statement, utility bill, or pay stub that includes name, recent date, and local place of residence
  • Current bank statements, retirement or pension fund statements, and life insurance policies
  • Signed copy of most recent filed federal tax return
    • If self-employed, also include Schedule C or F and last 3 months’ profit and loss statements
  • If current income is very different from tax return, then provide other documentation:
    • Last 3 pay stubs showing gross monthly income and dates paid
    • Current statements from other potential sources of countable income (listed below): 
      • SSA (Retirement, Disability, Survivors)
      • Retirement income  (IRA, 401(k), Pension, etc)
      • Unemployment benefits
      • Self-employment profits
      • Tips
      • Commissions
      • Royalties
      • Dividends
      • Annuities
      • Rental property
      • Tribal gaming distributions

Step 4: Follow up

Applicants have up to seven (7) working days to provide MISP with all information requested. MISP may extend the deadline based on circumstances. 

Applications will be denied if applicants fail to provide all requested information within the time frame specified.

Is there a charge for this service?

There is no fee to apply for MISP, but you may have to pay your providers some of the costs of your health care before MISP will pay the remainder. See the Share of Cost Fact Sheet or call MISP at (805) 781-4838 for more information.

When and where is this service offered?

The MISP office is open during regular business hours except during scheduled holidays.

Frequently Asked Questions

How does MISP work?

MISP is available to qualifying residents of San Luis Obispo County who have a current illness or injury and no other way to pay for necessary medical care. If you've experienced a recent medical event, such as a trip to the ER or a stay in the hospital, MISP may be able to help you pay for some of those costs.

Short-term Assistance

MISP provides short-term assistance to help MISP clients pay for a specific medical need. Once approved, clients are granted eligibility for either three months or for six months, depending on the medical need. Clients may reapply if they continue to have a medical need at the end of their eligibility period.

Share of Cost

Share of cost is the monthly amount clients have to pay their providers, or agree to pay, towards their health care costs before MISP will pay the remainder. Share of cost works something like an insurance plan's deductible.

Primary Care at CHC

MISP clients receive primary care through one of the Community Health Centers (CHC) clinics located throughout SLO County. For more information, call CHC at 805-929-3211 or visit

Clients do not have to pay a share of cost towards covered medical services received at CHC.

What does MISP cover?

Primary care, pharmacy, and some laboratory tests, x-rays, and ultrasounds are provided through the Community Health Centers (CHC) clinics located throughout SLO County.

All other medical services, except for emergency services, must first go through your CHC primary care provider AND receive prior authorization from MISP.

Not Covered: Preventative care, health screenings, contraception, and pregnancy services are not covered.

About Emergency Services: MISP covers emergency services at SLO County hospitals only for symptoms from an emergency medical condition. An emergency is a very serious problem that requires immediate medical attention to prevent serious harm or death. If it is not an emergency, then call your primary care doctor first. If the doctor's office is closed, you can still call and you will be referred to the on-call doctor. The on-call doctor can help answer your questions and let you know if you need to go to the emergency room. 

What are the qualifying income levels?

MISP uses the Federal Poverty Level (FPL) to determine income eligibility. These levels, set each year by the federal government, take into account the individual's annual household income and household size.

Qualifying income levels for MISP must be over 138% FPL, but not more than 250% FPL. View Covered California's Federal Poverty Level (FPL) chart .

Household income includes the income for each member of the household, even if only one member is applying for MISP.

Is MISP a health insurance plan?

MISP is not health insurance and it is not Medi-Cal. MISP offers short-term assistance to help pay for some medical expenses. MISP does not meet the legal requirement to maintain minimal essential coverage, which means you could be subject to a tax penalty.

How do I get full health coverage?

MISP does not provide full health coverage like Medi-Cal or an insurance plan. Covered California is our state’s online health insurance marketplace where you can find out if you are eligible for free coverage through Medi-Cal, or for financial assistance to purchase health insurance. Enroll or just get answers online at or call 1 (800) 300-1506.
Covered California can also find you nearby certified enrollment counselors or insurance agents who will provide in-person assistance.
If you have questions about insurance, obtaining medical care, plan options with Covered California or Medi-Cal, call CHC at (805) 929-3211. Or call the local office of the Department of Social Services at (805) 781-1600.

Is MISP part of the ACA or ObamaCare?

No. MISP is a program of the County of San Luis Obispo to help qualified low-income residents pay for necessary care.

How do I get a federal exemption for health coverage?

Most people must have qualifying health coverage or pay a fee for the months they don't have insurance. But if you qualify for a health coverage exemption you don't need to pay the fee (tax penalty).
Health coverage exemptions: Forms and how to apply

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