How the Benefits Check works
What the Benefits Check asks, what it refuses, and who decides.
The UniHealth Benefits Check compares your details against 243 published eligibility criteria covering 66 Santa Clara County programs. This page states what goes in, what comes out, and how to check either one. Every number on it is read from the service that does the work — not written here by hand.
What the Benefits Check asks
The Benefits Check opens with 13 questions and asks for more only when an answer would change a result. Each one is here because a published rule reads it.
The county planner can also ask for date_of_birth, because an assister working a case by hand may take it. The Benefits Check does not: it sends your age instead, and those field names are refused below.
About you
Age, household, status and residence gate almost every program.
| Field | Question | Kind |
|---|---|---|
household_size | Counting yourself, how many people live in your home? | Ordinary detail |
citizenship_or_immigration_status | What is your citizenship or immigration status? Some programs are only for citizens, and some are only for immigrants. | Highly sensitive |
zip_code | What is your ZIP code? | Identifying |
marital_status | Are you single, married, widowed, divorced, or separated? | Ordinary detail |
veteran_status | Did you serve on active duty in the U.S. military? | Ordinary detail |
Money coming in
| Field | Question | Kind |
|---|---|---|
unearned_income | How much do you get each month from Social Security, pensions, VA, or other income? Do not count pay from a job. | Financial |
earned_income | How much do you earn from a job each month, before taxes? Put 0 if you do not work. | Financial |
assets | How much do you have in savings and investments? Do not count your home or one car. | Financial |
Help at home
| Field | Question | Kind |
|---|---|---|
needs_help_with_daily_activities | Do you need help with daily tasks, like bathing, dressing, or taking medicine? | Health |
homebound | Are you mostly unable to leave your home on your own? | Health |
meal_need | Is it hard for you to make meals? | Ordinary detail |
institutional_resident | Do you live in a nursing home or another care facility right now? | Ordinary detail |
institutional_level_of_care | Has a doctor or program said you need nursing-home level care? | Health |
What the Benefits Check refuses
These field names are rejected before anything leaves your browser. Not discouraged, not deleted afterwards — refused, by the same list this page is printed from. Send one and the request fails.
Who you are
The Benefits Check never needs to know whose details these are, so it is built not to find out.
namefirst_namelast_nameemailphoneaddress
Government and insurance numbers
These identify you to an agency. Nothing in a rules check reads them, and they are what fraud asks for first.
ssnsocial_security_numbermedicare_numbermedi_cal_numberdate_of_birth
Documents and free text
Paperwork is read in your browser session and the details you confirm are what travel. The pages themselves never reach the rules engine.
documentdocumentsnotesfree_textproviderprovidersmedicationmedications
What the screening service reports about the request
- The Benefits Check does not store your answers.
- Running it creates no account and no case record.
- Identifying fields are not accepted.
- Documents are not accepted by the rules check.
- The response is never cached.
These are flags the service returns with every screening, not a description we wrote about it. If one ever stopped holding, this list would say so instead of the sentence above it.
They describe the Benefits Check itself. Keeping a copy of your results is a separate thing you would have to choose — never the default, never silent, and never something it does on its own.
Who actually decides
A match is never an approval. Each program carries the kind of decision that stands behind it, and for most of them the real decision belongs to an agency. Counts below are the 66 programs in the catalog, grouped by how their answer is reached.
| Programs | How the answer is reached | Engine names |
|---|---|---|
| 10 | Screened from the rules; an agency verifies before it is real. | RULE_PREQUALIFIED_WITH_AGENCY_VERIFICATION |
| 9 | Calculated directly from published criteria. | RULE_CALCULATEDRULE_CALCULATED_PRELIMINARY |
| 8 | An agency assesses and decides. | AGENCY_ASSESSMENTRULE_PREQUALIFIED_THEN_AGENCY_ASSESSMENT |
| 8 | Matched to a referral by published criteria. | RULE_MATCHED_REFERRAL |
| 8 | Screened from the rules; a licensed review of plan fit follows. | PLAN_FIT_REQUIREDRULE_PREQUALIFIED_THEN_PLAN_ASSESSMENTRULE_PREQUALIFIED_THEN_PLAN_FIT |
| 4 | Matched by rule; a clinical intake follows. | RULE_MATCHED_THEN_CLINICAL_INTAKE |
| 4 | Reviewed against rights and timing rules. | RIGHTS_REFERRALRULE_CALCULATED_WITH_RIGHTS_REVIEWRULE_PREQUALIFIED_AND_RIGHTS_CALCULATED |
| 4 | Screened from the rules; an agency calculates the amount. | RULE_PREQUALIFIED_WITH_AGENCY_CALCULATION |
| 4 | Screened from the rules; Social Security makes the decision. | RULE_CALCULATED_WITH_SSA_DECISION |
| 3 | Calculated from a published county table. | RULE_CALCULATED_WITH_COUNTY_AMOUNTRULE_PREQUALIFIED_WITH_COUNTY_TABLE |
| 2 | Screened from the rules; a service assessment follows. | RULE_PREQUALIFIED_THEN_SERVICE_ASSESSMENT |
| 1 | Calculated from the rules; a licensed quote follows. | RULE_CALCULATED_THEN_LICENSED_QUOTE |
| 1 | Prequalified by published criteria. | RULE_PREQUALIFIED |
Commission is never an input
UniHealth is paid nothing for a Medi-Cal, CalFresh, MSP, IHSS or Extra Help result. On the Medicare side a licensed agent can be paid, which is exactly why this is worth being able to check rather than believe: what an insurer pays is not a field the screening request accepts, so there is nothing for the ranking to weigh even if someone wanted it to. See who pays for this
Plans are put in an order for you. The order is built from your eligibility, your medicines, your clinicians and the published costs — never from what a plan pays, which is not a detail the Benefits Check receives. Nothing is chosen for you: enrolling is a licensed review with a person.
- Plans put in an order
- yes
- A plan chosen for you
- no
- Plans in the county
- 58
- Source
- medicare_plan_compare_2026 · 2026
How the order is built, in the engine’s own words
- Every plan is placed in one coverage path from the eligibility screen before it is compared.
- Only plans the person can enroll in are ranked: D-SNPs need Medi-Cal, C-SNPs need the matching condition, I-SNPs need an institutional level of care.
- Inside a path, plans with every requested medicine listed and every requested clinician confirmed rank first; plans whose directory or formulary is not loaded stay visible with that gap named.
- Then ranking uses the published monthly premium (net of Extra Help when the screen shows it), the in-network out-of-pocket maximum or Part D deductible, and the overall star rating.
- Nothing here is a recommendation or enrollment; hospital networks, prior authorization and expected annual spending are not assessed.
Plans are compared inside a coverage path, never across paths, so an order can never move you from one kind of coverage to another. Today that is Medicare and Medi-Cal together (D-SNP) (5 ranked), Medicare Advantage (26 ranked), Original Medicare with a stand-alone drug plan (12 ranked), and Original Medicare with Medigap.
Why 15 of 58 plans were left out for this example person
- 11 — Chronic-condition plan for CardiovascularDisorders, ChronicHeartFailure, DiabetesMellitus that is not reported
- 2 — Institutional plan; no institutional level of care is reported
- 1 — Chronic-condition plan for ChronicLungDisorders that is not reported
- 1 — Chronic-condition plan for ChronicMentalHealth, SubstanceUseDisorders that is not reported
Every exclusion is an eligibility rule, not a preference: a plan you cannot join is not shown as though you could.
Check a result yourself
Every screening names the exact rule set it ran against, so the same answers and the same catalog produce the same result — and a different result means the rules changed, visibly.
- Catalog
santa-clara-county-os-2026-v8- Catalog checksum
cd2b74a289bed85a422cb96b750f00f7333edfb374aceceaf77315738c9656c0- Criteria checksum
e38efdc3c90b3406268bf43a62d62658df1a222d1818a7ff55ffd0244916d5df- Criteria reviewed
- 2026-09-04 · next review due 2026-09-30
- Behind the criteria
- 92 source documents from 73 official sources
Each result on your screen carries the reason it appeared, in the rule’s own numbers, and links to the official source it came from. Every screening also returns its own checksum, so a result can be quoted and re-run.
Reviewing this for a county agency, a health plan, or a community organization? We will walk your compliance or program staff through the criteria set and the screening code directly. Ask for a review
A match is a place to look, not a decision.
The agencies and plans make the final decision. The Benefits Check is free, needs no account, and never submits anything on your behalf.
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