Medicaid Policy
Medicaid Policy
Previous Policy (431-11 was previously found in section 409-13 until November 1, 2021)
Members who are allowed these deductions have been approved for one of the following Home and Community Based Care waivers:
Personal Needs Deduction: Deduct an amount equal to 100% of the federal poverty rate for one from the member's income. (See Table II)
Shelter Cost Deduction: These members are allowed this income deduction so they can pay their shelter for themselves or share the cost with their spouse.
a. Allow actual costs up to $300 for rent, or mortgage, property taxes, home-owner’s or renter’s insurance, etc.
b. If member has a heating or cooling expense, allow the Standard Utility Allowance as allowed under the Food Stamp program. If the member does not have a heating or cooling expense, but has utility expenses other than just a phone, allow the Food Stamp WOHA (without heat) deduction. If the member only has a phone expense, allow the Food Stamps Phone Only allowance. (See Table II-A)
c. If the member is married, allow a shelter cost deduction of only ½ the allowable rates identified in #A and #B above.
d. If the members are married and both are eligible for one of these waivers, allow an actual mortgage/rent cost deduction of up to $300.00 for each person. (If actual mortgage or rental costs were $500.00 you can allow a $300.00 deduction for one spouse and a $200.00 deduction for the other. The total combined deductions cannot exceed the actual costs of the couple.) Allow only one utility deduction. The utility deduction may be split between spouses if this will reduce the total spenddown paid by the couple..
Spousal Needs Allowance: Deduct an amount for the waiver member's community spouse as described in Sec. 431-9.
Family Needs Allowance: Deduct an amount for the waiver member's dependent family members as described in Sec. 431-10.
Health Insurance Premiums: Deduct the amount of health insurance premiums the member pays for his or her own coverage as described in Sec. 431-1.3.
Medical Expenses: Deduct medical expenses the member pays or incurs for medical services as described in Sec. 463-3.
The amount of income left after deducting the above amounts is the member's contribution to cost of care. The member must pay that amount to the agency like a spenddown amount before receiving a medical card.