medicaid eligibility and patient liability determinations - Kymmis.com
medicaid eligibility and patient liability determinations - Kymmis.com
medicaid eligibility and patient liability determinations - Kymmis.com
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Cost Share Rules<br />
Calculating Patient Liability<br />
• The process starts by determining the total in<strong>com</strong>e of the member <strong>and</strong><br />
subtracting from that allowable deductions, the balance is the PL.<br />
• Allowable deductions include:<br />
– A personal needs allowance:<br />
• $40 NF {$30 for SSI recipients},<br />
• $694 Waiver- adjusted yearly to equal the SSI benefit plus $20<br />
– Community spouse’s monthly in<strong>com</strong>e allowance (if applicable <strong>and</strong><br />
paid)<br />
– Family in<strong>com</strong>e allowance if there are minor children in the home<br />
– Allowable medical expenses
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