Individual Contributions

Once an individual passes the eligibility rules for Long Term Care Medical Assistance, the rules check deductions (post-eligibility rules) to determine the individual's contribution towards their cost of care. This is the monthly amount an individual is obligated to pay to a medical institution, nursing home, or HCB waiver services provider for their care. The individual's contribution towards their cost of care for the month is determined as gross monthly income less allowable deductions/allowances. The allowances/ deductions specific to these calculations are the Earned Income Deduction, the Personal Needs Allowance, the Community Spouse Allowance, the Family Dependent Allowance, the Medical Expense Deduction, the Home Maintenance Allowance and the Legal Guardian Expense Deduction. The remaining amount after the deductions/allowances are applied is the individual's contribution towards their cost of care for the month. This amount is displayed as part of the eligibility decision.