Deductions

After being determined eligible for LTC Medicaid, some individuals who are residing in nursing homes, or who are receiving home and community-based (HCB) waiver services may be required to contribute a portion of their income toward the cost-of-care they receive. The post eligibility process involves determining the exact amount an individual is obligated to pay to the medical institution, nursing home, or HCB waiver services provider. The provider is responsible for collecting from the individual that individual's share of the cost-of-care. Medicaid reduces its payment to the provider by the amount of the individual's cost-of-care liability.

These are the steps to follow when determining the individual's contribution towards cost of care. The individual's contribution towards cost of care is calculated on a monthly basis.

• Determine the individual's gross earned income AND
• If the individual's earned income is greater than zero, apply the Earned Income Deduction to earned income AND
• Total the individual's unearned income and earned income to give gross income for the individual.
• If the individual's gross income is greater than zero, apply the Personal Needs Allowance AND
• If the individual's remaining gross income is greater than zero, apply the Community Spouse Needs Allowance AND
• If the individual's remaining gross income is greater than zero, apply the Family Dependent Allowance AND
• If the individual's remaining gross income is greater than zero, apply the Medical Expense Deduction AND
• If the individual's remaining gross income is greater than zero, apply the Home Maintenance Allowance AND
• If the individual's remaining gross income is greater than zero, apply the Legal Guardian Expense Deduction.
• The remaining amount after the deductions/allowances are applied, is the individual's contribution towards cost of care for the month.