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MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID MEDICAID Verification of each family member's gross income must be obtained. a) Subtract the family member's gross income from minimum needs allowance (150% of poverty). b) Divide the amount from (a) above by three. This is one family member's allowance. Repeat this calculation for each family member. If there is only one family member, the amount from (b) will be the family allowance deduction. If there is more than one family member, add each family member's allow­ ance to determine the family allowance deduction. 4. Dependent Allowance (Non-Spousal Impoverishment) A monthly income allowance for each dependent family member living in the Institutionalized individual’s home with no community spouse living in the home. Calculated by subtracting the dependents total income from the need standard (100% Need Standard) for the household size. 5. Expenses Incurred For Health Insurance Premiums, Deductibles and Co– Insurance Charges Deduct health insurance premiums, deductibles and co–insurance expenses incurred by the client. Clients/Representatives must advise the agency of medical insurance and provide proof of expenses. These expenses must not be paid or subject to payment by a third party. Medicare premiums are subject to payment by a third party. Any institutional case where the client is not a SSI recipient and will not receive a reimbursement for Medicare cost from any source, may have the Medicare premium deducted as an expense for months immediately preceding the second month after the month of approval. Example #1 (Medicaid Only): Client applied June 2nd and requests 3 months prior medical. Case is approved July 10th. Medicare premiums may be deducted from March through August. Beginning September, we cannot deduct the Medicare premium as it is then subject to third–party payments. Division of Welfare and Supportive Services F-325.5 Medical Assistance Manual LONG TERM CARE SERVICES 24 Sept MTL 05/24 PATIENT LIABILITY BUDGETING PROCEDURES