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This page last updated in Release Number: 08-01 Release Date: 02/01/2008 Effective Date: 02/01/2008 24.5 Calculating the Deductible 24.5.1 Deductible Amount To calculate the dollar amount of a Medicaid deductible for an SSI-related fiscal test group: 1. Determine the fiscal test group's total income for each month of the deductible period (see SECTION 24.3 DEDUCTIBLE PERIOD). Subtract the applicable income disregards and deductions (see SECTION 15.3 EXEMPT/DISREGARDED INCOME and SECTION 15.7 INCOME DEDUCTIONS).

Certain income disregards and deductions allowed in other forms of Medicaid, such as the COLA and OASDI disregards for Special Status Medicaid and medical/remedial expenses for MAPP, are not deducted when calculating a deductible. 2. Compare the total countable income of each month to the SSI-related medically needy income limit (see SECTION 39.4 ELDERLY, BLIND, OR DISABLED ASSETS AND INCOME TABLES). • If a given month's income is less than or equal to the medically needy limit, ignore it. • If a given month's income is more than the medically needy limit, find the excess income by subtracting the income limit from the net income of that month. 3. Add together the excess income of the months in the deductible period. The result is the Medicaid deductible. 24.5.2 Institution Cases 24.5.2.1 Backdating Institutionalized and non-institutionalized persons can be eligible back to the 1st of the month, three months prior to the month of application. Even if they are ineligible in the month of application, they may still be eligible for retroactive coverage. When an institutionalized person requests retroactive Medicaid, test him or her against the nonfinancial and financial standards that are appropriate to the month being tested. For the months he or she was not institutionalized, use the EBD asset and income limits (39.4 EBD ASSETS AND INCOME TABLES). For the months he or she was institutionalized, use the institutional eligibility criteria found in 27.1 INSTITUTIONS. 24.5.2.2 Deductible For the months in which he or she was not institutionalized, he or she may be eligible in some, but ineligible in others, due to excess income. In this situation, he or she has two choices: 1. To be certified for the months he or she is eligible, and accept the ineligibility of the other months in which he or she has excess income, or 2. To meet a deductible. The deductible period begins in the backdate month that he or she chooses, and extends six months. Calculate the deductible for the full 6-month deductible period. Calculate the deductible by comparing his or her monthly income for each of the 6 months to the SSI-related medically needy income limit, not the institutional income limit.