Page 350

24.9 Notice to Fiscal Agent Concerning Any Remaining Deductible When the member receives a medical bill that is equal to or greater than the amount he or she still owes on the deductible, he or she can be certified for Medicaid. He or she must pay the part of the bill that equals the deductible. Medicaid will consider the remainder of the bill for payment. To make sure that Medicaid does not pay what the member still owes on the deductible, send a Medicaid Remaining Deductible Update (F-10109) to the fiscal agent indicating the amount of the bill that the member owes. The fiscal agent subtracts this amount from the bill and Medicaid pays the rest. Fill out the Medicaid Remaining Deductible Update (F-10109) only if: A Medicaid certified provider has provided the billed services. The person, having met the deductible, is being certified. If he or she is not being certified, Medicaid will not pay any of the bill. The date of the bill is the date the deductible was met. Since the member is not eligible until he or she has met the deductible, he or she still owes for all bills prior to that date. If more than one bill was incurred on the date the deductible was met, send additional Medicaid Remaining Deductible Update (F-10109) forms for any other bills for which the member would be responsible. This page last updated in Release Number: 20-03 Release Date: 08/03/2020 Effective Date: 08/03/2020 24.10 Late Reporting of Deductible Information If the client turns in late reports on income changes or medical costs, recalculate the deductible as of the date the change took place or the medical cost was incurred. See what would have been the deductible had he or she reported the changes and the medical costs as they occurred. If the medical bills would have met the deductible for any past date, begin Medicaid certification on that date. This page last updated in Release Number: 08-01 Release Date: 02/01/2008 Effective Date: 02/01/2008 24.11 Reserved This page last updated in Release Number: 15-01 Release Date: 06/10/2015 Effective Date: 06/10/2015 24.12 Changes After Meeting a Deductible 24.12.1 Changes After Meeting a Deductible Introduction When the fiscal group has met the deductible, it can be certified for Medicaid to the end of the deductible period.