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1. Providing TPL coverage and access information. 2. Turning over payments from indemnity insurance policies. 27.6.5 Support Payments Support payments are payments which an institutionalized Medicaid member makes to another person for the purpose of supporting and maintaining that person. See SECTION 15.7.2.1 SUPPORT PAYMENTS. 27.6.6 Fees to Guardians or Attorneys See SECTION 15.7.2.3 FEES TO GUARDIANS OR ATTORNEYS. This page last updated in Release Number: 24-03 Release Date: 12/18/2024 Effective Date: 12/18/2024 27.7 Cost of Care Calculation 27.7.1 Introduction After an institutionalized person has been determined eligible for Medicaid, his or her cost of care must be calculated. Cost of care is the amount the person will pay each month to partially offset the cost of his or her Medicaid services. It is called the patient liability amount when applied to a resident of a medical institution, including those enrolled in Family Care, Family Care Partnership, or PACE who are in or likely to be in a medical institution for 30 or more days. Institutionalized people are expected to pay their patient liability to the institution they are residing in, or to their MCO if they are enrolled in Family Care, Family Care Partnership, or PACE, as of the first day of the month. Calculate the cost of care in the following way: 1. For a Medicaid member in a medical institution who does not have a community spouse, subtract the following from the person’s monthly income: a. $65 and ½ earned income disregard (see SECTION 15.7.5 $65 AND ½ EARNED INCOME DEDUCTION). b. Monthly cost for health insurance (see SECTION 27.6.4 HEALTH INSURANCE). c. Support payments (see SECTION 15.7.2.1 SUPPORT PAYMENTS). d. Personal needs allowance (see SECTION 39.4 ELDERLY, BLIND, OR DISABLED ASSETS AND INCOME TABLES). e. Home maintenance costs, if applicable (see SECTION 15.7.1 MAINTAINING HOME OR APARTMENT). f. Expenses for establishing and maintaining a court-ordered guardianship or protective placement, including court-ordered attorney and/or guardian fees (see SECTION 27.6.6 FEES TO GUARDIANS OR ATTORNEYS). g. Medical or remedial expenses (see SECTION 27.7.7 MEDICAL OR REMEDIAL EXPENSES AND PAYMENTS FOR NONCOVERED SERVICES). 2. For a Medicaid member in a medical institution who has a community spouse, follow the directions in SECTION 18.6 SPOUSAL IMPOVERISHMENT INCOME ALLOCATION. 3. For a community waivers member with or without a community spouse, follow the directions in SECTION 28.6.4 COST SHARE AMOUNT. 4. There is no cost of care for SSI recipients.