Budgeting Process 400-29-40

(Revised 3/02 ML #2795)

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The budgeting process for a Basic Care recipient is a two step process:

 

1. Determine the recipient liability for Medicaid in the TECS System. (See the Medicaid Manual, "Medically needy aged, blind, or disabled recipients, over age eighteen residing in a 'specialized facility' and 'Eligible family unit' with member(s) in a specialized facility.")

2. Determine the recipient responsibility for the room and board expense in a licensed basic care facility for the Basic Care Assistance Program through the Resident Payment System. (See the Resident Payment System Manual)

1. The recipient responsibility cannot be "offset" by outstanding medical bills. If an individual makes payment on a medical bill used to offset the Medicaid recipient liability and provides verification that payment has been made, the individual may be reimbursed for the payment by adding this as an income deduction. The state office will assist with these cases.

2. The recipient responsibility for married couples living in the same basic care facility, whether sharing a room or not, is determined separately. His income and deductions are used to determine his recipient responsibility and her income and deductions are used to determine her recipient responsibility towards the room and board expense.