State LTC Subsidy Program 510-05-95-45

(Revised 7/1/2026 Release 26.5)

 

The State LTC (Long-Term Care) Subsidy Program is a state funded program that provides additional income to qualifying Medicaid recipients who are subject to Post Eligibility Treatment of Income budgeting.  The state subsidy provides funds to help meet current maintenance needs of recipients.  This program began January 1, 2010.

  1. To qualify, an individual must:
  1. Be a Medicaid recipient;
  2. Be a SSI recipient who receives a SSI payment of $30 per month or less;
  3. Reside in a nursing facility, the state hospital, the Anne Carlsen Center; Prairie at St. John’s Center; the Stadter Center; a Psychiatric Residential Treatment Facility (PRTF), an Intermediate Care Facility for the intellectually disabled (ICF-ID); or receive swing bed care in a hospital;
  4. Have total income, between SSI and any other source, of less than $100 per month; and
  5. Be expected to reside in the facility for the entire calendar month.
  1. Determining the amount of the subsidy payment:
  1. The subsidy payment is the difference between the $30 SSI payment level and $100, less any other income available to the recipient.  The maximum subsidy cannot exceed $88 per month.
  2. If a recipient receives less than $30 in SSI benefits due to a SSI overpayment, because SSI benefits have not yet been paid, because of other income received by the recipient, because the SSI recipient is eligible under 1619(b), or for any other reason, the subsidy does not increase due to the lower SSI payment.  For subsidy calculation purposes, the SSI benefit is calculated at $88, even if the amount actually paid is less than that amount.

When a child who is a SSI recipient chooses to be eligible for Medicaid under a children and family eligibility category instead of as a disabled child, the child can still qualify for the subsidy.  

  1. Subsidy payments may be established for the application month and prospective months if the recipient is anticipated to be in the facility for the entire month for which the subsidy is determined. Subsidy payments are not established for the three months prior to application.
  2. When a recipient’s budget, including a retroactive budget in which a subsidy payment was previously established, is reworked for a month and results in an underpayment, the recipient will receive a supplement for the month.  If a reworked budget results in an overpayment for the month, the overpayment will be disregarded.
  3. Subsidy payments, including underpayments, are automatically calculated when Medicaid eligibility is authorized.
  1. Paying the subsidy
  1. There is no minimum payment amount required, however, if a payment amount is less than $10, the payment will be held until the total of the payment plus any subsequent payments total or exceed $10.  If the payment amount plus any subsequent payment amounts do not exceed $10 after three months, the payment will be paid regardless of the amount.
  2. Payments will be paid by check to the recipient.  A recipient may request a direct deposit of the payment by providing bank routing and account numbers to the county agency.  Questions related to checks or direct deposits should be directed to the Fiscal Administration Unit.
  3. Subsidy payments are issued on a weekly basis to accommodate new approvals and supplemental payments.  Checks are normally mailed on Fridays and direct deposits are normally processed on Thursday nights.
  1. Subsidy payment determinations are not appealable.
  2. There is no estate recovery for subsidy payments.