614.01 COST OF CARE: HCBC-DD/ABD SR 03-28, 05/03 (FAM-A)

There is no cost of care liability for individuals who are MEAD-eligible. After a non-MEAD-eligible individual is determined eligible for HCBC-DD/ABD (medical assistance-only), the individual is responsible for applying any of their net income toward the cost of care. Use the following steps to determine the amount of cost of care for HCBC-DD or HCBC-ABD:

1.  Subtract from gross earned income:

- the 50% EID for each employed TANF-related individual;

- the $90 EID for each employed poverty-level individual; and

- the child/dependent care deduction.

The result is net earned income.

2.  Add countable gross unearned income and SSI to net earned income.

3.  Subtract the $50 personal needs allowance.

4.  Subtract the TANF payment standard which corresponds to the individual’s living arrangement.

- Adjust the payment standard to include the individual’s spouse and/or children/budgetary unit members.

5.  Subtract the amount of the Medicare Part B premium if the individual:

- receives Medicare Part B; and

- is not buy-in eligible. See PART 717, BUY-IN OF MEDICARE.

6.  Subtract medical expenses incurred by the individual that are not subject to third-party payment including:

- health insurance premiums, deductibles, or coinsurance;

- necessary medical or remedial care recognized under state law but not covered by medical assistance, (see Medical Assistance Manual, Item 902); and

- currently obligated, prior unpaid medical debts.

7.  Add the VA Aid and Attendance Allowance.

8.  The result is the amount of income the individual must apply toward the cost of care.

Complete Form 517-C, Payment Towards Cost of Care Agreement.

Payment for Cost of Care: HCBC-DD/ABD

The recipient sends cost of care payments directly to the area agency. The area agency tracks cost of care payments.