Ch. 12-Medically Needy Flashcards
What deductions are allowed in non-magi under medically needy when determining eligibility?
When determining eligibility and there is earned income in the household, $65 is subtracted from the gross monthly income and then divided by two. That earned income is part of the countable when determining eligibility.
For unearned income, when determining eligibility for a non-magi household, for medically needy what deductions are allowed?
$20 is subtracted from the gross monthly unearned income which is referred to as “any income deduction” plus 0HCs (other healthcare ) expenses. Plus actual Medicare expense example being part B which is $164.90 a month educational expenses and 1/3 of child support payments received by disabled or blind child. Work expenses for the blind cost of in-home services paid by a BDMN person who is not a family member and impairment related work expenses
What is IRWE?
IRWE are those expenses of a working disabled applicant/beneficiary that are necessary for the person to become or remain employed
What is long-term care (LTC)?
Long-term care includes medical and non-medical care for people who have a chronic illness or disability and to assist people with support services, such as activities of daily living like dressing, bathing, and using the bathroom
When is a person considered to have LTC status?
These two conditions must be met: one the inpatient medical care is expected to last longer than 30 days of admission and their inpatient medical care is expected to last one full calendar month or more after the month of admission so example if a patient goes in on March 15 through the month and stays to the month of April
What other requirements occur when a patient goes into LTC?
The LTC resident will have their own MFBU and CalWIN case, and it will start the month of admission
What type of care will a medically needy LTC resident receive?
Medically needy TLC residents will have full scope Medi-Cal. This will cover the cost of the LTC facilities day as well as any other medical costs that are covered by the Medi-Cal program the maintenance the cost for the LTC is only $35.
How much is a maintenance need cost for LTC?
It is only $35
When an applicant moves into an LTC Are they allowed the $20 any income deduction?
No, they are not think of it this way “LTC, not 20 for me.”🎶
