Medicaid
Deductible
What happens if my income
is over the Medicaid income limits?
If
your income is higher than the income limits for Medicaid, you may qualify
by meeting a Medicaid “deductible.” The Medicaid deductible is the difference
between your income and the Medicaid income limit. The Medicaid deductible
is always calculated every six months. If you have medical bills up to
your deductible amount you may qualify for Medicaid. Not every Medicaid
category has a deductible program. Most children are eligible under the
deductible program except the OBRA Kids and BadgerCare recipients. Only
disabled and pregnant adults are eligible for the deductible program.
EXAMPLE:
You and your 15-year-old
daughter apply for Medicaid. The only income in your household is the $950
you earn from your job. This makes you both over-income for for all categories
of Medicaid. Your daughter may qualify if she meets a deductible. Because
the OBRA Kids program has no deductible program, she must be tested for
the AFDC-related Medicaid category.
Her deductible is calculated
as follows:
| Gross family income |
$950 |
| Earned income deduction |
- $ 90 |
| Net income |
$860 |
| AFDC-related income for
two |
- $591 |
| Income over Medicaid limit |
$269 |
| Medicaid deductible for
six-month period: |
$269×6 = $1614 |
If your family has $1614
in medical bills, your daughter may qualify for Medicaid. You will not
qualify for Medicaid because there is no deductible program for adults
who are not disabled or pregnant. You may be eligible for BadgerCare in
July 1999.
|
,BR>
Can I pay my deductible and become eligible for Medicaid?
Yes, if you do not
have medical bills, you can pay your deductible up front and get a medical
card. You will be eligible from the time you pay your deductible, so it
is always better to pay at the beginning of your deductible period. Ask
your caseworker how you can do this.
