Post-Eligibility Budgeting for Institutional Eligibility

Post-Eligibility Budgeting for Institutional Eligibility A. Post eligibility budgeting involves the calculation of the recipient’s cost of care, i.e., the amount of income that the recipient must pay toward the cost of institutional care referred to as Medicaid Income. Medicaid Income is the amount owed to the facility after all allowable deductions have been subtracted from the recipient’s total income. B. Total income includes income that is subject to averaging, such as recurring and non-recurring lump sum payments and income that varies, provided the recipient is eligible in the month of receipt of the income. C. Deductions allowable from total income include the following: 1. A personal needs allowance, 2. A community spouse income allowance, if appropriate, 3. An allowance for certain other family member(s), if appropriate, 4. Non-covered medical expense(s), such as health insurance premium(s) and expenses for medically necessary care, services and items incurred by the individual, within specified limits, that are not subject to payment by a third party.