Every person who is approved for ALTCS must contribute toward the cost of their care.
The amount he/she must contribute is determined first by adding together the ALTCS member's total gross monthly income.
Then ALTCS subtracts the personal needs allowance, amounts needed to pay premiums for health insurance, dental, and vision insurance, and if married or with children <18, spousal and family allowances.
The remaining amount must be paid to the facility in which the ALTCS member resides.
For those ALTCS members who have an income-only trust, they may be required to pay the Share of Cost to the Program Contractor and the Room & Board charge to the assisted living facility or assisted living home.
ALTCS members who reside at home and receive home-based care are allowed a higher personal needs allowance and typically do not incur a cost for their home-based care. The exception to this rule relates to ALTCS members who reside at home and who need an income-only trust to qualify. These persons may be required to contribute to the cost of their care.
Gross Income minus the allowable deductions:
15% of the FBR ($104.70 for year 2012) for those members residing in a skilled nursing facility or assisted living center or assisted living home
300% of the FBR ($2094.00 for year 2012) for those members residing at home
Community Spouse Monthly Income Allowance (CSMIA). This is a separate calculation using the spouse's income and household expenses (mortgage, rent, space rent, utilities, homeowner or renter's insurance, property taxes, homeowner association dues) to determine the amount the ALTCS member can give to his/her spouse to help pay the spouse's monthly expenses.
- Health Insurance Premiums
Medicare, Other Health Insurance premiums, Deductibles, Co-insurance
Dental-related medical expenses, Vision-related medical expenses, Hearing-related medical expenses, etc.
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