Medicaid Share of Cost

    

         

         

         

Medicaid Share of Cost

Individuals who are not eligible for "full" Medicaid because their income or assets are over the Medicaid program limits may qualify for the Medically Needy program. Individuals enrolled in Medically Needy must have a certain amount of medical bills each month before Medicaid can be approved. This is referred to as a "share of cost" and varies depending on the household's size and income.
 

What is Medicaid Share of Cost ?

A Medicaid program for people who have too much income or assets are over the limits for Medicaid, Some people call it the “share of cost” program. The Department of Children & Families (DCF) determines eligibility for the Medicaid Share of Cost Program.

A share of cost is the amount of medical bills that you must owe or have paid before Medicaid can pay any of your current unpaid medical bills. Your share of cost is based on your family’s monthly income. If we estimate your share of cost based on your statement of your monthly income, the income must be verified before Medicaid can pay any bills. The share of cost may change when your income changes.

How does the Medicaid Share of Cost work ?

Each month certain medical expenses you owe or have paid in the last 3 months are counted toward your share of cost. When your allowable medical expenses are equal to your share of cost, you are eligible for Medicaid for the rest of that month.

Here is an example: Your share of cost is $800. You go to the hospital on May 10 and send us the bill for $1000. You have met the share of cost and are Medicaid eligible from may 10th through May 31. Medicaid will pay the $1000 medical bill.

Some examples of medical expenses that can be used to meet the Medicaid Share of Cost . 

  • Unpaid medical bills you owe that have not been used to meet your share of cost before
  • Medical bills you paid within the last 3 months.
  • Medical bills that will not be paid by health insurance or any other source.
  • Health insurance premiums
  • Co-payments for medical bills.
  • Medical services prescribed by a doctor.
  • Transportation by ambulance, bus or taxi to get medical care.

Some examples of medical expenses that cannot be used to meet the Medicaid Share of Cost .

  • Premiums for insurance policies that pay you money when you are in the hospital or the payment is not intended to pay for medical expenses.
  • First aid supplies and over the counter supplies such as adhesive bandages, alcohol, cold remedies, etc.

Whose medical expenses can be used to meet the Medicaid Share of Cost ?. 

Any family member whose income is counted, even if the person is not eligible for Medicaid.

What to do when you meet the Medicaid Share of Cost .

Provide proof of medical expenses to a  DCF ACCESS office by fax, mail or in person. Include:

  • Your name and case number.
  • The amount of the expense.
  • The date the expense was incurred and
  • The date and amount of any payments that you have made for the expense.

Examples of proof you can provide:

  • Medical bills you have received.
  • Receipts for paid medical bills and
  • Cancelled checks for paid medical bills.

If you have questions about the Medicaid Share of Cost Program, want to see a list of our service centers, fax numbers or to apply for benefits, visit our website: www.dcf.state.fl.us/ess/

New Life Medical Institute, Inc. is a state of the art walk in medical clinic staffed by board certified Physicians. The center are licensed by the Florida State Department of Health and accept Medicaid, Medicare, and most other insurance plans.

Our goal at New Life Medical Institute, Inc.  is to provide, quality, convenient, comforting medical care in a state-of-the-art facility without the long waits and impersonal service associated with hospital emergency rooms. 

We offer medical diagnosis and care, information and health education, and wellness for all ages. New Life have physicians in general medicine, gynecology, surgery, dermatology, psychology, and psychiatry.  We offer ultrasound, x-ray, laboratory, physical therapy, group psychotherapy, vaccine, injectables , and many other services.

We are particularly attentive to children, women, seniors, and managing chronic illnesses such as asthma, diabetes, hypertension, hepatitis, and HIV.

New Life Medical Institute, Inc.  offers extended evening and weekend hours,  no appointment is necessary in most cases and  Free transportation to all of our patients. 

medicaid share of cost

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