Health Care Coverage Premiums

Health Care Coverage Premiums

The health care coverage premium deduction allows the premiums for other health care coverage

This may include general health care insurance, LTC insurance and dental insurance.

that the client is responsible to pay to be deducted from gross income.

Medicare Part C plans are other health care coverage. Allow verified Part C premiums to be deducted as health care coverage premiums. They must be listed on MAXIS STAT/BILS (expense type “26 – Other health insurance”) and STAT/INSA and the policy entered into the MMIS TPL Subsystem.

Exception:

Do not allow this deduction when a client has a combination LTC/medical spenddown. The cost of premiums is used toward meeting the medical spenddown. (You will learn about combination spenddowns later in this course.)

Reminder icon. Remember!

Do not deduct any portion of premiums paid or reimbursed by the county as a cost effective reimbursement.

Medicare premiums are deducted using the Medicare premium deduction and should not be deducted using this, the health care coverage premiums, deduction.

The deduction must be updated for the month in which it is no longer allowed, or when the client has a change in circumstance.

Example:

Can you use this deduction on Emily’s or Andreas’ LTC income calculation?

No, neither Emily nor Andreas pay for health care coverage, other than Medicare. Their Medicare premium costs were deducted earlier in the calculation.

Page 11

LTC Income Calculation - Deductions and Allowances

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