Medicaid Minute: Did Medicaid Send You a Notice Saying Your Care Cost May Be Increasing?

January 14, 2021

In this month’s Medicaid Minute, Elder Law Attorney Jessica Merkel answers the question of what to do if you or a loved one received a notice from Medicaid stating your monthly cost of care may rise in February.  She covered this topic in a previous Medicaid Minute from November 12, going back to April of 2020, certain Wisconsin Medicaid rules were modified to accommodate the COVID-19 public health emergency.

Video Transcript:

Are you or a loved one receiving Medicaid benefits to pay for assisted living or nursing home care, and within the last week or so, did you just receive a notice from Medicaid saying that your monthly cost of care may rise in February?

My name is Jessica Merkel and this is Ruder Ware’s Medicaid Minute. Today, we’re here to talk about the notice that you may have received from Medicaid a week or so ago warning you that the temporary change in program rules is set to expire at the end of January.

As I shared in our previous Medicaid Minute from November 12, going back to April of 2020, certain Wisconsin Medicaid rules were modified to accommodate the COVID-19 public health emergency.

This included that patient liabilities or cost shares (this is basically, the amount of money that folks receiving in-home care or care in an assisted living facility or nursing home pay for their care), these were not increased even if you had an increase in income or assets.

For many folks, this means that since you accrued additional income during the pandemic, if you didn’t spend those funds in some other way (like splurging during Black Friday or Cyber Monday), you are now likely over the $2,000 individual asset limit.

An increase in income may have seemed to be a welcome event, but it may now cause problems for you when the regular program rules start again. In their letter, Medicaid may have recommended spending your money or giving your money back to them, but fortunately, we have other options for you and we can help beyond their “suggested recommendations”.

So, to wrap up, let’s go back to my initial question regarding if your cost of care will be rising.

The notice that you may have received indicated that if your income has increased, this may mean your monthly patient liability or cost share will now also increase. Despite being a bit of a let down, this is par for the course.

When income changes, care costs change, and you should expect further letters to come from Medicaid regarding the new amount that you will owe.

Remember though, if you have any additional or new expenses, be sure to communicate them to Medicaid because these expenses may help to offset your increase in income.

I hope this Medicaid Minute helps to clarify the correspondence you received, and I also hope that if your benefits are negatively impacted due to the return of the “regular” program rules, you know that we’re here to help. Be safe and take care.

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