As part of the transition to Medicaid managed care, AHCA is in the process of requesting a new waiver from the federal government to charge Medically Needy patients a monthly fee for services. 

Currently, the Medically Needy program provides short-term coverage for individuals who have high health care costs, but do not otherwise qualify for Medicaid because of their income levels.  Under the existing program, patients can qualify for Medically Needy when they owe, or have paid, a certain amount of medical expenses (i.e. that patient’s “share of cost”), after which Medicaid will pay for the patient’s medical bills.  Share of cost is calculated based on verified monthly income. 

The new proposal would instead charge Medically Needy patients a monthly premium, of approximately $120 but varying based on income and other factors, for coverage.  The proposed changes, which have been previously requested by AHCA, require final approval from the federal Centers for Medicare & Medicaid Services before they can take effect.    

For more information or questions please contact FAC Health & Human Services Advocate Susan Harbin.