Wisconsin Medicaid - Patient Liability

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If you get Medicaid and you are in a nursing home or medical institution, you may be required to help pay for your health care cost. This is called a “Patient Liability.” This is the amount you will need to pay each month to the nursing home or care facility in which you live. The amount is based on your monthly income after certain credits are subtracted.

Monthly Credits

The credits we may be able to give you are:

  • A monthly personal allowance of $45.
  • Premiums you pay for health insurance.
  • Support for your spouse if you are married. (Ask your local agency about “Spousal Impoverishment” or go dhs.wisconsin.gov/medicaid/Publications/p-10063.htm.)
  • The monthly cost to maintain your home or apartment. (You can only get this credit if a physician states that you are likely to return to your home in the next six months.)
  • The actual amount you pay each month for court-ordered attorney or guardian fees, or the cost to set up and keep a guardianship.
  • The actual amount you pay each month for medical services not covered by Medicaid.
  • The actual amount you pay each month for support payments to someone else.
  • A job credit if you are employed.

If, after we subtract all of the credits from your monthly income and you have no income left, you will not have a patient liability. If you do have income left, that is the amount of your patient liability. Your nursing home or care facility will work with Medicaid to set up and maintain the patient liability.

How to apply

You can apply for Medicaid with your local Medicaid office in person, by mail, telephone or online at ACCESS.wi.gov. To find the Medicaid office in your area or to get an application mailed to you, visit the Customer Help web at dhs.wisconsin.gov/em/CustomerHelp, or call 1-800-362-3002.

If you apply online, you may need to talk with someone who works at your local Medicaid office after you submit the application. In many cases, this can be done over the telephone. You may need to mail, fax or take proof of some items (like your income, assets, bills, etc.) to the local Medicaid office before you can start getting benefits.

For more information:

State of Wisconsin
P-10061 (07/09)

Last Revised: February 4, 2015