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ADRC Professionals: Cost Share Frequently Asked Questions

This document answers common questions about a cost share. The information might apply to you if you enroll in a Medicaid long-term care program, such as:

  • Family Care.
  • Partnership.
  • IRIS (Include, Respect, I Self-Direct).
  • PACE (Program of All-Inclusive Care for the Elderly).

What is a cost share?

Cost share is a monthly amount that some members and participants may have to pay to remain eligible for their Medicaid long-term care program.

How is my cost share calculated?

Your income maintenance agency will determine the amount of your cost share before you enroll in a long-term care program. How much you pay is based on many factors. The examples listed below are not all of the factors that may apply.

  • Your gross income: How much money do you receive before taxes or other deductions?
  • Marriage status: Do you have a spouse who receives an income?
  • Where you live: How much are your housing costs?

When do I pay my cost share?

If you have a cost share, you must pay it each month. A cost share payment will be due the month that you enroll in Family Care, Partnership, IRIS, or PACE. Payment is due even if you only receive services for part of your first month. This rule applies regardless of your enrollment date.

Who gets the cost share payment?

With Family Care, Partnership, and PACE, you send your cost share payments to your Managed Care Organization. With IRIS, you send your cost share payments to your IRIS fiscal employer agent.

What happens to my cost share if I choose a new long-term care program?

You can change programs, your managed care organization, IRIS fiscal employer agent, or IRIS consultant agency. To make a change, talk to your ADRC (aging and disability resource center) or Tribal ADRS (aging and disability resource specialist). They will let you know what to do. If you make a change in the middle of a month, and you’ve already paid your cost share for the month, you don’t have to pay it again. Cost share payments are only collected once per month.

Glossary

 
Last revised August 17, 2026