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Family and Children's Medicaid MA-3315 MEDICAID DEDUCTIBLE

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iii. Applying Bills to Deductible

REISSUED 01/01/13 – CHANGE NO. 01-13

(III.A.1)

REVISED 1/01/13 – CHANGE NO. 01-13

(III.A.2.b)

REVISED 1/01/13 – CHANGE NO. 01-13

(III.A.4.)

REVISED 01/01/15 – CHANGE NO. 05-14

(III.B.1.)

REVISED 01/01/15 – CHANGE NO. 05-14

(III.B.2.c.)

REISSUED 01/01/14 – CHANGE NO. 05-14

(III.B.2.d.(2))

REISSUED 01/01/15– CHANGE NO. 05-14

(III.B.3.b.)

REVISED 01/01/15 – CHANGE NO. 05-14

(III.B.3.c.)

Father’s deductible

Child’s deductible

$4,908

 

$6,978

 

- 1,260

Part A deductible

- 1,260

Part A deductible

3,648

Remaining

5,718

Remaining

- 2,496

Additional charges

-2,496

Additional charges

1,152

Remaining

3,222

Remaining

-1,200

1/7 charges

-1,152

Father’s debt balance

   

$2,026

Remaining


The father is authorized on 1/7 with a deductible balance of $1,152. The child’s remaining deductible balance on 1/7 is $2,026.

REISSUED 01/01/15 – CHANGE NO. 05-14

(III.B.)

REVISED 1/01/13 – CHANGE NO. 01-13

(III.C.2)

REVISED 1/01/13 – CHANGE NO. 01-13

(III.D.2.b.)

REVISED 1/01/13 – CHANGE NO. 01-13

(III.D.)