What is the Medically Needy Program?

A Medicaid program for people who have too much income or assets are over the limits for Medicaid, Some people call it the “share of cost” program. The Department of Children & Families (DCF) determines eligibility for the Medically Needy Program.

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Under Medically needy or “Share of Cost”, each month certain medical expenses you owe or have paid are counted toward your share of cost. When your allowable medical expenses are equal to your share of cost, you are eligible for Medicaid for the rest of that month.

Medically Needy Examples:

In these examples your share of cost will be $700. (This is just an example scenario)

Case 1:

Your share of cost is $700. You go to the ER on April 10 and send Medicaid the bill for $1300. You have met the share of cost and are now Medicaid eligible from April 10 to April 30. Medicaid will pay the full $1,300 medical bill.

Case 2:

You go to a walk-in clinic and get checked and do some test. The bill is $370
You have no further medical expenses for Medicaid’s required time period. Medicaid will pay Nothing.