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Medicaid out-of-pocket costs rise under proposed state program

Changes in the state Medicaid program could affect as many as 24,000 Missourians.
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Changes in the state Medicaid program could affect as many as 24,000 Missourians.

Some low-income seniors and people with disabilities in Missouri could have to pay more out of pocket to qualify for Medicaid coverage under changes being initiated in the state program.

About 24,000 Missouri residents qualify for Medicaid — even though their income is higher than the program's federal limits — by "spending down" the difference between their monthly income and the federal eligibility limit.

The problem, as state officials told a Senate panel this past week, is that the state might have been giving people too much credit toward their monthly "spend down" amount.

Federal law says that people in the program are only supposed to receive "spend down" credit for the portions of the medical bills that they actually pay.

Department Interim Director Brian Kinkade said that people who joined the "spend down" program after February 1st will have their bills processed per the federal rule.

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