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State of Wisconsin |
Release 26-02 |
When the member receives a medical bill that is equal to or greater than the amount he or she still owes on the deductible, he or she can be certified for Medicaid. He or she must pay the part of the bill that equals the deductible. Medicaid will consider the remainder of the bill for payment.
To make sure that Medicaid does not pay what the member still owes on the deductible, send a Medicaid Remaining Deductible Update (F-10109) to the fiscal agent indicating the amount of the bill that the member owes. The fiscal agent subtracts this amount from the bill and Medicaid pays the rest.
Fill out the Medicaid Remaining Deductible Update (F-10109) only if:
A Medicaid certified provider has provided the billed services.
The person, having met the deductible, is being certified. If he or she is not being certified, Medicaid will not pay any of the bill.
The date of the bill is the date the deductible was met. Since the member is not eligible until he or she has met the deductible, he or she still owes for all bills prior to that date.
If more than one bill was incurred on the date the deductible was met, send additional Medicaid Remaining Deductible Update (F-10109) forms for any other bills for which the member would be responsible.
This page last updated in Release Number: 20-03
Release Date: 08/03/2020
Effective Date: 08/03/2020
The information concerning the Medicaid program provided in this handbook release is published in accordance with: Titles XI and XIX of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapters 46 and 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2, 10 and 101 through 109 of the Wisconsin Administrative Code.
Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.
Publication Number: P-10030