Administrative Rules of Montana
Department 37 - PUBLIC HEALTH AND HUMAN SERVICES
Chapter 37.55 - END STAGE RENAL DISEASE (ESRD)
Subchapter 37.55.3 - Eligibility
Rule 37.55.303 - FINANCIAL ELIGIBILITY REQUIREMENTS
Universal Citation: MT Admin Rules 37.55.303
Current through Register Vol. 24, December 20, 2024
(1) In order to participate in ESRD, the claimant must take all reasonable steps necessary to apply for and exhaust any and all third party benefits, other than ESRD, to which the claimant is or may be entitled.
(2) If costs of treatment for end stage renal disease remain unpaid after the claimant has exhausted all other third party benefits, ESRD will pay the following benefits, provided funds are available:
(a) for
claimants whose family unit's income is 200% of federal poverty level or less,
ESRD will pay the claimant's unpaid costs for treatment of end stage renal
disease or $1000 per month, whichever is less, except the ESRD will not pay
medicaid copayments or medicaid deductibles for the claimant;
(b) for claimants whose family unit's income
is between 200% and 300% of federal poverty level, ESRD will prorate the
available benefits by determining the percentage of income over 200% of federal
poverty level and applying that percentage to the benefit cap of $1000 per
month except the ESRD will not pay medicaid copayments or medicaid deductibles
for the claimant;
(c) for claimants
whose family unit's income is over 300% of federal poverty level, no benefits
are available from ESRD.
Sec. 50-44-102 and 53-6-202, MCA; IMP, Sec. 50-44-102 and 53-6-202, MCA;
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