If the client receives a third party medical payment directly and the medical expense for which the third party medical payment is intended is payable by Medicaid, the payment is considered unearned income for non-MAGI based categories unless reimbursed by the client. If the insurance payment exceeds Medicaid rates, the excess is considered unearned income for non-MAGI based categories unless paid out on other medical services or supplies. Regardless of the existence of a good cause claim, any third party medical payment that is received directly by the client must be reimbursed.
{01/2014}