|
Program |
Manual Section |
|
ALTCS |
When the penalty period ends during the application period, calculate the prorated SOC when processing the case. However, when the penalty period ends several months after the application period, create an alert for the month before the penalty period end date, and calculate the prorated SOC then.
Follow the procedures below to calculate the prorated SOC for the partial month of eligibility
|
Step |
Action |
|
1 |
Determine how many days are in the partial penalty month. |
|
2 |
Subtract the number of ineligible days in the partial month from the total number of days in that month. |
|
3 |
Calculate the daily prorated share of cost amount by dividing the full month’s share of cost by 30. Always use 30 as the divisor, no matter how many days are in the actual month. NOTE When the result ends in a fraction, round down to the nearest hundredth. For example, $23.7683 is rounded down to $23.76. |
|
4 |
Determine the prorated share of cost for the partial month by multiplying the days of eligibility from Step 2 by the daily prorated share of cost from Step 3. |
Example:
The customer has a penalty period of 2 months and 21 days. It runs from November 1, 2015 through January 21, 2016.
The partial penalty month is January 2016. January has 31 days.
31 - 21 = 10
10 is the number of days the customer is eligible for full long term care benefits in January 2016.
The customer’s full month share of cost is $1,500.00.
$1,500.00 ÷ 30 = $50.00
$50.00 is the daily prorated share of cost.
10 days of eligibility X $50.00 daily prorated share of cost = $500.00 prorated SOC.
$500.00 is the customer’s prorated SOC for January 2016.