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MEDICAL DEDUCTIONS

ISSUE DATE: 12/2014

MFIP, DWP, MSA, GA, GRH:
No provisions.


SNAP:

Units can receive a deduction based on medical expenses verified as noted below, including postage for mail-order prescriptions. See 0018.12.03 (Allowable SNAP Medical Expenses) for allowable medical expenses. The unit must fit into 1 of these groups:

Units with medical expenses for an eligible member age 60 or older, disabled, or receiving expedited SSI. The expenses may be paid or unpaid.

Units with hospital or nursing home expenses for a person who is disabled or age 60 or older, and who was an eligible unit member before entering the hospital or nursing home. The expenses may be paid or unpaid.

Units responsible for unpaid medical bills of a deceased member who was disabled, or 60 or older. The bills must have been incurred while the person was an eligible unit member.


See 0012.15 (Incapacity and Disability Determinations).

Units must report and verify all medical expenses at application. At recertification, units must verify changes in recurring medical expenses which total more than $25 and must verify any new expenses. Do not require units to verify expenses that have not changed at recertification. Units may, but are not required to, report changes in medical expenses during the certification period.

If the unit voluntarily reports and verifies a change, process it following the procedures in 0007.15 (Unscheduled Reporting of Changes - Cash), 0007.15.03 (Unscheduled Reporting of Changes - SNAP), 0008.03 (Changes - Obtaining Information).

If you learn of a change in medical expenses from a source other than the unit (for example, MA information), act on the change if it is verified when you receive it. Do not contact the unit for additional information or verification. If the change needs additional verification, do not act on it until recertification.

If a unit expects a medical expense at the time of certification but cannot verify at that time, allow the expense when they provide verification.

For units that did not report a change during the certification period, do not calculate corrective payments. If the unit does not report changes of more than $25 in recurring medical expenses at recertification, calculate overpayments back to the recertification date.

For regularly recurring medical expenses, MAXIS will subtract $35 per unit from the actual monthly expense to determine the amount of the deduction.

For non-recurring medical expenses, the unit has these options:

To allow the entire expense in 1 month.

To average the expense over the remaining months of the current certification period.

To allow the expense over the scheduled length of a payment plan. Clients may continue to use this expense as a deduction for the length of the payment schedule, even into another certification period.


If a unit has both recurring and non-recurring medical expenses in 1 month, list them separately and MAXIS will subtract the $35 medical deduction.

Units may choose to have fluctuating expenses averaged. They may also choose to have expenses which are billed less often than monthly averaged forward over the interval between scheduled billings or, if there is no scheduled interval, over the period the expense is intended to cover.

Do not use medical expenses from 1 certification period for a later period unless a payment schedule extends into that period. For applicant units, expenses must have been billed for the 1st time in the billing period before application.

For units which contain ineligible non-citizens, ineligible ABAWDs, and non-applicants, or unit members disqualified for non-compliance with Social Security enumeration requirements who have allowable medical expenses:

1.

Prorate medical costs billed to or paid by the ineligible person or disqualified unit member among household members.

2.

Disregard the prorated share of the costs for the ineligible person(s) or disqualified unit member(s). Allow the remainder of the costs as a medical expense for the unit.

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