Medical Expenses 430-05-55-20

(Revised 07/01/05 ML2972)

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That portion of medical expenses in excess of $35 per month, excluding special diets, of an elderly (beginning in the month an individual turns age 60) or disabled household member are allowable after third party payments. These expenses must be reported and verified within 30 days of the billing date.  

 

Medical expenses include all allowable medical expenses made by a household for an individual who was an elderly or disabled household member immediately prior to dying or entering a hospital or nursing home, if the remaining household members are legally responsible for payment of the expenses.  In order for TECS to allow expenses for these individuals, the worker must calculate the deduction, subtract $35 and enter it in as a child support deduction on the NOMD screen.  

 

Example:

  1. An elderly mother and daughter are living together and are one household for food stamp purposes. The mother goes into the hospital and the daughter who is not legally responsible for her mother’s medical costs is paying on those expenses as she can. The daughter is not allowed to claim a medical deduction for her mother’s costs because she is not legally responsible for them.
  2. An individual (not elderly or disabled) applies for food stamps. At the time of application, the individual reports that her disabled husband passed away and also reports medical expenses that were incurred by her husband that she is legally responsible to pay. These expenses are an allowable deduction for this individual.  This expense must be coded as OT on EXSA.

 

Households may but are not required to report any changes in medical expenses during the certification period. If the household reports a change, it must be acted on applying 10-10-10.

 

If the household reports a medical expense but is unable to provide verification of the expense, a deduction is not allowed.

 

The $35 applies to the total expenses incurred by all elderly or disabled household members, it does not apply to each person's expenses if more than one person in the household is elderly or disabled. TECS automatically deducts $35 from the amount entered on the EXSA screen.

 

Individuals receiving Social Security benefits as a dependent or survivor are not eligible to receive the medical deduction.

 

Individuals receiving emergency SSI benefits based on presumptive eligibility are eligible to receive the medical deduction.

 

At initial application and recertification medical expenses should be averaged from a prior three month period, if that is indicative of what the household anticipates to have as ongoing medical expenses in the new certification period.

 

The medical expenses from the three prior months may not be indicative of combination Food Stamps/Medicaid cases when the full recipient liability is not being met. The worker must thoroughly discuss this with the household to establish what the household anticipates as ongoing medical expenses.

 

In a combination FS/MA case, when making a change for both programs, if the recipient liability for MA changes and the recipient liability is being allowed as a medical expense for food stamps purposes, change the amount allowed as an expense for food stamps on the EXSA screen as follows:

  1. If the household is incurring the entire recipient liability, change the amount allowed as an expense for food stamps on the EXSA screen to the new amount.
  2. If the household is incurring only a portion of the recipient liability and the amount has been averaged, and the income or expenses for this case causes the recipient liability to change, continue to use the previously averaged amount as a medical expense for food stamps. At recertification, reaverage using the new recipient liability.

 

The SFN 187 - Medical Expense Worksheet should be used for all households entitled to a medical deduction.

 

If the SFN 187 is used, the household must be asked to complete the bottom portion of the form and the top half is completed by the worker. This worksheet also serves as documentation of verified medical expenses, the calculation and the amount allowed as a deduction.