Medical Expense Deduction During Review Periods

 

Medical Expenses at Interim Report and Recertification

Reporting changes in medical expenses is not required nor requested on the Interim Report. You must not ask clients to re-verify medical expenses during the Interim Reporting period, unless s/he indicates a change in the total medical expense amount by $25.00 or more in either direction (see Simplified Reporting - Interim Report).

At Recertification, if a client reports a change in his/her total medical expense amount, you must compare it to the monthly amount that is available in BEACON. If the reported change is less than $25.00 per month in either direction, verification is not required. You must use the same expenses that were used in the previous benefit calculation and process the Recertification. You must not remove recurring medical expenses that are on record at the point of Recertification unless the client reports a change that exceeds the threshold for verification. Review the Simplified Reporting - Recertification page for more information and case examples.

 

Note

One-time non-recurring medical expenses must be removed at Recertification if the household received full credit for the expense through the balance of their certification period.

 

Countable Expenses

A broad range of unreimbursed medical costs can be claimedby a person aged 60+ or an individual with a verified disability. This cost can still be claimed even if the client is not able to make payments or a bill is outstanding.

 

A medical expense is not countable if the:

 

Verification of Medical Expenses

Medical expenses must be verified before they are applied to the SNAP calculation, except for transportation mileage (which can be verbally self-declared). You must enter verified expenses in BEACON even if the benefit does not change to ensure an accurate Electronic Case Folder is maintained. Annotate the Narrative tab explaining the action taken.

Medical expenses can be verified through a variety of sources, including but not limited to invoices, receipts, cancelled checks, pharmacy print outs, documentation from Housing Authorities (when all household members are elderly and/or have a disability), or insurance printouts indicating patient responsibility. The verification does not need to specify the medical procedure, names of medications, or other private information regarding the nature of the health care treatment received. 

 

Reminder

You must attempt a cold call in all instances where a verification is received, but the document is unclear or unusable, so the client is informed of what is happening with his/her case.

 

 

Frequency of Verification Needed

Since we cannot restrict the type of verification provided by the client, i.e. a receipt versus a print out from the pharmacy, the frequency of medical expenses may be difficult to verify as all verifications do not include standardized information. While we cannot limit the type of verification, we can determine the frequency of the medical cost from what the client tells us on the Application, Interim Report, or Recertification.  If the information is not clear from the documentation provided, you must cold call the client to get verbal confirmation of the frequency.

If a client states in writing or verbally confirms that s/he purchases specific over-the-counter medications every month, you may use this as verification of frequency if the information is not questionable. If a client states that s/he is purchasing certain medical items every month such as a hearing aid or a ninety-day supply of medication, you must require actual verification since the frequency of this information is questionable.

 

EXAMPLE: Jane submits a statement of her prescription copayments for the month of July and two receipts for allergy medicine.  She does not indicate if this is one time or ongoing. You must contact Jane to find out if these are recurring amounts. If Jane submits two months of documentation of her pharmacy bills, you do not need to call her and may presume these are recurring monthly expenses.

 

This self-declaration of frequency of medical expense is acceptable when provided in person, over the phone, in a handwritten note/statement from the client, or on any DTA form. You must use discretion when allowing the self-declaration of frequency and must narrate the reasons why the self-declaration of frequency was or was not acceptable.

If an expense covers a period exceeding one month, be sure to designate the correct frequency in the Medical Expenses page. For example, if a client purchases a three-month supply of medicine in one month, the total amount of the purchase must be entered, and the frequency coded as quarterly. This will ensure that the correct monthly amount is used in the SNAP calculation.

 

Assisting Clients with Obtaining Medical Expense Verification

Getting proof of medical expenses can be a challenge for the elderly and/or individuals with a disability. You are required to assist clients who need help obtaining verification.

Assistance can include, but is not limited to:

 

   Last Update: August 08, 2019