(Revised 10/1/17 ML #3512)
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Medical expenses incurred by any current member of the household may be considered when calculating medical deductions. A medical expense may be deducted only if it has been paid, OR there is an agreement with the medical vendor for a specific payment plan.
Projected medical expenses can be deducted from the income. The amount of projected expenses can be determined by using previous months bills or receipts to estimate an average monthly cost. (This method can be used for prescription drugs and other medical costs. If a household member is on a regular monthly prescription annualize the cost to the household so it can be deducted for the fuel season.)
NOTE: (A minimum of three consecutive months' bills should be used to determine an average monthly cost for medical expenses such as prescriptions and other recurring items. Multiply by 12 to arrive at an annual figure. Non-recurring items such as eyeglasses, and other cost items should only be deducted once during a fuel assistance season.)
If an incurred expense may be reimbursed by an insurance policy, it cannot be deducted as a medical expense for this program until the insurance company has processed payment and the household has a specific payment plan with the medical vendor or has paid the bill. This would include reimbursement from the Veteran's Administration or private insurance for pharmaceutical expenses.
Similarly, medical costs and/or Medicare premiums which will have been paid by the Qualified Medical Beneficiary Program may not be deducted from income as a medical expense to the household.
Only payments made or scheduled between the previous June 1 and the following May 31 may be included.
The following list of allowable medical expenses is all-inclusive:
- Medical and dental care, including psychotherapy and rehabilitation services.
- Hospitalization or outpatient treatment, nursing care, and nursing home care, including payments by the household for an individual who was a 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.
- Prescription drugs and other over-the-counter medication (including insulin) when approved by a qualified health professional. Additionally, costs of medical supplies, sickroom equipment (including rental) or other prescribed equipment are deductible.
- Health and hospitalization insurance premiums (includes nursing home insurance) but NOT disability or accident policies that are primarily for income maintenance. Premiums for other insurance to protect against the medical expenses defined in this section may be allowed, but consult with the state office.
- Medicare premiums and any cost-sharing.
- Dentures, hearing aids, and prosthetics.
- Securing and maintaining a service animal, including the cost of food and veterinarian bills.
- Eye glasses, prescription eyewear, and surgery for eyes.
- Reasonable cost of transportation
and lodging to obtain medical treatment or services. Medicaid rates in
effect on October 1 of each year will be in effect for the entire fuel
season beginning on that October 1.
EXCEPTION:
Meals are not an allowable expense for households who must travel to obtain medical care. - Maintaining an attendant, homemaker, home health aide, or child care services or housekeeper necessary due to age, disability or illness.
- Premium amount and enrollment fee for Workers with Disabilities coverage.
