.01 Projecting Medical Expenses for NA
Establish the basis for projecting future expenses for NA by using past medical receipts showing stable or recurring medical expenses. When projecting medical expenses for which a due date is not indicated, consider the bill is due in the month following the billing date. Budget the expense to the participant's advantage, using one of the following options:
Average the expense. (See Averaging Medical Expenses)
Budget the entire expense in the month after it is incurred or billed.
Budget past due amounts in the month due or average the amount over the approval period, when there is a payment agreement in place, when determining benefits for future months.
Use the actual amount billed each month when the participant has established a repayment agreement.
Allow the total amount of the uninsured expense when verification has been provided.
NOTE Allow only the portion of the medical expense that is not covered by Medicare or other health insurance coverage. Determine at the interview, whether the participant can reasonably expect reimbursement for all or part of the expense.