NA Medical Expense Verification
 
(01/01/21 - 12/31/21)
The obligation to pay NA Medical Expenses must be verified when any of the following occur:
 
A new application is submitted or new changes in out-of-pocket medical expenses is reported during the certification period:
When the household is potentially eligible for the Standard Medical Deduction (SMD) verification of $35.01 must be provided.
When the household is potentially eligible for medical expenses, which exceed the SMD, all medical expenses must be verified.
Renewal applications:
Households receiving the SMD can use a participant statement as verification unless it is questionable.
Households receiving their actual medical expense in excess of the SMD can use a participant statement for changes less than $25. Changes in actual medical expenses of more than $25 must be verified.
The expense amount is questionable or unclear.
 
When the household does not provide verification of the actual medical expenses that exceed the SMD, but provides verification of at least $35.01, the household receives the SMD.
 
Acceptable verification includes, but is not limited to, the following:
 
Medical bills
Insurance receipts (latest payment or billing)
Current statement from a medical provider(g) responsible for providing care
Collateral contact with the medical provider or insurance company
For renewal applications or a reported change on an existing medical expense, a participant statement can be used when it is not questionable or unclear
 
Acceptable verification of a Medicare(g) expense includes, but is not limited to, the following:
 
Award or benefit letter from SSA
Collateral contact with SSA
See Home-Based Interview Procedures when verification must be obtained through a home visit