Participants Eligible for NA Medical Expenses
(01/01/21 - 12/31/21)
The following NA participants are eligible for a medical expense deduction when the amount of the medical expense is greater than $35:
Deceased participants, when both of the following requirements are met:
The deceased participant would have been eligible for the deduction in the month the expense was billed.
The remaining budgetary unit participants are legally responsible for the bill.
Participants who are eligible for and receiving SSI. When the participant begins receiving SSI, allow excess medical expenses incurred from the latter of the following:
The date of the NA application.
The date when SSI eligibility began.
Households with elderly participants or participants with a disability may receive one of the following deductions from their income:
A Standard Medical Deduction (SMD) of $160 minus a $35 disregard which equals $125.
An actual monthly out-of-pocket medical expense deduction, minus a $35 disregard when expenses exceed the $160 SMD amount.
AZTECS uses whichever medical deduction expense is higher to benefit the household.
At an initial application, or when the household is reporting new monthly medical expenses, staff must explain the SMD option to the household. The medical expenses must be verified before the medical deduction can be used as follows:
At least $35.01 when using the SMD
All out-of-pocket expenses when they exceed $160 per month
At an initial application, staff must complete the Standard Medical Deduction Worksheet (FAA-1813A) form explaining the SMD and the actual medical expense deduction. Upload the completed form into OnBase.
For renewal applications or a reported change on an existing expense, a client's statement can be used when it is not questionable or unclear. (See questionable or unclear)
Allow as a deduction the total medical expense cost that is not covered by Medicare or other health insurance coverage. This amount is used to calculate the medical deduction. AZTECS deducts only one $35 disregard per household.
The following are allowable medical expenses:
The following medical expenses are not allowable:
Charge accounts used for both medical expenses and other miscellaneous expenses
NOTE When a portion of the bill that is for medical expenses can be determined, allow only that portion. Medical expenses paid in monthly installments are considered billed when the statement is received. When no due date is indicated for a medical expense, consider it due in the month following the billing date.
Charge account interest when medical expenses are paid in monthly installments
Medical Bills that were paid before a new application month
Amounts carried forward from past billing periods and late charges even when included with the most recent billing and actually paid by the participant
Expenses covered by a reimbursement or vendor payment
Expenses covered by a second mortgage, treat as a shelter expense