Verification
Documented or collateral contact verification is needed to verify the obligation to pay NA medical expenses when any of the following occur:
● A new application is submitted or new change in out-of-pocket medical expenses is reported during the approval period and when any of the following occur:
When the budgetary unit is potentially eligible for the Standard Medical Deduction (SMD), verification of $35.01 must be provided.
When the budgetary unit is potentially eligible for medical expenses that exceed the SMD, all medical expenses must be verified.
● For renewal applications when a change of more than $25 in actual medical expenses that exceed the SMD must be verified.
● The expense amount is questionable(g) .
When the budgetary unit does not provide verification of the actual medical expenses that exceed the SMD, yet provides verification of at least $35.01, the budgetary unit is eligible for the SMD.
Verification that can be used includes, and is not limited to, any of 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.
NOTE Collateral contact can only be made to clarify documented verification or when the participant is unable to obtain the verification and asks for assistance.
Verification of a Medicare(g) expense that can be used includes, and is not limited to, any of the following:
● Award or benefit letter from the Social Security Administration (SSA).
● State Verification Exchange System (SVES).
● Collateral contact with SSA to clarify documented verification the participant has provided or when the participant is unable to obtain the verification and asks for assistance.