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CODE OF COLORADO REGULATIONS 10 CCR 2505-10 8.100 Medical Services Board

218 iii) The excess shelter allowance is the amount, if any, that exceeds 30% of the MMMNA. 2. An additional amount may be approved for the following expenses: a. Medical expenses of the community spouse or dependent family member for necessary medical or remedial care. Each medical or remedial care expense claimed for deduction must be documented in a manner that describes the service, the date of the service, the amount of the cost incurred, and the name of the service provider. An expense may be deducted only if it is: i) Provided by a medical practitioner licensed to furnish the care; ii) Not subject to payment by any third party, including Medical Assistance and Medicare; b. The cost of Medicare, Long Term Care insurance, and health insurance premiums. A health insurance premium may be allowed in the month the premium is paid or may be prorated and allowed for the months the premium covers. This allowance does not include payments made for coverage which is: i) Limited to disability or income protection coverage; ii) Automobile medical payment coverage; iii) Supplemental to liability insurance; iv) Designed solely to provide payments on a per diem basis, daily indemnity or non-expense-incurred basis; or v) Credit life and/or accident and health insurance. 3. If either spouse establishes that the community spouse needs income above the level provided by the minimum monthly maintenance needs allowance due to exceptional circumstances, which result in significant financial duress, such as loss of home and possessions due to fire, flood, or tornado, an additional amount may be substituted for the MMMNA if established through a fair hearing.

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Page 218

Official source

CODE OF COLORADO REGULATIONS 10 CCR 2505-10 8.100 Medical Services Board

218 iii) The excess shelter allowance is the amount, if any, that exceeds 30% of the MMMNA. 2. An additional amount may be approved for the following expenses: a. Medical expenses of the community spouse or dependent family member for necessary medical or remedial care. Each medical or remedial care expense claimed for deduction must be documented in a manner that describes the service, the date of the service, the amount of the cost incurred, and the name of the service provider. An expense may be deducted only if it is: i) Provided by a medical practitioner licensed to furnish the care; ii) Not subject to payment by any third party, including Medical Assistance and Medicare; b. The cost of Medicare, Long Term Care insurance, and health insurance premiums. A health insurance premium may be allowed in the month the premium is paid or may be prorated and allowed for the months the premium covers. This allowance does not include payments made for coverage which is: i) Limited to disability or income protection coverage; ii) Automobile medical payment coverage; iii) Supplemental to liability insurance; iv) Designed solely to provide payments on a per diem basis, daily indemnity or non-expense-incurred basis; or v) Credit life and/or accident and health insurance. 3. If either spouse establishes that the community spouse needs income above the level provided by the minimum monthly maintenance needs allowance due to exceptional circumstances, which result in significant financial duress, such as loss of home and possessions due to fire, flood, or tornado, an additional amount may be substituted for the MMMNA if established through a fair hearing.