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matter how old, for which the applicant/recipient remains responsible, may be used toward the spend- down deductible as long as it has not been used towards a previous spend-down deductible.

For prospective eligibility, medical expenses may be incurred during the prospective budget period or prior to the budget period. However, only unpaid expenses incurred prior to the budget period for which the individual is still responsible may count toward the spend-down deductible, except that expenses that were paid during the three months prior to the prospective period may be used as long as they were not used to establish retroactive eligibility.

Medical expenses may not be claimed in both the retroactive and prospective budget periods. Allowable medical expenses may be incurred by:  the person applying to receive MA benefits (recipient),  dependents of the person applying to receive MA benefits, and  parents or financially responsible caretakers of children applying to receive MA benefits.

Allowable medical expenses may be incurred or anticipated during the following periods of time:

 medical expenses (paid and unpaid) incurred during the budget period,  medical expenses incurred before the budget period but paid during the budget period (these expenses can only be used to determine prospective eligibility),  medical expenses incurred and paid during the three months period to the prospective budget period,  medical expenses incurred and billed before the budget period and remaining unpaid during the budget period,  health insurance, including Medicare Part B and Medicare Drug Plan expenses, paid in the retroactive budget period or anticipated during the prospective budget period. Only expenses for which the applicant/recipient is responsible may be used; and  costs of prescription and medically necessary over-the-counter (OTC) drugs paid in the retroactive budget period or costs of these drugs as they are incurred during the prospective budget period. Only costs which are not paid by a third party, such as a Medicare Drug Plan, may be used.

Allowable medical expenses may include the following:

 routine, preventive, and emergency medical treatment and services including; o physician services, o inpatient and outpatient medical services, o prescription and medically necessary OTC drugs, o medical equipment and devices prescribed by a physician, o ambulance services, o other medical expenses usually covered by Medicaid, o other medical expenses not usually covered by Medicaid but medically necessary, and o health insurance premiums. Example Mr. Noravian has a heart condition. He takes Ecotrin every month and is expecting to continue taking it for the next six months. As he incurs the expense of buying Ecotrin, the cost may be used toward meeting his spend-down.