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(The AG could have also had the one-time only expense prorated over the cert period which would have to be completed by a fiat if the client is also on Medicaid.) See Section 3440.65.05.

For elderly or disabled individuals who receive SNAP and regular Medicaid, the SNAP budget will include all medical expenses which are allowed for SNAP only and medical expenses not covered by Medicaid which exceed $35.

However, if a medical expense has been listed as reimbursable, the amount of the medical expense will not be included in the SNAP budget until the amount of the reimbursement is entered on screen. Once the amount of the reimbursement has been entered, the difference between the amount of the expense and the amount of the reimbursement is allowed in the SNAP budget when the amount exceeds $35.

Some of these expenses are Medicaid co-payment, lodging expenses to obtain medical treatment or services and securing and maintaining a helping animal. Some of these expenses are Medicare Part B premium which is paid by the individual and health and hospital insurance premiums. See Example #2.

EXAMPLE #2:

Client B receives SNAP and Medicaid. She has the following medical expenses, prescription, physical therapy and doctor visits, and health insurance.

$125 prescriptions (monthly) $50 physical therapy expense (monthly) $60 doctor visit expense (monthly) $45 health insurance premium (monthly)

The SNAP budget will include the health insurance premium only, $45 - $35 = $10 because Medicaid will pay for the remaining medical expenses.

The Medicare Premium Part B (self-pay) is always an allowable expense in the SNAP budget. The possibility that it may be paid or bought-in by the State does not make it a reimbursable expense.

Transportation and other medical services provided by neighbors or other non-Medicaid approved providers must be coded as non-Medicaid covered expense, to allow the actual out-of- pocket expenses in the SNAP budget.

If the SNAP AG member who has medical expenses is on the Medicare Savings Program as QMB- only (not full coverage Medicaid), Medicare covered services are not allowed in the SNAP budget because any out-of-pocket expense such as the coinsurance and deductibles will be paid by Medicaid.