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COMAR 10.09.24.01-.16 1706 State of Maryland Medical Assistance Manual Revised July 2012
statement from the provider shall include the item purchased and the date and cost of the purchase.
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COMAR 10.09.24.01-.16 1706 State of Maryland Medical Assistance Manual Revised July 2012
statement from the provider shall include the item purchased and the date and cost of the purchase.
(e) Medical expenses incurred during the time periods specified in §D(6)(b) and (c) of this regulation shall be deducted from the excess available income beginning with the earliest time period and in the following order:
(i) Medicare and other health insurance premiums, deductibles, or co-insurance charges;
(ii) Expenses incurred for necessary medical care or remedial services that are recognized under State law but are not covered under the State Plan;
(iii) Expenses incurred for necessary medical care or remedial services that are covered under the State Plan.
(f) Spend-down eligibility is established for the remainder of the period under consideration on the day the incurred medical expenses, considered under §D(6)(e) of this regulation, including projected private cost-of-care obligations, equal or exceed the amount of excess available income. Certification is established under Regulation .11D of this chapter.
(g) The medical expenses used to establish spend-down eligibility may not be: (i) Reimbursed by the Medical Assistance Program; or (ii) Used for any subsequent eligibility determination.
(h) Eligibility exists on the day that incurred medical expenses equal or exceed the amount of excess available income.
(i) When spend-down eligibility is not established during the application process, the applicant shall be notified of his ineligibility and advised of the spend-down provision. The application date shall be preserved for possible spend-down eligibility at any time during the established period under consideration.
(j) Eligibility exists on the day during the preserved spend-down period that incurred medical expenses equal or exceed the amount of excess available income. Certification is established under Regulation .11D of this chapter.
(k) When the incurred medical expenses do not equal the amount of excess available income during the period under consideration, eligibility does not exist. A new application date and period under consideration will be established when the applicant reapplies after the expiration of the established period under consideration.