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Except as listed below, products or services available without a prescription cannot be used to reduce the spend down. The following services/products are Medicaid-covered services recognized under state law and, as long as prescribed by a physician, must be used to reduce the spend down: NOTE: State law requires prescriptions to be renewed annually. 1. Diabetic supplies (including glucose test strips, insulin and syringes); 2. Antacids; 3. Analgesics containing aspirin; 4. Laxatives; 5. Medication to eradicate lice infestation; 6. H2 antagonist gastrointestinal products (such as Zantac); 7. Bronchosaline; 8. Nicoderm; 9. Adult diapers if the client: a. is over age three; b. has a diagnosis of incontinence; and c. does not reside in a nursing home; 10. Monthly personal vehicle costs for medical transportation at $.33 per mile provided Medicaid was not open on the travel date (medical transportation is a Medicaid-covered service). 11. Medically necessary personal care services provided by an enrolled Medicaid provider; NOTE: All medically needy clients, including waiver-eligible, can use medically necessary personal care services to reduce their spend down. 12. Mail order postage costs for prescription drugs and other services listed above when provided by a pharmacy in a community different than the client’s residence. Pharmacy delivery changes are not allowed. HEALTH INSURANCE PREMIUMS: Health insurance premiums due less frequently than monthly cannot be prorated over the coverage period. However, any premium amount exceeding the spend down obligation can be carried forward to reduce/meet future months’ spend down obligations. NOTE: This policy also applies to clients residing in a nursing home. Insurance premiums for specific illness/situation policies, such as cancer or long-term care polices can be used to reduce/meet the spend down, even if the client currently does not have the specific illness/situation. General indemnity policies that are not limited to a specific illness or situation cannot be used to reduce the spend down. BILLS WITH THIRD PARTY INVOLVEMENT: Take reasonable measures to determine a third party’s legal liability to pay a medical expense. However, an eligibility determination is not delayed because this liability cannot be verified.