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deduction amount. The eligibility staff member must wait until an expense or verification of third-party payment is provided if the obligated amount is still questionable. The eligibility staff member must document in case notes the medical expenses allowed for the deduction. CHANGES IN MEDICAL EXPENSES: A household may report changes in medical expenses during its certification period. The eligibility staff member is required to take an action on the change according to the household’s reporting requirements within 10 calendar days (SNAP 1501-1). The household must be allowed 10 calendar days from the date the verification is requested to provide verification of the reported change. The notice must also inform the household if verification is not provided within 10 days of the request, the medical expense will not be allowed. Cash Option Not Paid: If Medicaid closes anytime during the certification/ recertification period because the household did not pay cash option, the cash option expense is removed as the expense is no longer being incurred; the information is verified upon receipt and does not require the household to provide verification. The previously reported and verified medical expenses are used to determine the medical expense deduction. Do not remove the unpaid cash option amount at simplified report or recertification unless the medically needy Medicaid case has closed. Medical expenses submitted to meet a spend-down are treated as a reported change. The eligibility staff member must evaluate the medical expense deduction each time a new bill or co-payment is received. The eligibility staff member must document in case notes specific information about the change in the medical expense reported including the date of service or prescription, date expense was reported and the expense amount, even if the change reported does not change the benefit amount. ALLOWABLE MEDICAL EXPENSE: A medical expense can only be allowed once as a medical deduction. Medical expenses are allowed when they become due. Medical expenses carried forward from past billing periods are not allowed even if they are included with the most recent billing and actually paid by the household. Once an expense becomes past due, it remains past due. However, see the section below for expenses not considered ‘past due’, for example, installments, averaged over period of intended use, and averaged over period until next recertification. The eligibility staff member can use the expense for the next regular issuance if the household reported the change within 30 days of being billed. If the expense was not reported within 30 days of billing, it is not allowed unless it meets one of the exceptions. See the section below for expenses not considered ‘past due’, for example, installments, averaged over period of intended use, averaged over period until next recertification. NOTE: An expense is considered 'past due' 30 days after the billing date. 'Past due' means the payment is overdue to the provider not overdue at the time of application or recertification.