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Charges for medical services incurred during a period of ineligibility may be deducted from income as unmet medical needs if they meet the criteria below. 1. The charges are for a month when the a/b was ineligible for Medicaid. 2. There is a written agreement between the a/b and the facility specifying the amount to be paid and the schedule for paying. 3. The agreed upon payment to the facility can be allowed as UMN. 4. Note that expenses Medicaid does not cover due to a transfer of assets sanction cannot be used as an unmet medical need. See VIII.A.2.B. above. G. Report Unmet Medical Needs 1. Unmet medical needs must be reported to the caseworker by the a/b, the representative, LTC facility, or other medical provider as follows: a. For applications: (1) Include only those costs which are reported and verified by the time the application is approved. (2) Do not pend an application past the 45/90th day for verification of reported costs.

(3) Do not hold the application until the 45/90th day for unmet medical needs if no costs have been reported.

b. For authorized cases:

Costs must be reported by the end of the six month certification period which follows the certification period in which the service was rendered/cost was incurred.

If the a/b's representative reports a decrease or terminated unmet medical need (i.e. medical insurance stopped), verify from the source. Revise PML after timely notice is issued. 2. Verify all non-covered medical costs: a. At application, use DHB-5097, Request for Information. b. At the regular six-month review use suggested form (DMA-5163).

c. Send the request to:

(1) The a/b if acting on their own behalf;

(2) The representative acting for the a/b; or

(3) The business office of the LTC facility if the a/b cannot be reasonably expected to provide the information and has no representative.

Docusign Envelope ID: 950E9248-29CC-8930-81BC-BCEC667EB493