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b. End date. A one (1) month budget period ends with the last calendar month during which the person received LTSS for any part of the month and meets all other eligibility requirements. C. LTSS MN coverage begins on the first (1st) day of the budget period in which allowable expenses meet or exceed the spenddown requirement when using health insurance cost and noncovered health expenses to meet the MNIL. Eligibility becomes effective later than the first (1st) day of the month when a spenddown requirement is met using covered medical expenses. Medicaid LTSS coverage continues to the end of the budget period unless there is a change in income. 1. Penalty period and MN eligibility – The penalty start date for a person seeking LTSS MN eligibility is the date the spenddown is met. If the spenddown is not met in the month of application or the next month, the person is ineligible for LTSS MN coverage and the State must determine whether Community Medicaid MN eligibility is available based on a six (6) month spenddown period. 2. Overlapping providers – Applicants and beneficiaries are responsible for health expenses incurred before the date of eligibility. If receiving LTSS for more than one (1) provider on the date that coverage begins, the applicant/beneficiary must decide which services he or she will be responsible for paying and which providers Medicaid will cover. 2.6 LTSS Medically Needy Allowable Expenses A. The health expenses of the LTSS beneficiary and spouse and dependents, if applicable, may be used to obtain or retain MN eligibility if they qualify as allowable under this Part. The expenses may be paid or incurred and not paid depending on the deduction sequence, the age of the health bills, and whether the expenses are predictable and/or used for other eligibility purposes such as reducing resources or beneficiary liability for the cost of care. B. For an incurred health expense to qualify as allowable for a LTSS MN spenddown, the following apply: 1. No third-party liability – An allowable expense must not be eligible for payment by a third (3rd) party. For these purposes, a third (3rd) party could be individuals, entities or policies that are, or may be, liable to pay the expense including, but not limited to: other health care coverage, such as coverage through Medicare, private or group health insurance, long- term care insurance or through the Veterans Administration (VA) health system; automobile insurance; court judgments or settlements; or Workers’ Compensation. Expenses incurred by the spouse or a financially responsible relative are NOT treated as a third (3rd) party liability if such