Page 175

VIRGINIA DEPARTMENT OF SOCIAL SERVICES INCOME DEDUCTIONS

10/25 VOLUME V, PART X, PAGE 6

5. Medical Expenses (7 CFR 273.9(d)(3))

The cost of medical expenses incurred by elderly or disabled household members, excluding special diets, is allowed as a deduction for those households when the cost exceeds $35 a month. If the cost is $35 or less, no deduction is allowed. The $35- threshold applies to the entire household and is not applied individually to the expenses of members who may be entitled to a deduction.

A medical standard deduction of $235 has been established. Households must verify that eligible members incur more than $35 in allowable medical expenses per month to get a medical deduction of $200. Households that incur more than $235 in allowable medical expenses per month may opt out of using the medical standard deduction. These households may verify and claim all their medical expenses and have them evaluated as allowed by Part XIII.B.4. Households may switch between the medical standard deduction and actual costs only at the time of certification except when the household was not previously entitled to the standard. Once imposed, the medical standard deduction will remain in place for the balance of the certification period provided the household contains at least one elderly or disabled member who was part of the household at certification.

Persons who are 60 years of age or over or who are disabled, as described in Definitions, may be eligible for the medical deduction. An individual must be elderly or disabled when the medical expense is incurred. Spouses or other persons receiving benefits as a dependent of the eligible individual are not entitled to a medical deduction.

a. Allowable expenses include:

1) Medical and dental care, including psychotherapy and rehabilitation services provided by a licensed practitioner authorized by state law or other qualified health professional.

2) Hospitalization or outpatient treatment, nursing care, and nursing home care. Costs for persons who were household members immediately prior to entering a nursing home or hospital, will also be allowed.

3) Prescriptive drugs, when prescribed by a licensed or qualified practitioner, and other over-the-counter medication (including insulin, aspirin, antacids, etc.) which is approved by a licensed or qualified practitioner. Costs of medical supplies, sick room equipment (including rental), or other prescribed equipment are deductible.

4) Health and hospitalization insurance policy premiums. Costs of health and accident policies such as those payable in lump sum settlements for death

5) Medicare premiums related to coverage under Title XVIII of the Social Security Act and any cost-sharing or spend-down expenses incurred by Medicaid recipients.

TRANSMITTAL #36