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• Fees paid to a legal guardian or attorney that are not court-ordered payments. Do not include such payments in the person's monthly need, and do not deduct them from his or her monthly income. • Fees paid to a third party to reimburse a prepayment the third party made of a guardianship fee. Do not allow the payment even if the third party obtained a court order to recoup the prepayment. Exception: Deduct this third party prepayment if all the following are true: • The third party was the county acting as guardian ad litem. A guardian ad litem is someone appointed by the court to represent the best interests of a juvenile or disabled person during a particular court proceeding. • The prepayment was to an attorney who was not a county employee at the time the services were delivered. • A court ordered the institutionalized person to reimburse the county's prepayment. 15.7.2.3.2 Allowed Deductions The following fees to guardians or attorneys are allowable income deductions: • Court-ordered guardian and/or attorney fees paid directly out of the person's monthly income. • Expenses paid by the person for establishing and maintaining a court-ordered guardianship or protective placement for himself or herself. 15.7.3 Medical/Remedial Expenses Medical/remedial expenses are used in all the following: • Institutional monthly need calculations (see SECTION 27.6 MONTHLY NEED) • Patient liability calculations for Institutional Medicaid • Cost share calculations for Home and Community-Based Waiver Medicaid • Meeting a Medicaid deductible (SEE SECTION 24.7 MEETING THE DEDUCTIBLE) • MAPP eligibility determination if expenses are over $500 monthly (see SECTION 26.4.2.1 DEDUCTION FOR MEDICAL AND REMEDIAL EXPENSES OVER $500) • MAPP premium calculations Medical Expenses Medical expenses are costs for services or goods prescribed or provided by a licensed professional medical practitioner, for the purposes of diagnosis, cure, treatment, or prevention of disease or for treatment affecting any part of the body. These are expenses that are the legal responsibility of the member, and cannot be reimbursable by any other source, such as private insurance, or an employer. The following are examples of medical expenses: • Deductibles for Medicare or private health insurance. • Health insurance premiums and copayments for Medicaid, Medicare, and private health insurance. Note ForwardHealth interChange (iC) data may be used to determine Medicaid co-payment expenses. • Bills for medical services that are not covered by Wisconsin Medicaid or by any other source such as private insurance or Medicare.