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1. Be an expense for a member of the applicant or member's FTG.

Expenses may be counted if incurred for someone the member is legally responsible for if that individual could be counted in the member's FTG. The medical bill may be used even if the family member is no longer living or no longer in the current FTG. Example 2 Sally's spouse died in April. In September, Sally requests that a medical bill incurred for her spouse be used towards her deductible. Sally is still legally responsible for the bill. The bill can be used to meet the deductible as long it did not result in a Medicaid certification in an earlier period. 2. Meet the Definition of Medical or Remedial expense as defined in SECTION 15.7.3 MEDICAL/REMEDIAL EXPENSES and SECTION 24.7.1.1 COUNTABLE EXPENSES. 3. Meet one of the following four conditions a. Still be owed to the medical service provider sometime during the current deductible period.

Expenses which have been "deferred” by the provider are considered a countable cost still owed to the provider and can be used to meet a Medicaid deductible. i. The deferred charge should be viewed as an incurred expense that remains an unpaid obligation for the member. ii. If only a portion of the deferred charge was used to meet a prior deductible, any remaining balance can be used to meet future deductibles. iii. Many deferred charge situations involve very high costs for the services provided, it is extremely important to document in Case Comments which portion of the deferred charges are used to meet previous deductibles, and any remaining balance that can be used to meet current or future deductibles. Example 3 From May through July Helen resided in an Institution for Mental Diseases (IMD) and incurred a $14,000 bill. As of October, Helen has not paid this bill. In October Helen's social worker, Ruth, assists Helen in applying for Medicaid.

Ruth tried to help Helen meet her deductible by collecting Helen's medical bills. The "bill" for Helen's IMD stay listed $14,000 in "Deferred Charges". Ruth questioned what deferred meant. The accounts receivable person at the IMD indicated that charges for low-income people are often "deferred." "Deferred," she explained, means that the member would not be billed for the charges, but if she happens to come into a windfall of money (lottery or inheritance), they will change the status of those charges to current and try to collect the debt.

Helen can use this "deferred" charge toward her deductible.

Example 4 Lestat applies for Medicaid in July. A Medicaid deductible of $700 is calculated for him. In the year prior to applying for Medicaid he had a blood transfusion. The bill for the transfusion was $800. He never paid it and still owes it to the service provider. Lestat can use the unpaid bill to meet his Medicaid deductible, but he must provide documentation to show that the