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Example 11 Annie applied for Medicaid on July 25, requesting a one month backdate. Her deductible period is from June through November. She has paid her Medicare Part B premiums since she turned 65, seven years ago. She can use her Part B premium expense from the months of April, May and June as paid medical expenses. See Process Help 12.14.2.4 Medicare Premium Payments for processing information. 24.7.1.1 Countable Expenses The following are expenses that can be counted against the deductible if they meet the conditions listed in 24.7.1 COUNTABLE COSTS: 1. Medical expenses. Medical expenses are costs for services or goods that have been prescribed or provided by a professional medical practitioner (licensed in Wisconsin or another state) regardless of whether the services or goods are covered by Medicaid. Medical expenses for services or prescriptions acquired outside of the United States may be counted toward a deductible if a licensed medical practitioner or pharmacy provided the service or drug.

Some examples of medical expenses are deductibles and co-payments for Medicaid, for Medicare, for private health insurance; and bills for medical services which are not covered by the Wisconsin Medicaid program. See SECTION 15.7.3 MEDICAL/REMEDIAL EXPENSES. Note ForwardHealth interChange (iC) data may be used to calculate Medicaid co-payments from the previous deductible period. 2. Remedial expenses. Remedial expenses are costs for services or goods that are provided for the purpose of relieving, remedying, or reducing a medical or health condition (see SECTION 15.7.3 MEDICAL/REMEDIAL EXPENSES). 3. Ambulance service and other medical transportation (21.4.2 TRANSPORTATION). 4. Medical insurance premiums paid by a member of the fiscal test group. These insurance premiums include disease specific and per diem hospital and nursing home insurance payments. This includes all Medicare premiums paid by the member. See 24.7.1. # 3 regarding premiums paid for the three months prior to the deductible. Do not allow accidental insurance policy premiums as a countable cost. Note Unlike other expenses listed in this section that may not be applied toward a deductible until they are incurred, count medical insurance premiums from the first day of the deductible period, if the premium will be coming due anytime during the current deductible period. This includes all Medicare premiums owed by the member during the deductible period. 5. Medical bills paid by a party who is not legally liable to pay them can be counted against a deductible.

Examples of parties that pay medical bills when not legally liable include, but are not limited to: Churches, fraternal organizations, Children's Special Health Needs Unit of the Division of Public Health, Veterans Administration and the AIDS Drug Assistance Program (ADAP). 6. Medical services received at a Hill-Burton facility. The Hill-Burton Act was enacted by Congress to provide federal assistance for the construction and modernization of health care facilities. Medical facilities which receive Hill-Burton assistance must provide without charge a reasonable volume of services to persons unable to pay for those services. 7. In-kind payments. These are services or goods supplied to the provider in lieu of cash. Self declaration of the bill being satisfied is adequate verification. 8. Medical or remedial expenses that are paid or will be paid by a state, county, city or township administered program that meets the conditions detailed in 24.7.1. # 3.