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For the next prescriptions that Jeff has filled during his benefit period, he will pay only co- payment amounts. 2. When the cost of a covered prescription drug is applied toward meeting the spenddown and the amount exceeds the remaining spenddown amount, the excess will be applied toward the deductible. Example 2: Rachel's income is $1,800 more than 240% of the FPL for a FTG of one (see SECTION 39.11 SENIORCARE INCOME LIMITS AND PARTICIPATION LEVELS). Her spenddown amount for the 12-month benefit period is $1,800. In four months, Rachel has incurred all but $50 of her spenddown amount by purchasing covered prescription drugs at retail price. During the fifth month of her benefit period when she has $50 of her spenddown left, Rachel purchases a covered prescription drug that costs $100. Rachel pays the full $100. Of the $100, $50 is applied to her spenddown, and $50 is applied to her deductible. She now has satisfied the spenddown, and the remaining deductible amount is $800. 33.8.3 Date of Purchase A prescription is considered purchased on the date the prescription is filled. For the drug purchase to count toward either the spenddown or the deductible, the prescription must have been purchased during the benefit period. This page last updated in Release Number: 26-03 Release Date: 08/12/2026 Effective Date: 08/12/2026 33.9 SeniorCare Addition of a Spouse 33.9.1 SeniorCare Addition of a Spouse Introduction The following exceptions apply when one spouse (hereafter referred to as Spouse 2) is determined eligible after the participating spouse’s (hereafter referred to as Spouse 1) benefit period has begun. In all of these situations, Spouse 1’s eligibility and benefit period does not change, unless they choose to reapply (see SECTION 33.11 RE-APPLICATION). If Spouse 2 becomes eligible after Spouse 1’s benefit period has begun, Spouse 2’s benefit period ends on the same date that Spouse 1’s benefit period ends. The participation level for Spouse 2 depends on whether: 1. Spouse 2 was married and living with Spouse 1 at the time of Spouse 1’s application (see SECTION 33.9.2 ADDING A SPOUSE NO CHANGE IN FTG). a. If Spouse 1’s eligibility was determined at level 2a or 2b, then refer to 33.9.2 ADDING A SPOUSE NO CHANGE IN FTG. b. If Spouse 1’s eligibility was determined at level 3 then refer to SECTION 33.9.2.2 ADDING A SPOUSE, NO FTG CHANGE, AT LEVEL 3. Refer to the applicable policy depending on whether or not the spenddown has been met as follows: i. Unmet spenddown (SEE SECTION 33.9.2.2.1 UNMET SPENDDOWN) ii. Met spenddown (SEE SECTION 33.9.2.2.2 MET SPENDDOWN) Or