1. The worker enters the total verified monthly allowable medical expenses in the Family Assistance/Client Services (FACS) Expense tab "Elderly/Disabled Medical Expense." The computer subtracts the $35.
2. Ongoing monthly medical expenses may be anticipated by averaging at least the past two full calendar months' expenses. Expenses incurred each month may include prescription medication, monthly doctors' visits, monthly blood tests, and insurance premiums.
(1) The household may choose to average regularly recurring expenses, such as medication purchased every other month or insurance premiums paid quarterly. For example: The client pays a premium for hospital insurance once every six months. The total premium of $192 may be divided by six, making the monthly average expense $32.
(2) The household also has the option to have the expense deducted during the month incurred or when the bill is due.
3. After certification, when the household reports changes in medical expenses of $25 or less, the worker makes the change without requiring verification unless the information provided is incomplete, inaccurate, inconsistent, or outdated.
4. (a) One-time medical expenses are those the household does not expect to recur. Some examples include hospital costs, purchase of prescription glasses, or dental work expenses. The worker explains to the client the options in (1) through (3) of this Instruction. The client may choose the option most beneficial to his or her household. The options are:
(1) allow the entire expense the month incurred or when the bill becomes due;
(2) average the expense over the remaining months of the current certification period; or
(3) allow the expense over the scheduled length of a payment plan.
(b) One-time expenses are allowed at the time they are reported to the worker, only if the bill is current and has not become past due. When a portion of the medical cost is paid by vendor payment or reimbursed by insurance, the deduction is not determined until the vendor payment or reimbursement is verified.
(c) The worker must verify the amount of any deductible medical expenses. Verification of other factors, such as allowing an expense or the eligibility of the person incurring the cost, is required only if questionable.
5. These charges may also include, but are not limited to, office calls, hospital visits, house calls, special treatments, and chiropractic services.
6. Such costs may include, but are not limited to, room and board charges, drugs and medical supplies, therapy, surgery, and tests.
7. Over-the-counter medication must be a recommended part of the prescribed treatment plan, such as aspirin for arthritics. Medical supplies include, but are not limited to:
(1) needles and syringes used for insulin injection or other prescription medication;
(2) bandages and gauze for a surgical patient; and
(3) the cost of crutches, wheelchairs, hospital beds, colostomy bags, and portable oxygen.
8. Some health insurance policies cover household members who are not entitled to a medical deduction as well as those who are. When the portion of the premium paid for elderly or disabled members cannot be determined, the premium must be prorated among all members included on the policy. The prorated amount for one member must be multiplied by the number of elderly or disabled members. The resulting amount is considered a medical cost.
9. Other corrective devices are corrective braces worn on the limbs and braces worn on the teeth for orthodontic purposes. The cost of hearing aid batteries are considered a medical expense.
10. Contact lenses prescribed by an opthamologist or optometrist, are considered a medical expense.
11. (a) Transportation costs are based upon the type of transportation used by the elderly or disabled member. If his or her own vehicle is used, the state's current mileage reimbursement rate is allowed. If the household member uses public transportation, the actual cost of the transportation is allowed. If the member pays a non-household member for transportation, the amount charged by the person is allowed. Verification must be obtained and adequately documented in the case record.
(b) Lodging costs are allowed if the elderly or disabled member is required to spend the night away from home to receive medical services. Verification that medical treatment did occur, and receipts verifying the lodging expense must be obtained. The cost of lodging does not include meals or other incidentals.
12. (a) For purposes of this policy, child support is any court-ordered money designated to be paid for the support of a child. This may include, but is not limited to:
(1) child support;
(2) child support arrearages;
(3) medical insurance or other health care premiums;
(4) child care obligations; or
(5) other obligations specified in individual court or administrative orders.
(b) Verification of the court-ordered amount is obtained along with verification of the actual support payments made each month.
(c) Child support also means money owed to a state for services provided for a child, including, but not limited to, Temporary Assistance for Needy Families, SoonerCare (Medicaid) benefits, and foster care.
13. When shelter expenses are paid in advance, the monthly shelter cost is allowed as if the payments were made monthly. Down payments are not allowed as deductions as they are not continuing charges. Expenses are allowed if they are owed to someone outside the household and the household makes a monetary payment. For example, if someone outside the household pays shelter expenses to the vendor, they are not allowable. Exception: If the payment is considered a loan, the expense is allowed as a shelter deduction and the payment is excluded as income.
14.These types of shelter expenses, which may be billed less often than monthly, may be averaged over the interval between scheduled billings. For example, property taxes billed and paid yearly may be averaged over a 12 month period.
15. The appropriate utility allowance is prorated only when there is an ineligible or disqualified household member, or an ineligible student who is billed for or paying the utility costs.
16. To use the standard utility allowance (SUA) to calculate shelter costs, the utility charges for heating or cooling costs must be separate from the household rent or mortgage costs and actually incurred by the household.
(1) Cooling costs are limited to operation of room air conditioners and central air conditioning systems.
(2) Heating costs may be represented by a furnace, wood stove if wood is purchased, fireplace, or electrical or kerosene space heater, if the space heater is used as the primary source of heat.
17. (a) The worker must assess the household's eligibility for the SUA at each application, reapplication, and when the household moves.
(b) Shared utility costs examples among more than one household are given in (1) through (4) of this Instruction.
(1) When more than one household shares the same living quarters and shares one or more of the utility costs that are billed separately from rent or mortgage payments, (A) or (B) of this Instruction applies.
(A) If one household's name is on the utility bill and it alone pays the bill, allow the full appropriate utility standard for that household.
(B) If multiple households, whether receiving food benefits or not, are living in the same residence and sharing one or more of the utility costs billed separately from rent or mortgage payments, entitles each household to the full appropriate standard amount, regardless of whose name is on the bill.
(2) When two or more families share a meter but have separate living quarters and the utility bill is addressed to only one family, accept the unaddressed household's statement of liability for the expense unless it is questionable.
(3) Households residing in low income housing or other rental units with utilities included in the rent, but are liable for excess utilities are entitled to the basic utility allowance (BUA).
(4) If a rental household is billed monthly by the landlord for actual usage of heating or cooling expense as determined through individual metering or a utility company bill, the SUA is used. If the household is billed by the landlord for actual usage of utilities other than heating or cooling, the BUA is used.
18. Households who do not incur heating or cooling costs, but are billed separately for utilities such as cooking fuel, electricity not associated with cooling, water, sewage, garbage collection, and telephone are entitled to the BUA.
19. If the household's only telephone is a cellular phone, the telephone standard is given.
20.Households maintaining two residences are allowed deductions for both residences if they meet this criteria.
21. For example, the portion of rent or utility covered by excluded vendor payments or medical costs reimbursed by insurance is not calculated as part of the household's shelter cost or medical expenses. When only a portion of the medical cost is paid for by vendor payment or reimbursed by insurance, the amount not covered by the vendor payment or reimbursement is deductible at the time the amount of the vendor payment or reimbursement is verified.