Wash. Admin. Code § 388-450-0200 - Will the medical expenses of elderly persons or individuals with disabilities in my assistance unit be used as an income deduction for basic food?
(1) If your basic
food assistance unit (AU) includes an elderly person or individual with a
disability as defined in WAC
388-400-0040, your AU may be
eligible for an income deduction for that person's out-of-pocket medical
expenses. We allow the deduction for medical expenses over $35.00 each
month.
(2) You can use an
out-of-pocket medical expense toward this deduction if the expense covers
services, supplies, medication, or other medically needed items prescribed by a
state-licensed practitioner or other state-certified, qualified, health
professional. Examples of expenses you can use for this deduction include those
for:
(a) Medical, psychiatric, naturopathic
physician, dental, or chiropractic care;
(b) Prescribed alternative therapy such as
massage or acupuncture;
(c)
Prescription drugs except medical marijuana;
(d) Over the counter drugs;
(e) Eye glasses;
(f) Medical supplies other than special
diets;
(g) Medical equipment or
medically needed changes to your home;
(h) Shipping and handling charges for an
allowable medical item.
This includes shipping and handling charges for items purchased through mail order or the internet;
(i) Long distance calls to a medical
provider;
(j) Hospital and
outpatient treatment including:
(i) Nursing
care; or
(ii) Nursing home care
including payments made for a person who was an AU member at the time of
placement.
(k) Health
insurance premiums paid by the person including:
(i) Medicare premiums; and
(ii) Insurance deductibles and
copayments.
(l)
Out-of-pocket expenses used to meet a spenddown as defined in WAC
182-519-0100. We do not allow
your entire spenddown obligation as a deduction. We allow the expense as a
deduction as it is estimated to occur or as the expense becomes due;
(m) Dentures, hearing aids, and
prosthetics;
(n) Cost to obtain and
care for a seeing eye, hearing, or other specially trained service animal. This
includes the cost of food and veterinarian bills. We do not allow the expense
of food or veterinary bills for a service animal as a deduction if you receive
ongoing additional requirements under WAC
388-473-0040 to pay for this
need;
(o) Reasonable costs of
transportation and lodging to obtain medical treatment or services;
and
(p) Attendant care necessary
due to age, infirmity, or illness. If your AU provides most of the attendant's
meals, we allow an additional deduction equal to a one-person
allotment.
(3) There are
two types of deductions for out-of-pocket expenses:
(a) One-time expenses are expenses that
cannot be estimated to occur on a regular basis. You can choose to have us:
(i) Allow the one-time expense as a deduction
when it is billed or due;
(ii)
Average the expense through the remainder of your certification period;
or
(iii) If your AU has a 36-month
certification period, you can choose to use the expense as a one-time
deduction, average the expense for the first 12 months of your certification
period, or average it for the remainder of your certification period.
(b) Recurring expenses are
expenses that happen on a regular basis. We estimate your monthly expenses for
the certification period.
(4) We do not allow a medical expense as an
income deduction if:
(a) The expense was paid
before you applied for benefits or in a previous certification
period;
(b) The expense was paid or
will be paid by someone else;
(c)
The expense was paid or will be paid by the department or another
agency;
(d) The expense is covered
by health care insurance;
(e) We
previously allowed the expense, and you did not pay it. We do not allow the
expense again even if it is part of a repayment agreement;
(f) You included the expense in a repayment
agreement after failing to meet a previous agreement for the same expense;
or
(g) You claim the expense after
you have been denied for presumptive SSI; and you are not considered disabled
by any other criteria.
Notes
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