36-2901.04. Medical expense deduction eligibility process

A. The administration shall adopt rules for a streamlined medical expense deduction eligibility process to determine eligibility for any person who applies to be an eligible person as defined in section 36-2901, paragraph 6, subdivision (a), item (v). The administration shall adopt these rules in accordance with state and federal requirements and the section 1115 waiver.

B. To be eligible for the medical expense deduction program established pursuant to this section a person must meet the following requirements:

1. Have a family income that does not exceed forty per cent of the federal poverty guidelines after deducting allowable medical expenses.

2. Have family resources that do not exceed one hundred thousand dollars in net worth, including five thousand dollars in liquid assets. The administration shall exclude one vehicle.

C. An applicant may use the allowable medical expenses of a member of the applicant's family unit to reduce income to the required income level prescribed in subsection A of this section. The administration shall calculate income by using medical expenses that are not reimbursable by first or third party liability and that are incurred in a three month period beginning with the month before the month of application, the month of application and the following month.

D. To determine when spend down is met, the administration shall deduct from the applicant's family income incurred medical expenses sequentially beginning with the month before the month of application.

E. Eligibility is the date that spend down is met as determined by the department or the first day of the month of application, whichever is later.

F. The administration shall grant eligibility for five continuous months plus any remaining days starting with the first day of eligibility but not to exceed a maximum period of six months.