For community, NH, and SLF cases, when determining if an enrolled case meets spenddown, allow bills or receipts for the following types of medical expenses. When determining if spenddown is met, use the medical expenses of everyone included in the Standard, even if they are not included in the Medical case.
1. Do not allow routine and preventive dental services for regular medical customers living in Intermediate Care Facilities for the Mentally Retarded (ICF/MR).
2. Do not allow, as a deduction from income or when determining if spenddown is met, any bed reserve charges for a resident of an Intermediate Care Facility (ICF), Skilled Nursing Facility (SNF), ICF/MR, or Supportive Living Facility (SLF).
3. After eligibility is determined, the purchase of a funeral or burial contract may not be applied to reduce the group care credit or to meet spenddown. The purchase of the contract is considered an allowable transfer for LTC as long as the customer receives fair market value (FMV) but does not reduce the portion of the customer's resources that were originally determined available to pay for the customer's care.
For persons in the following community settings, room and board costs are not an allowable medical expense:
- public tuberculosis hospital; or
- residential home; or
- educational or vocational training facility; or
- rehabilitation facility that is not a medical facility; or
- facility that is not a licensed medical or sheltered care facility.