A medical expense deduction is only allowed for household
members meeting the definition of elderly or disabled, per OAC
340:50-5-4.
For these household members, medical expenses exceeding $35 per month are
deductible when verified. The $35 is subtracted from medical expenses once per
household, not per person, when the household has more than one elderly or
disabled member.
(A)
Allowable medical
expenses. Allowable medical expenses must be prescribed or approved by a
state licensed or qualified practitioner and include:
(i) medical and dental care, including
psychotherapy and rehabilitation services provided by a licensed practitioner
or other qualified health professional authorized by state law;
(ii) hospitalization or outpatient treatment,
nursing care, and nursing home care, including payments by the household for a
person who was a household member immediately prior to entering a hospital or
nursing home provided by a facility recognized by the state;
(iii) prescription drugs and other
over-the-counter medication including insulin, when approved by a licensed
practitioner or other qualified health professional authorized by state law.
This does not include the cost of a Schedule I controlled substance under the
Controlled Substances Act, Section
801
et. seq. of Title 21 of the United States Code, or any expenses associated with
its use;
(iv) costs of medical
supplies, sick-room equipment including rentals, or other prescribed equipment;
(v) health, dental, and
hospitalization policy premiums;
(vi) Medicare premiums and any cost-sharing
or spend-down expenses incurred by Medicare or SoonerCare (Medicaid)
recipients;
(vii) dentures,
hearing aids, and prosthetics;
(viii) eye glasses prescribed by a licensed
practitioner;
(ix) reasonable cost
of lodging and transportation to obtain medical treatment or services. Lodging
costs are allowed when the elderly or disabled member is required to spend the
night away from home to receive medical services. Reasonable transportation
costs are based on the type of transportation used. When the elderly or
disabled member:
(I) uses his or her vehicle,
the state's current mileage reimbursement is allowed;
(II) uses public transportation, the actual
cost of the transportation is allowed; or
(III) pays a non-household member for
transportation, the amount charged by the person is allowed;
(x) maintaining an attendant,
homemaker, home-health aide, child care services, or housekeeper due to age,
infirmity, or illness. When this expense also qualifies as a dependent care
expense per (4) of this subsection, it is considered a medical expense rather
than a dependent care expense. Additionally, when the household furnishes a
majority of the caretaker's meals, an amount equal to one allotment is added to
the medical expense for meals provided. The allotment used is the amount in
effect at certification; and
(xi)
costs associated with all service animals specially trained to serve the needs
of elderly or disabled program participants. This includes maintenance costs,
such as veterinary bills, food, and other expenses for these service animals.
(B)
Medical
expenses not allowed. Expenses not allowed include:
(i) costs associated with special diets;
(ii) premiums for health and
accident insurance policies, such as those payable in lump sum settlements for
death or dismemberment;
(iii)
premiums for income maintenance policies, such as those that continue mortgage
or loan payments while the beneficiary is disabled;
(iv) items that can be purchased with food
benefits, such as dietary supplements;
(v) the cost of meals or other incidentals
when the person spends the night away from home to receive medical services;
and
(vi) medical marijuana or any
expenses associated with its use.
(C)
Medical expense verification
requirements. Households are required to report and verify medical
expenses at certification and certification renewal. Households are not
required to report changes in medical expenses during the certification period.
(i) When a household voluntarily reports a
reduction in medical expenses that will decrease the food benefit allotment, no
verification is needed. However, the change requires notice of adverse action,
per OAC
340:50-9-5.
(ii) When a household voluntarily
reports additional medical expenses that will increase the food benefit
allotment, the household must verify the additional expenses before the worker
changes the medical expense deduction.
(iii) When the additional medical expenses
are one-time expenses, such as hospital costs, dental expenses, or the purchase
of prescription eyeglasses, the expense is only allowed when the person reports
and verifies the expense before it becomes past due. When a portion of the
expense will be paid by a vendor or insurance payment, the worker does not
allow the expense until the amount owed by the person is verified. Once
verified, the household may choose to:
(I)
deduct the entire expense in the month incurred or when it becomes due;
(II) average the expense over the
remaining months of the certification period; or
(III) average the expense over the scheduled
length of a payment plan.
(iv) When the worker finds out about a change
from a source other than the household, the change is acted on when verified
upon receipt, such as when the worker is notified via data exchange of a
Medicare premium change. The worker does not contact the household for
additional information. When the change requires household contact for
additional information or verification, the worker does not make the change.
(v) When a household reports but
does not verify an anticipated medical expense, the worker informs the
household the expense will be allowed when the household provides verification.