Section 17-1730.1-13 - Spenddown calculation for continued eligibility(a) An individual's excess income is the countable income which exceeds the medically needy income standard for the household of applicable size.(b) Medical expenses incurred by an individual or financially responsible relative not subject to payment by a third party shall be deducted from the excess income in the following order: (1) Expenses for Medicare and other health insurance premiums, deductibles or co-insurance charges including enrollment fees and co-payments. Payments made quarterly or for longer intervals shall be pro-rated on a monthly basis.(2) Necessary medical and remedial services recognized under State law but not included in the department's medical assistance plan to include expenses prior to the month of application not previously considered that remain a liability.(3) Necessary medical and remedial services that exceed the department's medical assistance plan in regards to amount, duration or scope of services to include expenses prior to the month of application not previously considered that remain a liability.(c) An employer's contribution to a health plan and any premium voluntarily paid in whole or in part by someone other than the individual shall not be deducted from excess income.(d) Evidence of medical services received shall be required to determine eligibility for a given month.(e) The number of unborn child(ren) shall be included in the household for a pregnant woman only.Haw. Code R. § 17-1730.1-13
[Eff 09/30/13] (Auth: HRS § 346-14; 42 C.F.R. §§435.2, 435.831 ) (Imp: HRS § 346-14; 42 C.F.R. §§435.2, 435.831 )