3-003.01D3 “One Time Only” Medical Expenses

475 NAC 3-003.01D3

A “one time only” medical expense is the cost of a medical occurrence which is not ongoing or routine.

Example: A broken leg is a one-time occurrence, but high blood pressure is an ongoing, routine medical occurrence for anyone who has it. The cost of medication for high blood pressure is therefore not a one time only medical expense.

The following procedures apply solely to one time only medical expenses:

1. If a household reports a one time only medical expense at certification or recertification, the worker shall offer the household the choice of having the expense:

a. Budgeted as a lump sum; or

b. Averaged and budgeted over the certification period.

2. If a household reports they anticipate a medical expense during the certification period and at the time of certification they can provide adequate verification of the anticipated expense, the expense can be prorated over the entire certification period.

3. If a household reports a one time only medical expense during the certification period, the worker shall offer the household the choice of having the expense:

a. Budgeted as a lump sum; or

b. Averaged and budgeted over the remaining months in the certification period; and

4. If a household reports they anticipate a medical expense during the certification period but are unable to provide the verification at the time of certification, the worker must inform the household that the expense will be allowed if the verification is provided during the certification period and the expense will be prorated over the balance of the certification period.

5. If a one-time medical expense was averaged over the certification period and the certification period is extended, the one-time medical expense must be recalculated. The medical expense must be averaged over the months in the extended certification period.