In determining spend down eligibility when the recipient is also eligible for QMB, use only those incurred allowable medical expenses which would not be covered by the QMB program. When spend down eligibility is determined in the same quarter in which a claimant becomes QMB eligible, allow incurred medical expenses as for any other spend down claimant until the month QMB eligibility is effective. In the month(s) QMB is effective, use only those allowable expenses which would not be covered by the QMB program.
NOTE: Medical expenses paid by Medicare in combination with QMB are not allowable as spend down expenses. (Refer to Section 0810.010.15 . )