MEMORANDUM

DISCUSSION:

The purpose of this memorandum is to introduce a change in policy for MHABD spend down. This policy, which is effective immediately, will allow participants to carryover medical expenses that were incurred and paid in the current eligibility month and/or the three months prior to the current eligibility month, in addition to those that were incurred and currently owed.

Spend down participants can use eligible expenses incurred and paid in the current eligibility month and/or the three months prior to the current eligibility month to meet spend down. In addition, if the amount of the incurred and paid expenses from prior month(s) exceeds the current month's spend down amount, the remaining balance can be used towards their spend down for the following three months.

These incurred medical expenses can be used to meet spend down if all of the following requirements are met:

• The medical expenses were incurred while the participant was eligible for MO HealthNet spend down;
• The medical expenses were not paid and will not be paid for by MO HealthNet;
• The medical expenses were not previously applied in any month to meet spend down, including use as out of pocket expenses;
• The medical expenses are currently owed by the participant or were paid by the participant or spouse or a third party public program of a State or political subdivision of a State such as Department of Mental Health or Department of Health and Senior Services; and
• The medical expenses were not incurred in any months in which the participant received SLMB2 (QI-1).

NECESSARY ACTION:

• Review this memorandum with appropriate staff.
• Effective immediately allow paid or unpaid medical expenses incurred in the current eligibility month and/or the three months prior to the current eligibility month to meet spend down in the current month or as carryover.

AC/