Pre-eligibility Medical Expenses and Calculations of Recurring Income for Long Term Care Beneficiaries

Effective Oct. 1, 2015, the South Carolina Department of Health and Human Services (SCDHHS) will modify the Medicaid State Plan regarding non-covered, pre-eligibility medical expenses. Medicaid policy allows non-covered medical expenses to be used to reduce a beneficiary’s recurring income for long term care services. Currently, the Medicaid State Plan does not limit the time period from which non-covered, pre-eligibility medical expenses can be applied. Medicaid policy will be modified so that reasonable and necessary medical and remedial care expenses not covered by Medicaid incurred in the three months prior to the month of application are allowable deductions. Expenses incurred prior to this three month period are not allowable deductions.

Please contact Medicaid Eligibility Policy at (803) 898-4562 if you have questions regarding this bulletin. Thank you for your continued support of the South Carolina Healthy Connections Medicaid Program.

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