L Expenses

Revised 07/12/2019

Policy

The customer may report changes to the following types of expenses:

Share of cost (SOC) related expenses;
Work-related expenses; or
Adjusted gross income deductions.

When the customer reports a change in...

Then the change may affect...

SOC-related expenses

The customer’s SOC when the customer receives:

ALTCS; or
FTW-ALTCS and lives in a long-term care medical facility.

Work-related expenses:

Blind Work Expenses; or
Impairment Related Work Expenses

The customer’s income eligibility or premium amount when the customer receives:

SSI-MAO;
MSP; or
FTW.

Adjustments to Gross Income:

Educator expenses;
Certain business expenses of reservists, performing artists and fee-basis government officials;
Health savings account deduction;
Moving expenses for members of the Armed Forces who move as a result of military orders;
Deductible part of self-employment tax;
Self-employed SEP, SIMPLE and qualified plans;
Self-employed health insurance deductions;
Penalty on early withdrawal of savings;
Alimony paid; when the spousal support agreement was created before 12/31/2018 and has not been modified since that date to add the provisions of the Tax Cuts and Jobs Act of 2017;
IRA deduction;
Student loan interest deduction.

The customer’s KidsCare premium amount or income eligibility when the customer qualifies for any of the following MA programs:

Adult;
Caretaker Relative;
Pregnant Woman;
Child; or
KidsCare.

Definitions

Term	Definition
Adjustments to Gross Income	Expenses and income deferrals allowed to determine Adjusted Gross Income (AGI) for tax purposes are also allowed when determining income eligibility using MAGI rules. See MA609C for additional information. See also IRS Publication 17 for full list of the requirements for each adjustment at http://www.irs.gov/publications/p17/index.html).
Blind Work Expenses (BWE)	The reasonable cost of services and items that a person with a DDSA determination of blindness needs in order to work and are necessarily incurred by that person because of the visual impairment. (See MA609B.7)
Impairment Related Work Expenses (IRWE)	The reasonable cost of services and items that a person with a disability needs in order to work and are necessarily incurred by that person because of a physical or mental impairment. (See MA609B.5)
Share of Cost Related Expenses	Certain expenses subtracted from the customer’s total counted income to figure the share of cost (SOC) amount. See MA1201C for additional information. These expenses include: Medicare premium amounts; Third Party Liability insurance (TPL) premiums; Non-covered medical expenses; or Shelter expenses

Proof

Changes to expenses are verified as follows:

When the expense is...	Then the policy used is located at...
Medicare and TPL premium amounts	MA1201C.7
Non-covered medical expenses	MA1201C.8
Shelter expenses	MA1201C.4
Blind Work Expenses	MA609B.7
Impairment Related Work Expenses	MA609B.5
Adjustments to Gross Income	MA609C

Programs Affected

This applies to the following programs:

ALTCS;
SSI MAO;
Medicare Savings Program (MSP);
Freedom to Work (FTW);
Adult;
Caretaker Relative;
Pregnant Woman;
Child; and
KidsCare.

Timeframes

Changes must be reported as soon as the future event becomes known. Unanticipated changes must be reported within 10 calendar days of the date the change occurred.

Legal Authority

Program	Legal Authorities
ALTCS	42 USC 1396a(q) and 42 USC 1396r-5(d) 42 CFR 435.725 and 726 AAC R9-28-411
SSI MAO Medicare Savings Program (MSP) Freedom to Work (FTW)	20 CFR 416.1112(c) 42 CFR 435.916
Adult Caretaker Relative Pregnant Woman Child	42 CFR 435.603 42 CFR 435.916 AAC R9-22-306(B)(3)(c)
KidsCare	42 CFR 457.315