Important: Stay covered! Are you enrolled in Apple Health (Medicaid) coverage? Make sure your address and phone number are up to date so you can stay enrolled. Report a change.
Allowable expenses chart
|Medical supplies (e.g. syringes, adult diapers, etc.) and drugs, including OTC drugs prescribed by an M.D., D.O. or A.R.N.P.||Cost of, or payments if rental or purchase contract for durable medical equipment, including aids to mobility, rehabilitative aids, prosthetic/orthotic devices and Electronic Emergency Response Systems (EERS)|
|Hospital services, emergency room, clinic (including mental health clinics) and nursing facility expenses||In-home nursing care if need is documented with a physician's statement|
|Insulin and its necessary administration devices||Blood and its derivatives|
|Hearing aids and related supplies||Oxygen|
|Medical/dental insurance deductibles & coinsurance charges incurred during the base period||Out of State billings for medical services recognized under WA State law|
|Remedial care such as dialysis helpers||Community case management in support of medical services or care|
|Medical transportation by personal vehicle at the current state reimbursement rate||Medical transportation by other means at the actual fare or fee. May include parking fees|
|Medically necessary improvements to the home to accommodate a disabled person||Other services prescribed by an allowable medical practitioner|
|Away from home lodging costs related to medical treatment||Food and other expenses for a medically necessary service animal|
See Allowable Medical Expenses for more information.
|OTC drugs & medications not prescribed, including medical marijuana even if it is prescribed||Out of State billings for medical services not recognized under WA State law|
|Services obtained out of the US||Food, health food & nutritional supplements, unless prescribed|
|In-home cooking/cleaning services||Property maintenance|
|Trips or retreats||Health camps or retreats|
|Dietetics||Unpaid LTC participation incurred while active on an institutional Medicaid program|
|Commercial diet clinics & gyms||Telephone charges|
|Physical fitness aids unless prescribed for medical services||Massage Therapy, unless prescribed (must be provided by licensed practitioner)|
Note: When an individual lives in an alternate living facility (ALF) and pays privately to the facility for their care, these charges are not considered a medical expense and therefore cannot be allowed towards meeting spenddown. See WAC 182-513-1205 for rules on how to determine Medicaid eligibility for an individual who is living in a licensed, state contracted alternate living facility.
Long-term care medical expense chart
The Allowable medical expenses is a chart that describes the allowable medical and remedial services allowed to reduce participation in post eligibility.