Classic (non-MAGI) based programs manual

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Allowable expenses chart

Revised Date: 
July 13, 2017
Allowable expenses  
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.

Nonallowable expenses  
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.