OAR 461-160-0030
Overview of Costs


(1)

Costs incurred by the filing group that the filing group has a legal responsibility to pay are deductible from income in accordance with the rules in this division of rules.

(2)

The following costs are not deductible:

(a)

A cost paid by someone outside the filing group through a reimbursement, vendor payment, or in‑kind benefit.

(b)

A cost that is paid by a person or company outside the filing group or that is written off by a medical facility. These are referred to as third‑party payments.

(c)

The cost for a service provided by someone in the filing group, such as child care provided by the father while the mother works.

(d)

A cost used as an income deduction in one budget month or averaged over several months cannot be used again.

(e)

In the OSIPM program, a cost that the client incurred while the client was serving a disqualification from Medicaid under OAR 461-140-0210 (Asset Transfer; General Information and Timelines) to 461-140-0300 (Adjustments to the Disqualification for Asset Transfer) for a transfer of assets for less than fair market value.

(3)

In the OSIP and OSIPM programs, the medical deduction allowed under OAR 461-160-0620 (Income Deductions and Client Liability; Long-Term Care Services or Home and Community-Based Care; OSIPM) is determined as follows:

(a)

In order to be allowed as a deduction, a cost or portion of a cost that has already been paid must be reported in the month it is paid or within 10 days of the date it is paid.

(b)

For one-time costs that have been incurred but not paid in full:

(A)

Any amount already paid when reported is allowed if it was reported in the month that it was paid or within 10 days of the date it was paid.

(B)

For amounts not already paid, the amount allowed as a deduction is the amount the individual expects to pay each month, not to exceed the total amount due at the time the cost is reported.

(c)

Deductions for one-time medical expenses that have been paid with a credit card are allowed as follows:

(A)

The amount allowed as a deduction is the amount the individual expects to pay or is currently paying each month on the card until the outstanding balance of the medical cost would be paid in full.

(B)

For costs charged prior to the month reported, the outstanding balance is the amount of the original cost charged to the card less any subsequent payments to the card.

(C)

Count all payments made to the credit card toward the principal balance of the medical cost.

(D)

Additional deductions are not allowed if the individual incurs interest or fees.

(d)

Recurring costs, such as those for ongoing prescription medications, may be anticipated and allowed until the total amount of the cost has been allowed or through the next annual redetermination (see OAR 461-115-0430 (Periodic Redeterminations; Not EA, ERDC, SNAP, or TA-DVS)), whichever occurs first.

(A)

The amount anticipated should reflect actual and verified costs.

(B)

Recurring costs may not be averaged.

(e)

The effective date for an allowable cost is determined in accordance with OAR 461-180-0020 (Effective Dates; Changes in Income or Income Deductions That Cause Increases).

(f)

Additional deductions are not allowed if the individual fails to pay the cost.
461‑160‑0010
Use of Resources in Determining Financial Eligibility
461‑160‑0015
Resource Limits
461‑160‑0030
Overview of Costs
461‑160‑0040
Dependent Care Costs
461‑160‑0055
Medical Costs That Are Deductible
461‑160‑0060
Use of Rounding in Calculating Benefit Amount
461‑160‑0070
Benefits for Less Than a Full Month
461‑160‑0090
Employment and Independence Expenses
461‑160‑0100
How Income Affects Eligibility and Benefits
461‑160‑0140
How Income and Resources are Used to Determine Eligibility and Benefit for EA
461‑160‑0160
Earned Income Deduction
461‑160‑0193
Determining Eligibility and Calculating Payment
461‑160‑0300
Use of Income to Determine Eligibility and Benefits for ERDC
461‑160‑0400
Use of Income to Determine Eligibility and Benefits
461‑160‑0410
Use of Income and Income Deductions When There Are Ineligible or Disqualified Group Members
461‑160‑0415
Medical Deduction
461‑160‑0420
Shelter Cost
461‑160‑0430
Income Deductions
461‑160‑0500
Use of Income to Determine Benefits
461‑160‑0540
Determining Income Eligibility
461‑160‑0550
Income Deductions
461‑160‑0551
Income Deductions
461‑160‑0552
Income Deductions
461‑160‑0570
Excluded Resource
461‑160‑0580
Excluded Resource
461‑160‑0590
Assessment of Resources
461‑160‑0600
Availability of Income
461‑160‑0610
Client Liability
461‑160‑0620
Income Deductions and Client Liability
461‑160‑0630
Deduction for Maintaining a Home
461‑160‑0780
Determining Adjusted Income
461‑160‑0800
Determining Participant Fee
461‑160‑0855
Excluded Resources for Payments Received Under a Qualified Partnership Policy
Last Updated

Jun. 8, 2021

Rule 461-160-0030’s source at or​.us