An official State of Texas website.
Revision 16-2; Effective June 1, 2016
Medicare Part D related expenses may include:
- Part D premiums;
- prescription drug co-payments/costs;
- prescription drug deductibles; and
- non-formulary Part D drugs.
Allow Medicare Part D related expenses as an incurred medical expense (IME) deduction for a recipient who:
- has Medicare;
- has a co-payment; and
- is receiving home and community-based waiver services, or is residing in a long-term care (LTC) facility.
If a recipient provides verification of payment of an out-of-pocket Medicare Part D related expense, allow the expense as an IME.
Form H1263-A, Certification of Medical Necessity, is not necessary to request an IME deduction for Medicare Part D related expenses, but may be used for documentation of a request. If a recipient is unable to make a request and has no authorized representative, facility staff or home and community-based waiver case managers may provide verification and request an IME deduction.