F Non-Covered Medical Expenses SOC Examples

1)    Current Payments for Services

The customer is on ALTCS and has a SOC of $583.00.  On August 5th, she turns in proof that she paid a $700 dental bill on July 30th. 

The customer's July SOC is reduced from $583.00 to zero. The $117.00 left over does not carry over to the August SOC.

2) Unpaid Expenses

The customer’s SOC is $120.00.  In May, he provides proof that he owes $525.00 for dental expenses from January. The customer's insurance company paid $225.00. The customer is responsible to pay $300.00. 

The unpaid balance is higher than the customer’s monthly SOC. The SOC is reduced to $0.00 for June, $0.00 for July and $60.00 for August.

3)  Calculating the SOC Deduction for Non-Covered Medical Expenses

In February, the customer received a bill of $400.00 for a hearing aid and batteries. In March, the customer began paying $25.00 per month toward the bill. The customer did not report the bill to AHCCCS until July.

·        The payments for March, April, and May are not allowed as deductions because the expense was report in July.

·        The payments for June and July are allowed as SOC deductions in the month that each payment was made.

·        The unpaid balance of $175.00 is allowed as an SOC deduction in the next prospective month (August).