1st - Decide if you should dispute this item.
To determine the amount in dispute you will need (1) your Form 433-A, (2) the IET (Income/Expense Table) Worksheet sent to you with the rejection letter, and (3) the Out-of-Pocket Health Care Standards Table.
Follow these steps:
Identify the amount you used for out-of-pocket health care costs found on line 39 on page 4 of Form 433-A.
Identify the amount shown for out-of-pocket health care costs from the IET Worksheet you received.
Identify the amount from the Out-of-Pocket Health Care Standards Table that applies to you based on your age.
Compare the out-of-pocket health care standard amount to the amount from the IET Worksheet: If the IET Worksheet amount is LESS than the out-of-pocket health care standard, then you have a disputed item and may consider filing a request for an appeal.
Compare the amount on line 39 of page 4 of your 433-A to the out-of-pocket health care standard: If the amount on line 39 of page 4 of the Form 433-A is GREATER than the out-of-pocket health care standard, then you may appeal. You must provide supporting document for your living expenses.
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2nd - Do you need help in identifying the documents supporting your item(s) in dispute?
3rd - Do you want assistance in identifying other disagreed items?