When Recovery Would Defeat the Purpose of Title II or Title XVIII

50.13 – When Recovery Would Defeat the Purpose of Title II or Title XVIII (Rev. 12438; Issued: 01-04-24; Effective: 02-06-24; Implementation: 02-06-24) This means recovery would defeat the purpose of benefits under these titles, i.e., would cause financial hardship by depriving a beneficiary of income required for ordinary and necessary living expenses. This depends upon whether the beneficiary has an income or financial resources sufficient for more than ordinary and necessary expenses, or is dependent upon all of their current benefits for such needs. A beneficiary’s ordinary and necessary expenses includes: a) Fixed living expenses, such as food, clothing, rent, mortgage payments, utilities, maintenance, insurance (e.g., life, accident, and health insurance, including premiums for supplementary medical insurance benefits under Title XVIII), taxes, installment payments, etc.; b) Medical, hospitalization, and other similar expenses not covered by Medicare or any other insurer; c) Expenses for the support of others for whom the beneficiary is legally responsible; and d) Other miscellaneous expenses which may reasonably be considered necessary to maintain the beneficiary’s current standard of living.