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What Is A Spend Down for Medicaid

What YOU need to know about Medicaid eligibility and spend down. Help is HERE. Spend down your medical bills to lower your income and get Medicaid.

Medicaid spend down is a term used to describe a formal process that will reduce an individual’s income so that s/he may be able to qualify for Medicaid benefits.

Who qualifies for Medicaid?

Overall, Medicaid (also known as medical assistance) benefits are available to people considered to be ‘low-income’ who are also elderly (minimum age 65 years) or disabled. People who qualify as disabled do not need to be age 65 and their disability may be physical (i.e. blind, loss of limb) or psychological.

What qualifies for a psychological disability?

A psychological disability is a mental illness or cognitive impairment that interferes with the individual’s ability to work or function independently in his/her environment (i.e. those who are developmentally disabled).

How is ‘low-income’ defined in a spend down for Medicaid?

The Federal government sets the dollar amount that qualifies an individual for Medicaid. When a person’s income surpasses the dollar amount allowed by Federal regulation but s/he meets age and/or disability eligibility, then that person may need to engage in a spend down to qualify for Medicaid.

How does one spend down to qualify for Medicaid?’

The spend down for Medicaid process applies to seniors and disabled people who do not live in nursing homes. Each state has its own processes that will assist an individual with his/her spend down.

How do I know if I qualify for Medicaid or spend down for Medicaid?

Contact your local social services department and ask to schedule an appointment to discuss Medicaid eligibility and spend down for Medicaid options. The spend down process frequently includes using your money to pay medical bills; however, other options may be available in your specific community.



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