What is a Medicaid Spend Down?

What is Medicaid Spend Down?

The Medicaid “Spend Down” program (also known as Medicaid Excess Income or Surplus Income) is for people who have too much income for the regular Medicaid program, but who also have high medical bills. In this program, Medicaid can pay some, but not all, of a person’s medical bills.

If a person’s monthly income is over the Medicaid level, the amount their income over the Medicaid level is called excess income. It is like a deductible. If a person is eligible for Medicaid except for having excess income and can show that they have medical bills equal to their excess income, Medicaid will pay their additional medical bills beyond that for a determined amount of time.

In effect, the person can “spend down” their income by paying some of the medical bills. Depending on the State, and whether the medical bills are for Outpatient or Inpatient/Hospital Care and Services, this benefit is granted from one to six months at a time. Each time period a person will have to meet a new “spend down amount.” The person will be responsible for all medical bills up to their “spend down amount.” Medicaid will cover all medical costs above that amount for the rest of that timer period.

Medicaid Spend Down Programs

When your income is above the Medicaid income guidelines in your state, your State may offer a Medicaid spend down program for aged, blind, and disabled (ABD) individuals. In this program, you can deduct certain medical expenses from your income so that you can qualify for ABD Medicaid. You may qualify for Medicaid Spend Down program if you have medical expenses that significantly reduce your usable income.

Furthermore, you may qualify for Extra Help for Medicare Part D. Find out if you qualify for Full Low-Income Subsidy (LIS) or partial subsidy.