How to understand Medicaid Spend down

Medicaid is a medical assistance program designed to aid the elderly, disabled, legally blind, poor, and other within the criteria of eligibility. Those individuals that meet this criteria and are below a certain income, are eligible for Medicaid.

Difficulty: Moderately Easy

Instructions

1. An individual whose income is above a certain threshold (which differs from state to state) can not normally qualify for Medicaid. An individual who is eligible for Medicaid but makes excessive income can meet the criteria for eligibility by meeting their "Spend down".

2. What is a Spend down? This term is used a lot in the world of Medicaid and Social Services. Simply put, Spend down is the difference between the individual's income and the Medicaid threshold. For example, if John Doe makes $1000 and the Medicaid limit is $750, the Spend down would be the difference between the two, or $250.

3. So, one way John Doe can qualify for Medicaid is to meet his Spend down. One simple way to do this is to send the Spend down amount to the local Department of Social Services/Medicaid. Visualise this as a "co-pay" for Medicaid assistance or insurance. If John Doe' s medical needs cost $1000 a month it would benefit John more to meet his spend down, verses pay for health cost he can not readily afford.