Medicaid Spend Down

  • Medicaid has set an income limit for an individual to qualify for Medicaid. These income limits differ from state to state.
  • When an individual’s income is more than the set limit then he/she cannot qualify for Medicaid. An additional income over the Medicaid limitation is called Excess income. For example, if the Medicaid limit is $1,000.00 for a month and an individual’s monthly income is $1,200.00 then his income is higher than the Medicaid limitation by $200.00. This additional income ($200.00) is known as Excess income.
  • In the above example, an individual is not eligible for Medicaid due to higher income. However, if he/she spends the excess income ($200.00) on Medical bills then he/she can qualify for Medicaid. This is called “Medicaid Spend Down”. 
  • Medical bill expenses cover health insurance premiums, doctor’s visits, prescription costs, and others.

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