For seniors who need Medicaid coverage, but make slightly too much income, there’s still hope. The Medicaid spend down program can offer important health coverage for individuals who make too much money but still suffer from limiting medical expenses.

Read on to learn more.

What is Medicaid Spend Down?

In order to qualify, individuals need to fall into a certain income bracket. In some cases, though, a person’s income is too high to qualify for Medicaid.

In these cases, it’s possible that the person may qualify for Medicaid if they spend their excess income (income beyond what is required to qualify for Medicaid) on medical bills.

This is known as the spend down program (commonly called the Medicaid Excess Income Program). While not all states have this program, it can be helpful for people who need Medicaid benefits to assist with significant medical expenses, but make too much money to qualify.

Who is Eligible for Spend Down?

While spend down is a helpful program, it’s not open for everyone. In order to qualify for spend down benefits, people must fall into one of the following groups:

• Disabled or blind
• Children under 21 years of age
• Adults aged 65 or older

Spend Down 101

In many ways, Medicaid spend-down works exactly like a car insurance deductible. When an individual accumulates medical bills that go beyond their excess income, they will qualify for that month. Keep in mind, however, that individuals are responsible for medical bills up to the point of the excess amount. Medicaid only pays for the bills that go beyond the excess amount.

Which Expenses Can Be Counted Toward Spend Down?

Just like not everyone qualifies for Medicaid, not all expenses can be counted toward spend down. The following forms of bills and expenses can be counted toward a spend down total:

• Your individual medical bills
• A spouse’s medical bills
• Bills of a dependent child
• Bills of a child who doesn’t live in the home, but whose medical bills you pay
• Unpaid medical bills from years passed (bills within 6 years are often applicable)
• Some transportation expenses for medical services
• Some payments to therapists, drug and alcohol programs, PCAs and home health aides
• Prescription drug expenses

Qualifying for Spend Down

Medicaid spend down programs vary from state to state. States with spend-down programs may require you to meet the spend-down amount for each period in order to qualify for coverage. Even if you don’t qualify for spend-down coverage in a certain month, though, it’s possible to get Medicaid coverage later when you meet your spend-down amount again.

Conclusion

For people with limiting medical expenses but no Medicaid coverage, the spend down program can provide much-needed financial assistance. To learn more about spend down coverage, contact Lifelong Insurance, LLC today. We can guide you through Medicaid spend down coverage and help ensure that you’re getting the quality coverage you need.