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What is the Medicaid Spend Down Program?

The Medicaid Spend Down Program is a provision that allows individuals and families with incomes above the Medicaid eligibility limits to qualify for benefits by "spending down" their excess income on medical expenses. This program is designed to help those with high medical costs gain access to necessary health care services.

How It Works

For applicants whose income exceeds the Medicaid threshold, the spend down approach requires them to utilize their excess income on approved medical expenses—such as hospital bills, prescriptions, or long-term care. Once these expenses are paid, the individual may then qualify for Medicaid benefits to cover further healthcare needs.

Eligibility Criteria

To take advantage of the Spend Down Program, one must meet certain qualifications, including:

  • Being a resident of the state where applying.
  • Meeting the state's income and asset limits after spending down.
  • Providing documentation of medical expenses.

Benefits

The Medicaid Spend Down Program can alleviate the financial burden of medical expenses, providing necessary support for individuals who require ongoing or extensive healthcare, making healthcare accessible even for those with higher incomes.

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