What is a Medicaid Spend Down?

Medicaid is a government health insurance program that has strict income and asset requirements that all participants must meet. The amount of monthly income and assets that you can have and still qualify for Medicaid can vary from one individual to the next. For instance, your maximum monthly income if you are married will be different than if you are widowed and living alone. If an individual has too much income to qualify for Medicaid, he or she may be able to spend this excess income on medical bills and then qualify for Medicaid. This is called a Medicaid spend down. However, only certain people are eligible for a Medicaid spend down, such as children under the age of 21, adults over the age of 65, disabled or blind individuals, and families who have one or both parents absent, deceased, disabled, or unemployed.

Basically, once you have accrued medical bills and expenses in a month that are more than your monthly excess income, you will be eligible for Medicaid for that month. You will be responsible for the costs of those medical bills up to the amount of your monthly excess income, and Medicaid will cover any remaining bills. Eligible medical bills for spend down purposes include your own medical bills, your spouse’s medical bills, parents’ bills for a child’s spend down, past unpaid medical bills for you, your spouse, or your child, any medical bills not covered by either Medicare or private insurance, and medical expenses paid by certain public programs, including insurance premiums. Aside from regular medical bills, other qualifying medical expenses include some transportation expenses to get medical care, prescription drug bills, and the costs of surgical supplies, eyeglasses, hearing aids, and medical equipment.

Comprehensive Medicaid planning is an important issue to address for all individuals, particularly given the high costs of long-term care. Here at Legacy Law Center, we want to ensure that you have an effective plan in place to both achieve your goals for long-term care and distribute your assets as desired following your death. We have the skills and knowledge that you need to make the appropriate decisions about estate planning. Call your Michigan long-term care attorneys at (734) 995-2383 and schedule an immediate appointment.