I was recently told by a person on the Medicaid hotline that as of August 1, there is no more spend down for Medicaid.

Started by

Is this true and what does it mean, exactly? Trying to sort through Medicaid is like trying to learn a foreign language.


I hadn't heard this. Medicaid is a state run progam so this would vary by state. The only information I can see online is that Ohio is preparing to end the spend down (I don't live in Ohio). This could mean that people who are using this method to qualify/stay qualified for medicaid no longer will be able to. Scary for those already using this method.

I have read on-line that this is true for certain states.
Hmmm - on the one hand, forcing seniors to spend what little money that have in an almost frantic manner in order to qualify has never made much sense. On the other hand, this is the government... But if there is any truth to this, I imagine there's more to it. It makes no sense that a person could hang on to a large sum of money and recieve full assistance. But back to that other hand...
Found article from February 2016 in an elder law journal that has had accurate useful info for me in past. The August date relates to actually implementing the income cap in certain states (Ohio will be added to the list below on 8-1-16) for the 2016-2017 budget.
"...But some states set a hard limit on the income permissible to qualify for Medicaid -- no spend-down is allowed. In these states, known as "income cap" states, eligibility for Medicaid benefits is barred if the nursing home resident's income exceeds $2,199 a month (for 2016), unless the excess income above this amount is paid into a "(d)(4)(B)" or "Miller" trust. If you live in an income cap state and require more information on such trusts, consult an elder law specialist in your state. The income cap states as of this writing are: Alabama, Alaska, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Idaho, Iowa, Kentucky, Louisiana, Mississippi, Nevada, New Mexico, New Jersey, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, and Wyoming."
What's confusing to me is that SPEND DOWN doesn't have to do with INCOME, it has to do with ASSETS, doesn't it? Where's IGGY?
It has to do with both. You have asset limits and income limits.
So what happens if the resident's income exceeds 2199/ month? How is long term care paid for?
This is interesting. Is this saying if your income is 2200 and you only have assets of $1,999.00 you can not get Medicaid and you end up old and homeless? This is not good at all.
guestshopadmin mentioned what has to be done when income is too much to qualify for Medicaid, but too little to pay for NH care -- a Miller trust to deposit extra cash in each payday. From what I understand, the money in the trust is paid to the state and lets people keep their assets from being too high for assistance.
Just checked and saw that monthly spend-down in states that allow it has to be on medical bills not covered by Medicaid. Only certain people qualify to do this. It includes people over 65.

Keep the conversation going (or start a new one)

Please enter your Comment

Ask a Question

Reach thousands of elder care experts and family caregivers
Get answers in 10 minutes or less
Receive personalized caregiving advice and support