Would you call a spend down account some sort of money manager for a person on Medicaid? I'm trying to explain to my siblings and can't wrap my head around giving my Dad's money to a company to manage his bills....of which he still has many until we get rid of the house.
Are these companies to be trusted?
How can I find out if there are any bad ones out there?

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Thanks again for all the helpful information. We have now switched to long term nursing home need and it takes the spend down equation out.
the facility would not let us handle the spend down on our own. We live in Nassau County in NY. Rules must be different in each county.
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This is the link to the article the previous poster mentioned, I believe.
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Dear htoomuch,
You can go to and read the article "How a Medicaid Spend Down Account Works" as a place to start. It has a lot of informative information in it. Hope that helps and good luck!
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Are you talking about the "optional pay-in program"?

It's an option, not a requirement unless things have changed drastically.

Have you consulted a certified Eldercare attorney?

Is dad over 65?

Who has POA?

Is there a spouse still at home?

Is this for Community Medicaid or LTC Nursing Home Medicaid?
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Who told you that you have to use a company?
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Who is telling you that you should use a third party company?

Who in your family has power of attorney for dad's finances?
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Required to use a money management company for spend down?! That is absurd. Barb, where are you?

Sounds like a setup for scam artists.
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You do not have to use a company or "money manager" to do this. And they will charge a fee for their services.
Use your dad's money to pay any outstanding bills. If they are a lot you could try contacting companies and work out a plan for pay back.
Use other money to :
Pre pay funeral costs
Buy clothing
Pay for any dental work, eye glasses that Medicare does not cover.
Make any repairs to the house so that it can be sold for a fair price. (and it has to be at least Fair Market Value)
Also a visit to an Elder Care Attorney to get paperwork in order Will, Trust if needed, POA, Health Care Directives.
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htoomuch Jul 2020
Thank you for your information.
In New York we are required to use an outside company.
So I guess I have to use his money before Medicaid is activated and creates the need for a spend down company. For some reason I just don't trust them. If Dad wants something I have to go through them for money...
I guess I'll have to start cold calling the companies.
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