NerdWallet: How to use a ‘spend down’ to qualify for Medicaid

by | Sep 26, 2023 | Stock Market

This article is reprinted by permission from NerdWallet.  More than 1.4 million people have lost Medicaid coverage in 2023 because they no longer meet the eligibility requirements, according to August tracking data from KFF, a health policy nonprofit.

After a pause on disenrollments during the COVID-19 public health emergency, beneficiaries now must prove that they still meet the income limits for Medicaid. People whose income has gone up risk losing their coverage. What some beneficiaries might not realize is that even if their income seems too high for Medicaid, they might be able to spend down some income to qualify. For certain beneficiaries, spending on medical bills, including Medicare premiums, can be subtracted from their income when applying for Medicaid. Plus: What a government shutdown would do to Social Security paymentsWhat is a Medicaid spend-down? A spend-down is like a health insurance deductible, according to Catrice Simpson, a supervisory social service representative for the Washington, D.C., Department of Health Care Finance. “It is the amount you must show proof of meeting or exceeding before the insurance plan starts to pay, in this case it’s before Medicaid starts to pay,” Simpson wrote in an email. For example, someone with income $200 above their state’s limit for Medicaid might become eligible if they have at least $200 in qualifying medical bills. People who qualify as “medically needy,” such as those with certain disabilities, children or people age 65 and older, are eligible to spend down income to qualify for Medicaid. Rules for who counts as medically needy vary by state. For example, in Washington, D.C., parents or caretakers of children under 21 years old, pregnant people and people living in nursing homes can also spend down to become eligible for Medicaid.How does spending down affect medical bills? Spending down to …

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