Medicaid Spend-Down Requirements?

rph3664 · Jul 4, 2008

My experience with this is that it's mostly used by people who are income-eligible for Medicaid but otherwise own too much property to qualify, and are unable to work because they are elderly or totally disabled.

Almost all of the people I have encountered on this were elderly, or had full-blown AIDS. I saw spend-downs ranging from $14 (he would come in every month and give us the exact change) to nearly $1,000 a month.

Jolie, BSN · Jul 4, 2008

The answer to this depends upon whether the patient is married (if so, spouse is allowed to retain some assets) and whether the patient and/or spouse have "disbursed" of assets in the past. (For example, have they "gifted" assets such as money, stocks or their home to children in an effort to reduce their worth in order to qualify for benefits?)

Multicollinearity, BSN, RN · Jul 4, 2008

Hi Vicky!

I'd recommend googling your state's medicaid agency and seeing if they post the guidelines online. I bet they do. Since medicaid is administered by each state with Federal funds, each state will have slightly different eligibility rules.

Jo Dirt · Jul 5, 2008

Medicaid in this state (TN) requires a spend down that leaves the person with money/assets of $2500 or less.

If they are married their spouses can live in the house until they die, but the property is still owned by the government to reimburse the nursing home after the spouse that lives in the home dies or goes to the nursing home themselves.

If that patient has transferred any assets within the last 5 yrs. the government will want them back (the lookback period used to be 3 yrs. but in accordance with the Deficit Reduction Act of 2005 it's 5 yrs.)

APS caringly calls transferring assets within the lookback period to "forced property transfers" and will come after the family the property was transferred to.

They want it all, basically.