Medical Eligibility Overview |
Spenddown |
Spenddown is the process through which excess income for MN and excess income and/or resources for MI are assigned to the client's cost of medical care. The client must incur medical expenses equal to the excess amount (spenddown) before medical benefits can be authorized. Spenddown is like an insurance deductible. The amount of the client's spenddown is computed using a base period, consisting of three or six consecutive calendar months. Depending on when spenddown is met, the client may get medical benefits for all or part of the base period.
SPENDDOWN EXAMPLE: Applicant is a single woman, age 67. She receives $704 Social Security benefits each month and has $1,000 in savings.
Resources: The client's $1,000 resources are below the aged resource limit of $2,000, so she is resource eligible.
Income:. Her income is above MN income limits, but MN allows spenddown of excess income. She is eligible for MN when she meets spenddown.
| SSA benefits | $704 |
| General disregard* | -20 |
| $684 | |
| Less MN income limit | -674 |
| Excess income | $ 10 |
The client can choose between a three-month or a six-month base period, depending on the amount of spenddown and the amount of medical bills she expects. She will have to incur either $30 ($10 per month for 3 months) or $60 ($10 per month for 6 months) medical expenses before she is eligible for MN. She will be responsible for these expenses; MAA will pay for her covered medical expenses after she meets spenddown.
*General Disregard: The federal government allows $20 of the client's income to be disregarded when determining income limits.
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Page modified: November 2009
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