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What is the Medicaid spend-down?

On Behalf of | Jan 3, 2023 | Medicaid |

If you or someone you love needs long-term care, you may be considering applying for Medicaid benefits to cover the high cost of care. Medicaid is an income-based program, and there are strict income and asset requirements for eligibility.

Even if your worth is currently too high to qualify, you may be able to reduce it below the threshold using Georgia Medicaid’s spend-down program.

What is the Medicaid spend-down?

The Medicaid spend-down allows you to deduct certain expenses from your income and asset values to bring them within Georgia Medicaid’s eligibility range. In 2022, an individual receiving Social Security Income is eligible for Medicaid if their income does not exceed $841 a month or $10,092 a year. Individuals living in skilled nursing facilities or receiving community care services at home are eligible for Medicaid if their income is lower than $2,523 per month or $30,276 per year. There is a $2,000 resource cap for all individuals to remain eligible for Medicaid.

What expenses count toward the spend-down?

You may reduce your asset value below the limit by making payments toward debt, spending on vehicle repairs or paying for home upgrades and repairs, such as accessibility modifications or roof or window replacement. Additionally, several expenses can help you reduce your income below Medicaid’s threshold, such as:

  • Medical bills
  • Prescription drugs
  • Medical equipment and supplies
  • Health insurance premiums

Understanding the eligibility requirements for Georgia Medicaid and how to utilize the spend-down option can help you or your loved ones pay for the level of care you need to thrive.

Do You Always Need To Spend Down?

As with many things in life, there are certain assets that you do not need to spend down. Some examples of these assets include your home, retirement accounts (IRA or 401k), automobiles, and personal effects that do not need to be spent down to qualify for Medicaid whether you are single or married. If you are married, you may have up to $150K in brokerage or bank accounts that are protected from the spend-down. If these assets are protected, then there is no reason to give up ownership of these assets. In that case, placing them in an Irrevocable Trust or titling them in your kids’ names may make more sense.

If you are expecting to apply for Medicaid for yourself or a loved one, discussing your situation with a skilled elder law attorney can help you and your family protect what you have worked so hard and long for.