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What is Medicaid Spend Down?

Spend down means that you meet all eligibility requirements for Medicaid except for income. To become eligible for Medicaid your allowable medical expenses must be more than your spend down amount. Your spend down amount is the amount by which your monthly income exceeds the Medicaid allowance for living expenses. Your caseworker will send you a letter called the Spend Down Notice. This will give your spend down amount and tell how you may become eligible for Medicaid when your medical expenses are more than your spend down amount. You will also be given a form on which to list your medical expenses. It is called a Spend Down Report. Expenses for medical care include care from hospitals, doctors, clinics, dentists, drugs, medical supplies and equipment, health insurance premiums, transportation to get medical care, personal assistance services, adult home help services, and other services from Community Mental Health.

Your spend down amount can change if your circumstances change. Some examples of these include changes in income, people living with you, employment or hospitalization. You must report any changes to your caseworker within 10 days. Please note that you may need to do a spend-down if you switch from Supplemental Security Income to Social Security Disability Insurance due to the retirement, death, or disability of a parent. This change in cash benefit may mean that you need to apply for Medicaid separately from your cash benefit from the Social Security Administration.

If you have questions about Medicaid spend down, you can call your local Michigan Department of Human Services or visit them online at www.michigan.gov/dhs. You can also call The Arc at 734-729-9100.

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