What is a Medicaid spend-down plan?

A Medicaid spend-down plan is an option for individuals in Virginia who need additional assistance with health care costs that Medicare and/or private insurance does not cover. Through a spend-down plan, individuals with higher incomes than what Virginia’s Medicaid program considers eligible may still receive Medicaid benefits if they spend down their savings and income below the eligibility threshold. To be eligible for a Medicaid spend-down plan, an individual must meet certain criteria. This includes being a resident of Virginia, having a disability, or be aged 65 or older, among others. In addition, the individual must also have income and assets below a certain threshold to be considered eligible for a spend-down plan. Once an individual is eligible for Medicaid through a spend-down plan, the individual must use his or her income and assets to cover their healthcare costs. For example, if an individual’s income is over the eligibility threshold, the individual must pay all of their medical costs until their income is below the threshold. Once that point is reached, the individual qualifies for Medicaid and any remaining medical costs are covered. In Virginia, Medicaid spend-down plans are an excellent option for individuals who have higher incomes than what Medicaid typically considers eligible, as it allows them to receive additional assistance with medical costs that Medicare and/or private insurance may not cover.

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What is a Medicaid spend-down plan?

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