In this Elder Law Minute, Wes Coulson, Illinois and Missouri Elder Law attorney, discusses Medicaid spend-down and what it means in the context of two different kinds of Medicaid.
What Does Medicaid “Spend-Down” Mean?
Hi, I’m Wes Coulson from Coulson Elder Law with offices in St. Louis, Missouri and O’Fallon, Illinois serving people throughout the St. Louis metropolitan area on both sides of the river and this is your Elder Law Minute. What is the expression Medicaid spend-down mean? If you have had anything to do with that process, you’ve heard the expression. Interestingly enough, it means two different things in the context of two different kinds of Medicaid.
For someone who is receiving community Medicaid, basically they’re at home but need help paying for medical expenses, they look each month at a comparison between income (there are ceilings on that) and your medical expenses, and you get those medical expenses paid to the extent that they exceed a certain amount in the month. One bit of advice there, because they wipe the slate clean each month, people who are on community Medicaid are best to try to bunch medical expenses in a particular month. So, get 90-day prescriptions, go to all your doctors in the same month in which you do that, so that you have as much of that covered as possible.
For a nursing home resident, what that refers to is the amount that is the difference between the amount of assets that you have when you apply and the asset limit that is applicable to you. So, a very small limit in the case of a single person, the case of a married one there’s assets allowed to the applicant and assets allowed to the other spouse. We really don’t like to hear about a spend-down requirement when we’re doing nursing home Medicaid because basically it represents a failure. It means that there are assets that could have been applied to something beneficial and are instead going to the nursing home. So, the lesson here for nursing home Medicaid is that anybody whose asset picture at the time that they enter the nursing home means that they would have money that they would have to spend-down before they would become eligible for Medicaid is going to come out much better if they come and see a good elder law attorney like us, because the goal of the planning in that situation is to make it so that that money goes to benefit you, or to benefit your family, and doesn’t just get spent down to pay the nursing home until you’re broke. Come see us, we can help. Thanks.
For more information about Medicaid and Asset Preservation, visit these articles:
- Do Living Trusts Protect Assets From Medicaid or VA Spend Down?
- How an Asset Preservation Trust Protects Your Life Savings From Long-Term Care Costs
- Why Do I Need an Asset Preservation Plan?
“Your Trusted Advisor on the Elder Care Journey”
Coulson Elder Law is dedicated to providing families in the St. Louis area with their Elder Law needs. Our practice areas include Asset Preservation Planning, Veterans Benefits, Medicaid Eligibility, Alzheimer’s Planning, Special Needs Planning, Estate Planning and more. We understand the financial challenges you may face as you and your loved ones grow older. At Coulson Elder Law, our clients’ well-being is our number one priority. For immediate help, call (618) 632-7000 or (314) 567-9292, or Contact Us and we will get in touch as soon as possible.