AABD Medicaid Spenddown Guide 1 Last updated June 2024 Copyright AgeOptions 2024 Medicare vs Medicaid 2 Medicaid 3 Seniors 65 and people with disabilities can normally get Medicaid in addition to Medicare if they earn less than....
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Medicaid 3 Seniors 65+ and people with disabilities can normally get Medicaid in addition to Medicare if they earn less than....
$1,280.00 for individual or $1,728.00 for a couple
Have less than $17,500.00 in assets<br>
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Medicaid and Medicare 4 If you have Medicare, Medicaid is supplemental insurance that pays whatever Medicare doesn’t cover.
You can have Medicaid if you have a Medicare Advantage plan
You must go to a provider who accepts Medicaid to use your Medicaid insurance
Medicaid also covers dental, vision, and hearing services<br>
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What if you make more than the income limit for Medicaid? You may still be able to get it! 5<br>
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Medicaid Spenddown Program If you have paid or unpaid medical expenses from the past 6 months you can use them to “spenddown” to meet the Medicaid income limit.
If you are married or if you have a dependent child, you can use their medical expenses too. 6<br>
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7 Jenny lives alone. She has Medicare but also wants Medicaid. She meets the asset limit but earns $1,500.00 a month from Social Security Retirement Benefits. Meet Jenny<br>
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8 The income limit for Jenny to get Medicaid is $1,280.00 a month.
$1500 (Jenny's income)
- $1280 (Medicaid income limit)
= $220.00 $220 is Jenny’s Spenddown amount!<br>
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9 Whenever Jenny collects more than $220.00 in medical bills to show to the state, they will give her Medicaid coverage for the following month! This is called “meeting a spenddown”.
Jenny can combine any number of medical bills from the past 6 months.
She can also use bigger medical bills to get multiple months of coverage.<br>
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10 If Jenny doesn’t have $220.00 in medical bills one month she can:
Opt not to get Medicaid coverage for that month
Pay $220.00 to get her Medicaid coverage
Submit as many medical bills as she can, and then pay the remaining amount
Remember! If Jenny shows one big bill, she can spread it out and give herself up to 6 months of coverage<br>
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What counts as a Medical Bill? 11 Health insurance premiums count as bills!
Any bill you submit should have:
The name of the person the bill is made out to
A date from the past 6 months
The name and address of the doctor or facility that is billing you
What the bill is for<br>
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What doesn’t count as a Medical Bill? 12 No handwritten notes or personal ledgers
No bank statements or credit card bills
Nothing that says “this is not a bill” in tiny letters
A bill without a date<br>
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Call us! Lots of different things can count as medical expenses, including health insurance premiums, pharmacy receipts, and more
If you have Social Security disability or are over 65 and have lots of medical bills, call us! 13<br>
