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What is a Medicaid Spend Down?


When you apply for Medicaid there are income requirements that are part of the factors considered to determine your eligibility. In applying you may find that you are just above that financial threshold to qualify but nevertheless unable to afford your healthcare costs without Medicaid assistance. This does not necessarily mean that you cannot qualify for Medicaid.


The Spend Down Program for Missouri Medicaid (MO Healthnet) allows qualifying individuals to pay the difference between their income level and the allowed level to the state so as to qualify. Alternatively, proof of approved healthcare expenses meeting or exceeding that same income difference can be submitted so as to qualify. The Spend Down must be met for each month in order for the individual to have active Medicaid status. Options for ensuring the Spend Down is met include automatic bank withdrawals so as to ensure consistent coverage. It is in many ways similar to a deductible that must be met in order for your insurance coverage to begin covering costs.


How does this impact Consumer Directed Services in Missouri? The personal care services that individuals receive through the Consumer Directed Services Program are funded through Missouri Medicaid (MO Healthnet). If an individual must meet a Spend Down in order to maintain their active Medicaid status, meeting the Spend Down is required to ensure coverage of his or her Consumer Directed Services (CDS) for the corresponding month.

For some, paying the Spend Down can have its difficulties but it is often a much more financially feasible option for individuals with limited incomes who need coverage.

If you are a Missourian in need of Personal Care Services and are unsure of whether a Spend Down makes sense for you or have additional questions, we can help you evaluate the likelihood of your qualification for the Consumer Directed Services program and provide additional information about your options.

Contact us at 816-822-7432.



For additional information about Spend Downs in general, visit: https://modss.uservoice.com/knowledgebase/topics/80263-spend-down-program






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Kansas City, Missouri 64105

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