It is widely known that the U.S. welfare system provides the most benefits to low-income individuals. One of the most prominent programs is Medicaid. Medicaid is a health insurance program for low-income children, pregnant women, and seniors aged 65 and older, and is jointly administered by the federal and state governments.
Medicaid eligibility requirements vary by state, and unlike Medicare, Medicaid benefits are available only within the state where you are enrolled. You must meet the income and asset limits set by your state. Some states have implemented Medicaid expansion programs to raise income limits or lower age restrictions, making the program available to more people. In some states, limited benefits are also available to undocumented individuals.
One program that many people are not familiar with is the Medicaid Spend Down program. This program allows individuals whose assets and income exceed Medicaid eligibility requirements to reduce their income or assets by paying out-of-pocket medical expenses, thereby qualifying for Medicaid benefits. Medical expenses that can be used toward the spend down include hospital bills, prescription costs, and medical equipment expenses.
Although this program is not particularly well known within the Korean-American community, it can be useful for those whose income and assets fall just short of Medicaid eligibility requirements or who face high medical costs due to a sudden accident or illness. Since it allows you to apply for Medicaid only for the period you need it, those in such situations should consider the Span Down program. In particular, if you exceed the Medicaid income limit by a very narrow margin, or if the medical costs you must cover exceed the difference between the Medicaid income limit and your actual income, we strongly recommend consulting with a professional for assistance.
Eligible medical expenses include a variety of costs, such as hospital bills, doctor’s fees, prescription drug costs, and medical equipment expenses. Certain non-medical expenses may also be covered. For example, long-term care costs or services such as home care or adult day care may be included if approved by Medicaid.
Although the application process can be cumbersome because you must regularly submit the required documents and proof of medical expenses, there is the advantage that you can receive Medicaid benefits only for the months you need them. We recommend contacting your state’s Medicaid office to obtain detailed information about your state’s Spend Down program.
- Son Ji-seon / Executive Director, Hanul Comprehensive Welfare Center (Chicago)
B.A. in International Studies, M.A. in Social Work, Washington University in St. Louis
Over 20 years of experience working in the nonprofit sector
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Source: Christian Journal (https://www.kcjlogos.org)
