Medicaid Spend Down
- Medicaid has set an income limit for an individual to qualify for Medicaid. These income limits differ from state to state.
- When an individual's income is more than the set limit then he/she cannot qualify for Medicaid. An additional income over the Medicaid limitation is called Excess income. For example, if the Medicaid limit is $1,000.00 for a month and an individual's monthly income is $1,200.00 then his income is higher than the Medicaid limitation by $200.00. This additional income ($200.00) is known as Excess income.
- In the above example, an individual is not eligible for Medicaid due to higher income. However, if he/she spends the excess income ($200.00) on Medical bills then he/she can qualify for Medicaid. This is called "Medicaid Spend Down".
- Medical bill expenses cover health insurance premiums, doctor's visits, prescription costs, and others.
Hi Sir, Can we bill patient if Medicaid denies as "Patient has not met the required spend down requirements"
ReplyDeleteGenerally, you cannot bill Medicaid patients. However, some clients allow Medicaid patient billing in a few scenarios. So, it would be good if you confirm this to your client and work accordingly.
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