How Does ALTCS Spend Down Work?
Medicaid is a popular way for people to afford living in communities like BridgeWater Assisted Living and other long-term care homes. If you’re aware of how Medicaid long-term care coverage works, you know that you have to meet certain income requirements to be considered eligible for the program. Your income and assets must be under a specified amount, which is determined by the state you live in. Should you exceed that limit, you may assume that you’re unable to apply and be approved for the program, but that may not be the case.
The Arizona Long-Term Care Systems (ALTCS) offers a spend-down program that allows for a little bit of flexibility when it comes to your income and assets. Knowing about this information and how it applies in your situation may provide a financial solution that you didn’t know was available.
What Is Asset Spend Down?
Medicaid spend down refers to both the assets and income of a person or married couple. The assets or resources a person has must be under a certain limit to be considered eligible for Medicaid, but not all assets will go toward that final total. It varies depending on things like marital status, type of Medicaid, and level of care required. Some assets are considered exempt, and everything after that will go toward that final total considered for approval.
After exemptions are evaluated, potential Medicaid applicants have the option to “spend down” their assets, or offload them. That is, applicants can spend their financial resources. There are certain guidelines, however. For instance, individuals cannot spend down their assets too far under market value in order to meet the guidelines for Medicaid. Past transfers within a certain time period will be eligible to be reviewed to make sure everything is being done fairly.
What Is Income Spend Down?
ALTCS spend down is another way that people who may not have been eligible before can become eligible for Medicaid. Much like asset spend down, income spend down allows potential Medicaid recipients to exempt some of their income, or offload it. One of the major income options for ALTCS spend down is called the “Medically Needy Pathway.” This allows applicants to excess income on medical bills and expenses. After this excess money is spent on the appropriate expenses, they will be eligible for the remaining for the “spend-down” period. More information on specific income and asset limits can be found here.
What Are You Allowed to Use Your Income/Assets Toward?
In the state of Arizona, there are a variety of options that you can use for spend down in order to be eligible for Medicaid. Some of those examples include purchasing medical care and equipment, replacing an old vehicle, paying for in-home care, or purchasing a new home.
As far as gifting assets goes, there are more restrictions on that. This avoids seniors gifting assets to family members in order to be eligible. The exemptions to that rule include transferring assets to a child who is disabled, to a spouse, or to a trust fund for someone younger than 65 and permanently disabled and transferring their home to someone under 21.