Income above this maximum is considered available to meet allowable medical costs. You may still be eligible for Medicaid under the spenddown provision. Eligibility is determined on a three-month basis. The difference between your actual income and the SSI maximum is the spenddown amount, or the amount of medical expenses which you must incur in order to become eligible for Medicaid. If medical expenses incurred during the three months equal or exceed the spenddown amount, Medicaid will be available to you.
Some income is excluded such as irregular or unpredictable monetary gifts and in-kind income.
Resources include checking accounts, savings bonds, stock, some jewelry, savings accounts and other valuables. When only one member of a couple resides in a Medicaid certified nursing facility or receives home and community based waiver services, other special resource rules apply. Any nonexempt resource in which ownership is transferred to another person for less than fair market value can result in ineligibility for nursing home care or home and community based waiver services. Your monthly income is computed and the amount you pay to the nursing facility is figured on a budget form by a Division of Family Services caseworker. To get a general idea of how the monthly payment is determined, see the example below.