The income limit for the Medicaid spend-down varies in every state, but is sometimes more restrictive than the regular income limits for Medicaid for the aged, blind and disabled.
A total of 33 states and D.C. offered Medicaid spend-down coverage as of 2018.
In some states, the Medicaid spend-down covers Long Term Services and Supports (LTSS), such as nursing home care or Home and Community Based Services (HCBS). But in many states the spend-down program does not cover LTSS.