In the context of Medicaid, “spend down” refers to the process of reducing your income and assets to meet the eligibility requirements for Medicaid. The spend down process is also known as “medically needy” or “income spend down.” To qualify for Medicaid, your income and assets must fall below a certain threshold. If your income or assets are above this threshold, you may still be able to qualify for Medicaid through a spend down program. Essentially, you would be required to spend down your excess income or assets on medical bills or other allowable expenses until you meet the eligibility requirements for Medicaid. For example, let’s say that your income is $2,500 per month, and the Medicaid income threshold in your state is $2,000 per month. In this case, you would be over the income limit and would not qualify for Medicaid. However, if you have $500 in medical bills each month, you may be able to use the spend down program to qualify for Medicaid. You would be required to pay the $500 in medical bills out of pocket each month until your income falls below the $2,000 threshold, at which point you would be eligible for Medicaid. It’s important to note that the spend down rules and thresholds can vary by state, and the process can be complex.