---
title: "What Is Spend down? Home Care Glossary | HomeCare.com"
description: "Spend down is a way to qualify for Medicaid when your income is above the state limit. In states with a medically needy program, you subtract medical..."
url: https://homecare.preview.multisites.ai/glossary/spend-down/
publisher: HomeCare.com
phone: 800-974-3458
start: https://care.homecare.com/?source=homecare.com
---

Paying for care

# Spend down

Spend down is a way to qualify for Medicaid when your income is above the state limit. In states with a medically needy program, you subtract medical expenses from your income. When the remainder reaches the limit, you become eligible. Medicaid then pays for care after the spend-down amount is met.

## Why it matters for your family

The idea is simple, but the details are state specific. Imagine a person whose monthly income is $600 above the limit. Medical bills of $600 can bring countable income down to the limit, and Medicaid pays for care after that. The bills only need to be owed, not paid. Some states use a monthly budget period, so the spend down repeats. A common mistake is to confuse income spend down with giving away assets. They are different, and gifts can trigger a penalty. Some states have no medically needy program at all. Ask the state Medicaid agency or an elder law attorney.

Source: [acl.gov](https://acl.gov/ltc/medicare-medicaid-and-more/medicaid/medicaid-eligibility)

[Read more: Paying for care](https://homecare.preview.multisites.ai/paying-for-care/)

## Related terms

-   [**Medicaid eligibility**Medicaid eligibility for long-term care depends on need, income, and assets.](https://homecare.preview.multisites.ai/glossary/medicaid-eligibility/)
-   [**Income cap trust (Miller trust)**An income cap trust, also called a Miller trust or income-only trust, holds part of a person's monthly income so the person can meet a state's Medicaid income limit for long-term care.](https://homecare.preview.multisites.ai/glossary/income-cap-trust/)
-   [**Medicaid planning**Medicaid planning is the legal arrangement of income and assets so a person can meet Medicaid rules for long-term care.](https://homecare.preview.multisites.ai/glossary/medicaid-planning/)
-   [**Look-back period**The look-back period is the time window Medicaid reviews when someone applies for long-term care coverage.](https://homecare.preview.multisites.ai/glossary/look-back-period/)
-   [**Medicaid asset limit**The Medicaid asset limit is the cap on countable assets a person may own and still qualify for Medicaid long-term care.](https://homecare.preview.multisites.ai/glossary/medicaid-asset-limit/)
-   [**Elder law attorney**An elder law attorney is a lawyer who focuses on legal issues of older adults.](https://homecare.preview.multisites.ai/glossary/elder-law-attorney/)

[All glossary terms](https://homecare.preview.multisites.ai/glossary/)

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