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Medicaid Spend Down Rules in Indiana

The Indiana Medicaid program has specific eligibility criteria, including income limits, which must be met for an individual to qualify. While most Indiana Medicaid eligibility requirements are mandatory, such as being a resident of Indiana, there are exceptions to the income limit for those with complex medical conditions or who are developmentally disabled.

  1. High Medical Expenses

    • According to Indiana Family and Social Services, the usual income limit to qualify for Medicaid is less than 300 percent of entitled Social Security Income, but there is an exception if you have high medical expenses. You can still qualify for Medicaid if you fall under this income limit after paying your monthly medical expenses. This is known as a "spend down" because you are spending down your excess income by using the money to pay for your medical bills.

    Social Security Income

    • There'ss also an exception for Social Security Income. If you receive Social Security Income, that money will not be counted against the program's income limits. Therefore, you will not be required to "spend down" this additional income to qualify for the Indiana Medicaid program. Federal law prohibits this practice since SSI is intended to pay for necessary living expenses---such as food, clothing and shelter---not medical bills.

    MED Works

    • An income limit exception allows the working disabled who are above the program's income limits to qualify. Indiana has developed a program called MED Works, which has higher income limits for the working disabled, as opposed to the lower limits imposed by Indiana Medicaid. MED Works can provide Medicaid benefits to you if you fall within these higher income limit requirements, so that you don't have to "spend down" as much of your income as you would under the lower income limits.

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