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Missouri Medicaid Spend Down Laws

Medicaid is a program that offers government assistance with treatment and/or medical bills to the needy. In some cases, people who would qualify for Medicaid or similar programs still make too much money to meet the financial requirements. However, some states have a "spend down" program, where certain expenses can be deducted to lower the applicant's income to meet Medicaid standards. Missouri has such a "spend down" program if certain rules are followed.

  1. Income Rules

    • To be eligible for Missouri Healthnet, the state's version of the Medicaid program, a single individual must have an income not greater than $768 per month, and assets of no more than $999. A married couple can have an income of $1,033 per month and assets of up to $2,000 to qualify. However, in some cases, individuals with higher incomes or assets may require the assistance of Missouri Healthnet and can choose to pay into the program through a spend down, which is similar to an insurance premium that they pay each month which effectively lowers their income to the level required to collect benefits.

    Spend Down Requirements

    • If you do not meet your spend down every month or make your spend down payment, you will lose your Missouri Healthnet coverage for the month(s) in which you did not meet this requirement or make your payment. Payments are tracked and recorded by an eligibility specialist who will check to make sure that if you are claiming medical expenses towards your spend down they are valid and you have receipts to prove them. If you do not spend the amount in medical expenses, you can pay it directly in to Missouri social services as directed by your eligibility specialist; your eligibility specialist will then keep track of that information to make sure you receive your coverage.

    How to Pay

    • You can pay your spend down with cash, check or money order, or by submitting the appropriate amount in eligible medical bills to your eligibility specialist and having them approved. In addition, the law allows you to have your spend down deducted automatically from a bank account each month, provided the money is there and you have authorized the debit by filling out and returning a Spend Down Automatic Withdrawal Form to your eligibility specialist.

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