PM I-03-01: Spenddown

The nonfinancial rules for regular and spenddown cases are the same. Spenddown cases are approved when a benefit unit has countable income that is above the correct income standard or, for AABD Medical, has countable resources that are over the correct resource limits and the conditions in PM 17-02-04 are met. The extra countable income, and for AABD Medical the extra countable resources, are the spenddown amount. Spenddown cases receive coverage for part or all of the month when they show that allowable medical bills and paid receipts equal the month's spenddown amount. HFS does not pay medical expenses used to meet spenddown (see PM 15-08-00 ).

Some AABD spenddown clients who live in the community may enroll in the Pay-in Spenddown option and send a payment to HFS to meet their spenddown for a selected month(s). Clients enrolled in Pay-in Spenddown may decide monthly whether to meet spenddown by submitting medical expenses to their DHS caseworker, submitting a Pay-in payment to HFS, or a combination of both (see PM 15-08-15 ).