Spenddown definition

Spenddown means the process by which a medically needy person obligates excess income for allowable medical expenses to reduce income to the appropriate MNIL.

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Spenddown means the process by which a person who has income in excess of the Medical Assistance income standard allowed in Minnesota Statutes, § 256B.056, subd. 5, becomes eligible for Medical Assistance by incurring medical expenses that are not covered by a liable third party, except where specifically excluded by state or federal law, and that reduce the excess income to zero.

Spenddown means the amount of money a Senior- Care participant must spend on prescription drugs before the par- ticipant becomes eligible for SeniorCare deductible and copay- ment benefits and services.

Examples of Spenddown in a sentence

• The Enrollee will not be allowed to re-enroll in MSHO after termination for non-payment unless all past due Medical Spenddowns are paid in full and the Enrollee no longer has a Medical Spenddown at the time of application; The Enrollee changes MCOs without cause pursuant to 42 CFR §438.56(c) within ninety (90) days following the Enrollee’s initial enrollment with the MCO.

• For MSHO enrollment, the Beneficiary will be re-enrolled in MSC+ retroactively, and the capitation will be re-processed; For MSHO, for non-payment of Medical Spenddown if the Enrollee does not pay the Medical Spenddown in full for three (3) months directly to the State as described in section 3.1.1(G)(1)(c).

• This includes non-Dual members that were formerly Medicaid Spenddown prior to ODM’s 1634 eligibility conversion.

• Non-citizen Beneficiaries who receive emergency medical assistance under Minnesota Statutes, §256B.06, subd.4. Beneficiaries receiving Medical Assistance on a medical Spenddown basis.

• SED waiver enrollees, individuals incarcerated and individuals on Spend-down.

More Definitions of Spenddown

Spenddown means an amount of income in excess of the allowable income standard that must be paid in cash to the eligibility agency or incurred through the medical services not paid by Medicaid or other health insurance coverage, or some combination of these.

Spenddown means an amount of income in excess of the allowable income standard that must be paid in cash to the department or incurred through the medical services not paid by Medicaid, or some combination of these.

Spenddown means the process by which an applicant obligates income for allowable medical expenses to reduce income to a qualifying level. The medical expenses used for spenddown cannot be paid for with funds from this program.

Spenddown means the process by which a person uses incurred medical expenses to offset income and/or resources to meet the financial standards established by the department. See chapter 388-519 WAC.

Spenddown means the amount of an individual’s income in excess of the medically needy income standard identified by the department as available to meet a portion of the individual’s health care cost.

Spenddown means the process by which a person who has income in excess of the income standard allowed under MN Rules part 9505.0065, subp. 1 becomes eligible for Medical Assistance (Medicaid) as a result of incurring medical expenses that are not covered by a liable third party and that reduce the excess income to zero (MN Rules part 9505.0015, subp. 44).

Spenddown means the process by which a person who has income in excess of the MA or GAMC income standard, allowed in Minnesota Statutes, Section 256D.03, Subdivision 3, and Section 256B.056, Subdivision 5, becomes eligible for MA or GAMC by incurring medical expenses that are not covered by a liable third party, and that reduce the excess income to zero.