States can allow people to pay monthly premiums to the state equaling the difference between the family's income and the medically needy income levels to qualify for Medical Assistance.

The difference in the households actual income and the income limit for the specific Medically Needy program is called the SpendDown Amount. Pay-In payments can be used on their own or in conjunction with certain types of expenses in order to meet the SpendDown. As Pay-In evidence is directly associated with a SpendDown product delivery, it is captured as Product Specific Evidence.

Evidence Generation Pattern: Search Case Participants

The validations performed are: -

• The Participant must be selected.
• Amount Paid must be greater than zero.
• Check number must be populated if Payment Method selected is Check.

Example

Linda Smith is pregnant and is eligible for medical assistance. Linda Smith's income is above the qualifying limit to gain eligibility for medically assistance. Linda Smith agrees to make payments to the state for the difference between her total income and the income limit. A case worker creates a Pay In record on the product delivery for Linda Smith's medical assistance program with the details of the amount she is paying to the state.