Spend Down Medical Expense: The obligated amount that a Household Member should pay for a medical expense incurred. The medical expense could be for a service received by the Household Member, or for a non-member, provided that the Household Member has the responsibility to pay for his/her expense.

Spend Down is a Medical Assistance term which refers to the payment that a Household Member has to make in order to meet the eligibility criteria for Medical Assistance. This is only applicable for households where income is above the threshold for the State's designated medically needy criteria, but are below this threshold when medical expenses are factored in. An individual can meet the Spend Down amount by submitting allowed medical expenses to reduce/meet the Spend Down amount.

Example

Linda Smith has a child, Susan Smith. Susan Smith is ill and has received medical treatment for her condition. A Medical Expense is incurred for the care the hospital provided while she was ill. As Susan Smith is a child her mother, Linda Smith is responsible for paying the expense. A case worker creates a Medical Expense record for Linda Smith with details of the hospital Susan Smith attended and the care Susan Smith received. Linda Smith is only obligated to pay a portion of the Medical Expense. A case worker creates a Spend Down Medical Expense with details of the obligated amount and Susan Smith as she is the person in receipt of the medical services. The Spend Down Medical Expense record is associated with the corresponding Medical Expense.