Obtaining Medicaid through the Medically Needy or Spend Down program

Kathy813

Well-Known Member
Staff member
My difficult child is not covered by insurance. She makes to much to qualify for SSI. However, I found a program that may include my difficult child. The Medically Needy Program is described as:

Medically needy individuals include individuals with disabilities or blindness, who would qualify for SSI, but have income or resources above the SSI limits set by their state.


My state is listed among the 34 states have have established this program. There is a spend down option that allows the individual to subtract medical expenses to bring down their countable income to below the medically needy level. Even her free mental health care from our county would be allowed to count as what it costs the county to provide that care. Other expenses that may be used include doctor bills, mental health bills, dental bills, prescription drugs, over the counter drugs, and optometry bills.

Is anyone here familiar with this program?

~Kathy
 

DammitJanet

Well-Known Member
Somewhat. The question is if she would qualify for SSI. That is where they denied me for medicaid while I was waiting for my disability to get approved. Even though I had doctors saying I was disabled because the agency that determines if you are disabled for social security is the same one who decides it for the state here. I have no idea if its that way in every state or if its even that way here now. Here that agency is named DDS I think. Maybe not...I cant remember now. Its been a long time. I think it was Disability Determination Services if I am right.

As far as how the spend down works, I do know a bit more about that but its a bit lengthy to go on here. I can do that on the phone if you want or you can read it in the manual and ask me questions if you dont understand.

Apply..all they can say is no.
 

Kathy813

Well-Known Member
Staff member
Thanks, Janet. The community mental health program where difficult child gets her medications has an office dedicated to helping people apply for medicaid. I am going to have her go to them and see if they can help her apply for this.
 

DammitJanet

Well-Known Member
Thats what I would do. I know one thing, she is eligible for birth control no matter what. Just so you know. I know that wasnt a question but it was a thought that jumped into my head as I was typing out this post...lol. Yes, I am a bit scatterbrained right now.
 
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