Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability

2.3.3.4 Medical Spenddowns

A medical spenddown is a cost-sharing approach that allows Medical Assistance (MA) eligibility for people whose income is greater than the applicable income limit. Federal rules refer to this population as “medically needy.”

People with an aged, blind or disabled basis of eligibility, who are not eligible for Medical Assistance for People Who Are Age 65 or Older and People Who Are Blind or Have a Disability (MA-ABD) because they are over the income limit and who have medical expenses may be eligible for MA-ABD with a spenddown.

See the MA for Families and Children Medical Spenddown policy for more information about medical spenddowns for parents, pregnant people and children.

Topics included in this section are:

Retroactive Eligibility for MA-ABD with a Medical Spenddown

A person may qualify for MA-ABD with a Medical Spenddown up to three months before the month of application.

MA-ABD with a Medical Spenddown and Other Insurance Affordability Programs

A person may be eligible for MA-ABD with a Medical Spenddown in the same month they are or were eligible for or enrolled in MinnesotaCare, Advanced Premium Tax Credits (APTC) or qualified health plan (QHP) without subsidy. Eligibility for or enrollment in MinnesotaCare, APTC, or QHP without subsidy is not a barrier to eligibility for MA-ABD with a Medical Spenddown.

MA-ABD Spenddown Standard

The spenddown standard for MA-ABD with a spenddown is:

Before June 1, 2019: 80% FPG
On or after June 1, 2019 through June 30, 2022: 81% FPG
On or after July 1, 2022: 100% FPG

Legal Citations

Code of Federal Regulations, title 42, section 435.811

Code of Federal Regulations, title 42, section 435.831

Code of Federal Regulations, title 42, section 435.840

Minnesota Statutes, section 256B.056, subdivision 5