Spenddown Standards (Archive)

Clients in the community, whose total net income is greater than the applicable Federal Poverty Guideline (FPG), must have their eligibility calculated using a FPG spenddown standard.

Which FPG spenddown standard to use is based on the client’s basis of eligibility and method of calculating income. There are two spenddown standards:

l  100% FPG:  People using a families and children basis of eligibility need to spend down to the 100% FPG standard.

l  75% FPG:  People using a blind, disabled, or age 65 or older basis of eligibility need to spend down to the 75% FPG standard.

Note:  There is no spenddown standard for the Medicare Savings Programs or GAMC because these programs do not allow a spenddown.

Change to the appropriate FPG spenddown standard based on the client’s basis of eligibility when the net income exceeds the FPG non-spenddown standard.

Example:

Mildred, age 67, has an age 65 or older basis of eligibility. Her net income of $950 exceeds the 100% FPG standard for a household of one.

Action:

Since Mildred’s net income is over the 100% FPG standard for a household of one, use the 75% FPG standard for a household of one to determine the amount of her spenddown.

Example:

Joe lives with his five-year-old son, Nick. He has a basis of eligibility as a Parent/Relative Caretaker, and Nick has a basis of eligibility as a child under age 21. Joe’s monthly net income is $1,900.  

Action:

Based on Nick’s age (five years) Joe’s deemed net income is first compared to the 150% FPG standard. Since the net income exceeds that standard, compare the net income to the 100% FPG standard for both Nick and Joe.

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