Term used to describe individuals who meet all conditions of enrollment in Medicaid programs, except that they are over the income guidelines. Individuals can use incurred medical expenses to “spend down” to income limits. Compare with categorically needy”.
Individuals and their families who have too much income to qualify under Medicaid's mandatory or optional categorically needy groups but can qualify for certain funds due to their high level of medical expenses. This can be accomplished by "spending down" to Medicaid eligibility by incurring medical and/or remedial care expenses to offset excess income, thereby reducing it to a level below the maximum allowed by that state's Medicaid plan. Also known as "medically indigent."
Medically Needy is another Medicaid Program in New Jersey that in the long-term care arena covers only nursing homes. It does not cover assisted living, home care or adult day care.
A term used when a person is eligible for Medicaid, not because of absolute lack of income, but because income, less accumulated medical bills, is below state income limits for the Medicaid program.
A term used to describe an optional Medicaid eligibility group made up of individuals who qualify for coverage because of high medical expenses, commonly hospital or nursing home care. These individuals meet Medicaid= s categorical requirements i.e., they are children or parents or aged or individuals with disabilities but their income is too high to enable them to qualify for categorically needy@ coverage. Instead, they qualify for coverage by spending down@ i.e., reducing their income by their medical expenses. States that elect to cover the medically needy@ do not have to offer the same benefit package to them as they offer to the categorically needy.
Refer to MN for definition. See: Adult Medical Programs; Family Medical Programs; Spenddown; Scope of Care