Medicare-Medicaid Pay-Down of Assets
State law and regulations impose income and asset limits on persons applying for Medicaid.
The income limit for the institutional Medicaid program and certain home and community-based waiver programs is determined by the Department of Human Services. Beginning on July 1, 2025, the Medicaid income limit for individuals eligible for the Nursing Home (institutional) program is $2,901 per month. To qualify for Medicaid through SSI the income limit for an aged, blind or disabled individual cannot exceed $1,305 per month or $1,764 for a couple.
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. A person may qualify for MA-ABD with a Medical Spenddown up to three months before the month of application.
There are two medical spenddown types: a six-month spenddown and a monthly spenddown.
Six-month spenddown:
A six-month spenddown is the difference between the person’s net income for a six-month period and the applicable Federal Poverty Guidelines (FPG) for a six-month period. Each household member may have a different spenddown amount depending on their net income and the FPG standard used to determine that member’s eligibility but all household members with a spenddown must use the same spenddown type.
Monthly spenddown:
A monthly spenddown is the difference between the person’s net income for a one-month period and the applicable FPG standard for that month. The spenddown is determined separately for each month of a six-month period. Each household member may have a different spenddown amount depending on their net income and the FPG standard used to determine that member’s eligibility but all household members with a spenddown must use the same spenddown type.
For those Applying for Long-Term Care Services, the lookback period is 60 months prior to the baseline date. A new lookback period is established each time a person requests MA-LTC following a break in LTC services. A break in LTC services is a gap of one calendar month or more in receiving MA-LTC because the person either:
Became ineligible for MA-LTC services
Stopped residing in a LTCF or receiving services through an HCBS waiver program.
A new lookback period is established with each new request for MA-LTC following a break in LTC services.
Minnesota Department of Human Services – Insurance Affordability Programs (IAPs) Income and Asset Guidelines
Minnesota Health Care Programs Eligibility Policy Manual Rule 2.3
Minnesota Health Care Programs Eligibility Policy Manual Rule 2.4