What is a Medicaid spend-down?
A Medicaid spend-down is the process of reducing your countable assets to the program limit, usually about $2,000 for an individual, so you qualify for long-term care Medicaid. You spend excess assets on care, exempt items, or debt, not on gifts, which trigger penalties.
What assets are exempt from Medicaid spend-down?
Common exemptions include your primary home (up to the equity limit, about $713,000 in most states in 2024), one vehicle, personal belongings, a prepaid irrevocable funeral plan, and, for married couples, the Community Spouse Resource Allowance (CSRA).
How much can a spouse keep when the other needs Medicaid?
The healthy community spouse can keep the Community Spouse Resource Allowance, which in 2024 ranges from a minimum of $30,828 to a maximum of $154,140, typically half of the couple's countable assets within that band, plus the exempt home and vehicle.
Can I give away money to qualify for Medicaid faster?
No. Gifts or below-market transfers within the 5-year look-back period create a penalty period during which Medicaid will not pay. Spend down only on legitimate care, exempt assets, or debts. An elder law attorney can advise on lawful planning strategies.
Does Canada have a Medicaid spend-down?
No. Canada has no Medicaid. Provincial long-term care is income-tested rather than asset-tested, so there is no requirement to spend down savings or the home, and no 5-year gift look-back for standard care.