When countable monthly income and/or excess nonexempt resources are at least $1 more than the AABD medical standard for one person, the case is a spenddown case. Before medical coverage for the month can begin, medical expenses must equal the amount of the person's countable income and excess nonexempt resources. When applying NH or SLF charges to the spenddown amount, always use the cost of care at the private rate.
Begin medical eligibility when charges at the private pay rate, plus other allowable medical expenses not previously used, equal countable income and excess resources. Use the private pay rate or the state rate in full-month increments. A month is either entirely state rate or entirely private pay rate.