PM 15-08-04-b.

Regular to Spenddown

  1. (FCRC) When a case changes from Regular to Spenddown, complete and send Form 2434A (with Form 458SPA/SPB attached, if needed) or Form 2434C in a timely manner. Form 2434A or Form 2434C tells the client that they will no longer receive a MediPlan Card and that they are enrolled for spenddown because of excess monthly income and/or assets.
  2. (FCRC) Revise and submit Form 552 with TA 31/TAR 57 to enroll the client for spenddown for the first month for which medical benefits can be stopped (see WAG 18-05-04).
  3. (FCRC) Enter code 390 SPD or 391 SPDGC in Item 80.
  4. (FCRC) For AABD Medical, enter code 392 AST in Item 80.
  5. (FCRC) Show spenddown status as unmet.

    Example: The Family Community Resource Center determines that due to a change in income a regular AABD Medical case should be enrolled in spenddown. On 01/31 the Family Community Resource Center takes action to process the change on Form 552. The client has already received the February MediPlan Card on 01/29. To stop medical benefits for March, enter 03/99 for effective date in Item 2, and code 2 (spenddown) in Item 80. 

  6. (FCRC) Establish a spenddown record in ASDS.

Spenddown to Regular

Take the following action for a spenddown case, whether in met or unmet status, when a case changes from Spenddown to Regular.

  1. (FCRC) Complete and send Form 2434A (with Form 458SPA/SPB attached, if needed) or Form 2434C to notify the client of the change and the date that medical eligibility begins.
  2. (FCRC) Revise and submit Form 552 with TA 31/TAR 57 if sufficient time remains in the approval period (see WAG 18-05-02).
  3. (FCRC) Delete the spenddown code, indicator, and amount in Item 80.
  4. (FCRC) If the case was in met status (code 1 or 3), make no entry in Item 77.

    Enter the month, day, and year that eligibility for Regular began, in Item 77 if the case is in unmet status. 

  5. (FCRC) For AABD Medical cases, delete code 392 AST in Item 80.
  6. (FCRC) If the Spenddown case is centrally ended before it can be changed to Regular, complete and submit a Form 552 for the month for which the Spenddown case has been ended, approving a Regular case (see WAG 15-08-10).

    Do not ask the client to complete an application form to establish the Regular case.