For community, LTC, and SLF cases, spenddown met day is the day in the month that medical bills and/or receipts meet spenddown. Spenddown met day is the first day of medical eligibility.
To determine the spenddown met day, deduct medical expenses in the following order from the monthly spenddown amount:
When charges at the private pay rate are more than the amount needed to meet spenddown, but the Medicaid rate is less than the amount needed, spenddown is considered met but the client is responsible for the entire amount of the bill at the private pay rate. The difference between the private charge and the amount needed to meet spenddown may be used to meet spenddown in a later month.