Growing older brings many challenges, especially when it comes to your health and healthcare costs. Assistance from Medicaid’s long-term care program offers relief for many seniors.
But many New Yorkers find themselves in a difficult position—earning more than Medicaid’s income limits but struggling to afford quality healthcare. If this is your situation, Medicaid spend-down is the way to go.
The basics of Medicaid spend-down
Medicaid spend-down is a strategy for those whose income exceeds Medicaid’s limits. It allows you to “spend down” or spend the extra amount on medical costs until you qualify.
The income limit is about $1,820 for one person and $2,453 for couples in New York as of 2025. So, if you make $2,000 monthly, you would need to spend $180 on healthcare before Medicaid kicks in to cover the rest.
This approach helps you get crucial medical care without losing all your financial security.
Strategies for effective spend-down in New York
You can reduce your countable income and assets through several approved methods. These include:
- Pay medical bills: Use extra income for doctor visits, prescriptions or old medical bills
- Make your home safer: Add wheelchair ramps, grab bars or other necessary medical improvements
- Insurance premiums: Apply health insurance payments toward your spend-down amount
- Home healthcare: Count expenses for in-home medical care and equipment
- Dental care: Include costs of dental procedures and routine maintenance
- Medical supplies: Factor in expenses for necessary medical supplies and equipment
Additionally, if you get help from New York’s Elderly Pharmaceutical Insurance Coverage for your prescription drug costs, that also counts towards your Medicaid spend-down.
Taking control of your healthcare future
Starting your Medicaid planning early on gives you a greater advantage. Spend-down strategies require careful timing and an understanding of state regulations. Working with an experienced Medicaid planning attorney helps protect your income and assets while ensuring you receive the medical care assistance you need.
Remember, proper planning doesn’t just secure your healthcare access—it provides peace of mind for you and your loved ones during your golden years.
