Medicaid Spend Down: What It Is, How It Works, and How to Qualify

Three things to know before anything else

If you’re reading this while stressed about a hospital discharge or watching home care costs spiral, here’s what matters most.

Spend down is a real Medicaid pathway—not a loophole. In New York State, spend down typically applies to non-MAGI Medicaid categories (you’ll sometimes see these called Aged/Blind/Disabled programs, sometimes linked with SSI recipients). In New Jersey, it’s often tied to the Medically Needy pathway. Here’s why this matters: if you apply under the wrong category, you can have perfect paperwork and still get denied. Before you spend hours tracking down medical bills, confirm which office handles your case. In New York, that means knowing whether you’re dealing with NYC HRA or a county DSS. In New Jersey, you’ll work with your County Welfare Agency under DMAHS guidance.

Most problems come from documentation issues, not the medical expenses themselves. Caseworkers aren’t making judgment calls about whether you feel financially squeezed. They’re checking whether each expense is clearly tied to the applicant by name, clearly medical in nature, and clearly timed with specific dates of service. The fastest approvals? They tend to come from clean, straightforward documentation—itemized bills, premium notices, pharmacy printouts that identify the patient, and payment records that match up.

Timing and transfer rules can make or break your case. Spend down is measured over a defined period (often monthly, though some Medically Needy structures use multi-month “budget periods”). And if you’re applying for long-term care Medicaid, any transfers for less than fair market value can trigger penalties—typically within a 60-month look-back window for nursing home coverage. That’s why it’s worth pausing any gifting, “cleanup” transfers, or big account moves until you understand exactly what your state’s Medicaid office will examine. You can accidentally create a problem while trying to help.

Your best first step: Gather your last 6 to 12 months of medical bills and premium documentation. Start a simple ledger. Then confirm your exact program category and budget period with your local Medicaid office—or a qualified professional—before you pay large bills or move assets around. That sequence alone prevents a lot of avoidable denials.

Who tends to benefit most from spend down?

The spend-down process works well for people who are close to Medicaid’s eligibility limits but carry significant, provable medical costs. Older adults whose Social Security and pension income puts them slightly over the threshold—but who pay substantial monthly health care costs—are prime candidates. Families covering home care or nursing home care for a parent or spouse frequently use this pathway too. So do people with disabilities under 65 whose income level fluctuates and periodically exceeds program limits.

It helps to hold two truths at once here. The hopeful news: you may access Medicaid eligibility even though your monthly income or assets look “too high” on paper. The real risk: use the wrong expenses, miss deadlines, or make transfers that create penalties (especially when long-term care is involved), and you could lose precious time or face an unexpected denial.

Questions you need to answer before you start

Before diving into document collection, get clear on the fundamentals. These aren’t bureaucratic details—they determine whether your effort pays off.

This table has three columns—What to confirm, Why it matters, and Example—and lists three key pre-filing checks: the Medicaid program category, whether expenses qualify with documentation, and timing/budget-period rules.

What to confirm	Why it matters	Example
Which Medicaid program	Spend down applies to certain non-MAGI categories (Aged, Blind & Disabled or Medically Needy). It generally doesn’t work the same way in MAGI programs tied to tax-filer rules.	New York uses the non-MAGI excess income program; New Jersey often uses the Medically Needy pathway.
Whether expenses qualify and can be proven	Only certain medical expenses count, and they need clear documentation to back them up.	An itemized hospital statement with service dates works. A generic “amount due” printout often doesn’t.
Your timing and budget-period rules	What counts depends on when bills were incurred, billed, or paid—and counties may differ in what they accept.	One county might accept unpaid medical bills; another might insist on specific formats or timeframes.

Give yourself a quick self-check: Are your bills itemized and tied to the applicant by name and service dates? Do you have payment proof or current statements showing balances owed? Have there been gifts, property transfers, or unusual withdrawals (especially relevant for long-term care)? Do you know how your local office wants documents submitted and what deadlines apply?

The smartest move is to gather current medical bills and premiums, then do a preliminary Medicaid eligibility check with your local Medicaid office or a qualified professional before making big payments or moving assets around.

How to prepare your case the right way

When families run into trouble with Medicaid spend down, it’s usually not because they didn’t have enough bills. It’s because they didn’t prepare documentation in a way that’s easy for the agency to verify quickly.

Five preparation steps that actually matter

Start by collecting 6 to 12 months of medical bills and premium proof. Make sure everything is itemized with service dates and the applicant’s name clearly visible. Then create a master ledger—a simple spreadsheet works perfectly—listing each expense alongside the exact document that proves it. Save official rule pages you rely on as PDFs with URLs and access dates (loose screenshots won’t hold up if questions arise later). Pause any nonessential transfers and “cleanup moves” until you understand the transfer risk, especially if long-term care is involved. Finally, schedule a targeted eligibility consultation to confirm your program category, budget period, and what your specific county accepts as proof.

When you should get expert help first

Stop and get guidance before filing if any of these situations apply: you suspect gifts or transfers happened and you’re pursuing long-term care coverage; bank statements show large withdrawals or account closures you can’t explain with documents; you can’t obtain itemized bills quickly and there’s a facility discharge deadline looming; your family situation is complicated (separation, shared property, outdated powers of attorney); or your finances include trusts, business income, retirement accounts, or real estate issues that need sorting out.

A realistic preparation timeline

This table organizes preparation into three timeframes—48–72 hours, 1–2 weeks, and 30 days (or your deadline)—and lists what to do in each period and what completion looks like.

Timeframe	What to do	What “done” looks like
48–72 hours	Collect and scan recent bills and premiums; start your ledger; confirm submission method; stop nonessential transfers	One folder of itemized bills, one folder of proof, ledger started, local office contact info saved
1–2 weeks	Request missing itemized statements; reconcile payments to bills; gather bank accounts, income, and resource records	Ledger totals match documents; gaps identified and requested; bank statements assembled
30 days (or your deadline)	Finalize packet with cover letter, ledger, and proof; submit with delivery confirmation; set follow-up reminders	Submission proof saved; complete copy retained; follow-up plan in place

A practical tip for staying organized: Use monthly folders (“2026-01,” “2026-02”) and consistent file naming like 2026-01-10_Hospital_ER_$632_Itemized.pdf. Your ledger columns should include date of service, provider, description, amount billed, amount paid, unpaid balance, proof type, file name, and notes.

New York vs. New Jersey: Key differences that affect your case

Both states offer pathways for applicants who are “over the limit,” but they don’t work identically. County practices can also shape what’s actually accepted.

This three-column comparison table lists four categories—Income & asset limits, Look-back period (LTC), Household definition, and Expense categories—and provides the corresponding New York and New Jersey notes for each.

Category	New York	New Jersey
Income & asset limits	Varies by Medicaid category (often the non-MAGI excess income program for spend down); the Medicaid income limit and asset limits update periodically	Varies by program; Medically Needy standards apply for certain pathways
Look-back period (LTC)	60 months for nursing home Medicaid; community-based long-term care look-back rules have evolved—confirm current requirements with the Department of Health	60 months for long-term care Medicaid
Household definition	Depends on MAGI vs. non-MAGI; spousal rules central in LTC cases	Differs by program type; spousal rules critical in LTC cases
Expense categories	Hospital/medical care, LTC costs, health insurance premiums, prescription drugs when properly documented	Same general categories when properly documented

Make a note of the specific category you’re using and the official page you verified, including the URL and the date you accessed it. If you’re married, separated, or supporting dependents, confirm how your program defines household and counts income.

Building an application that reviewers can actually work with

A strong packet doesn’t try to impress with volume. It makes verification easy. Think “clear and cross-referenced,” not “thick stack of paper.”

What your packet should include

This table outlines four packet sections—Cover letter, Ledger, Proof, and Copies & submission proof—and describes the contents and purpose of each to help reviewers verify eligibility efficiently.

Section	Contents	Purpose
Cover letter	Program type, budget period, spend-down amount target (if known), list of enclosed documents	Prevents misreads and reduces back-and-forth
Ledger	Row-by-row expense list with totals matched to file names	Lets reviewer cross-check quickly
Proof	Itemized bills plus payment proof or balance-owed statements	Turns ledger into verifiable evidence
Copies & submission proof	Full duplicate set plus confirmation/receipt	Protects you if documents are lost or deadlines disputed

Sample cover letter template

  RE: Medicaid Application – Spend-Down Documentation
  Applicant: [Full Name], DOB: [MM/DD/YYYY]
  Program/Category: [Non-MAGI ABD / Medically Needy / LTC Medicaid]
  County/Office: [County + office name] Enclosed:
  1) Spend-down ledger for [Month/Year or budget period dates]
  2) Supporting documentation for each medical expense (itemized bills + payment/balance proof)
  3) Premium proof (Medicare/health insurance) with payment/withholding evidence
  4) Additional eligibility documents (income/resource statements) Total qualifying medical expenses: $[Total]
  Please confirm receipt and advise if clarification or additional proof is needed. Contact: [Name], [Phone], [Email]

How to submit and follow up

For online portal uploads, save the confirmation screen or receipt PDF. For certified mail, keep the mailing receipt and tracking confirmation. For in-person drop-off, request a date-stamped intake receipt listing what you submitted.

Set a weekly follow-up rhythm unless the office provides a specific processing timeframe. Each follow-up should reference the applicant name, case number (if assigned), submission date, and one specific question (for example, “Is the ledger accepted? Are any documents missing?”). Keep a contact log with date/time, phone number, person or department, summary of the conversation, and next steps.

Which expenses count—and how to prove them

The exact items accepted vary by program category and county. The safest approach: stick to clearly medical expenses and make sure every bill has the proof elements caseworkers look for.

Commonly accepted when properly documented: hospital, ER, and physician bills (itemized with service dates); nursing home or long-term care facility invoices; licensed home care agency invoices for personal care services; prescription drugs and copays (pharmacy receipts identifying patient and medication); health insurance premiums (Medicare Part B/D, Medigap); durable medical equipment (supplier invoice with item detail); hearing aids and eyeglasses (with itemized receipts); and medical supplies like diabetic testing supplies or incontinence products.

Often problematic: cash payments without receipts and provider identification; non-itemized statements that don’t explain charges; over-the-counter medications (unless specifically prescribed and documented); and informal payments to family members as caregivers—especially without a compliant personal care agreement, proper payroll, and tax handling.

Documentation checklist for each bill

Before adding an expense to your ledger, confirm the document shows: patient/applicant name, provider name (ideally with address and phone), date(s) of service (not just the statement date), description of service or item, and amount billed along with amount paid and balance due where relevant.

For paid bills, keep the itemized bill and matching payment proof—a receipt, canceled check, or bank/credit record clearly tied to the provider. For unpaid bills, keep the itemized bill and a current statement showing the balance is still owed. If a bill went to collections, get documentation confirming the debt is the applicant’s responsibility with original service dates.

How to handle partial payments and credits

If you made a partial payment or the provider applied a credit, reflect that in your ledger so your totals match what the Medicaid office sees. List the full amount billed, the amount paid (with proof file name), the remaining balance (with current statement), and note any insurance adjustments with the EOB attached if it clarifies the reduction.

How to calculate your spend-down amount

Having a spend-down amount estimate helps you plan which bills to use and how much documentation you’ll need. Keep in mind that the actual calculation depends on your specific program’s rules—what follows is illustrative.

Information you’ll need to gather

You’ll want your monthly income (and what counts under your Medicaid category), countable assets/resources (and what’s exempt under asset limits), household size and marital status, your county and state program category (budget periods vary), and expected medical expenses like premiums, prescription drugs, and medical care invoices.

The basic calculation

Required spend-down amount = (Countable income − Income limit) × Number of months in period

The gap between your income and the program’s threshold is sometimes called your surplus income or excess income—that’s the amount you must “spend down” on qualifying medical expenses each period.

Here’s an example to make it concrete: If your countable income is $2,000 per month and your program’s limit is $1,732 per month, your monthly gap is $268. Over a 6-month budget period, that’s $268 × 6 = $1,608 in qualifying medical expenses needed. (This is a simplified illustration—your program may calculate differently, and income limits change periodically.)

When estimates can go wrong

Online calculators can produce inaccurate results when you have unusual assets, unclear household rules, recent transfers, or an active dispute or appeal. In those cases, a manual review backed by actual documents is safer. When using any online tool, enter only what’s truly needed for the estimate, avoid sending full account numbers through unsecured channels, and prefer tools that calculate locally and clearly state their data retention policies.

Guidance for specific situations

Single applicants

Priority action: Build a month-by-month ledger where every line item matches a document. What to watch for: Missing service dates, non-itemized bills, payments that can’t be matched to specific bills. Questions for a consultation: Which category am I in and what’s my budget period? Which bills are strongest for spend-down proof? What’s my fastest path to a submit-ready application given my county’s procedures?

Married couples

Priority action: Separate whose income and assets belong to whom, and confirm how spousal protections apply in your state and program. What to watch for: Joint bank accounts with unclear ownership, home equity issues, outdated POA or healthcare proxy documents. Questions for a consultation: How does my state apply spousal impoverishment protections (which may allow the community spouse to retain certain income and assets)? What documents prove separate vs. joint ownership cleanly? Is spend down the best approach, or should we do planning first?

Adults under 65 with disabilities

Priority action: Confirm the correct Medicaid category and ensure disability and income documentation is complete. Some individuals may qualify through SSI-related pathways or waiver programs that have different rules. What to watch for: Fluctuating income, missing eligibility proofs, bills that don’t clearly tie to the applicant. Questions for a consultation: Which income sources count and which deductions apply? Do my expense documents meet the proof standard? What’s the simplest application process to maintain eligibility month to month?

Recent transfers or gifts (long-term care)

Priority action: Freeze transfers and build a transfer ledger before filing. What to watch for: Gifts to family members, below-market property sales, adding or removing names from deeds, large unexplained withdrawals. Questions for a consultation: Which transactions will likely be treated as penalizing transfers? What documentation do we need to defend or correct them? What timing and strategy reduces penalty exposure?

How to handle large or older bills

Older and oversized unpaid medical bills can help your case, but they’re also where families make timing mistakes. Rules vary by program and county—confirm before relying on any particular strategy.

For older unpaid bills, get a current statement showing the bill is still owed. Request an account history showing service dates, payments, and remaining balance. If needed, ask for a provider letter confirming service dates and that the balance is the applicant’s responsibility.

Don’t assume that “extra” from a large bill automatically carries forward to future periods. If your county allows allocating portions across periods, your ledger should show exactly what portion applies to each period and why your documents support that split.

When working with providers, ask for re-issued itemization (many denials stem from missing detail, not lack of cost). Request payment plan statements that clearly show amounts and due dates. Ask billing to separate combined family statements into the applicant’s name only.

The look-back period and transfer penalties

If you’re applying for Medicaid covering long-term services and supports—such as nursing home care—transfers inside the look-back window can delay Medicaid coverage, even if you otherwise qualify. This often becomes one of the biggest surprises families face.

Transfers that Medicaid reviews

The Medicaid office scrutinizes gifts to family members (transfers to a spouse may be treated differently), property sold below fair market value, adding or removing names from deeds for little or no value, large unexplained withdrawals or account closures, and asset conversions that appear to give value away without adequate compensation.

How penalties work

In long-term care Medicaid, a penalty period means Medicaid delays paying for care—even though you’re otherwise medically and financially eligible. The exact penalty calculation uses state-specific rules and divisor rates, which change over time. Divisor amounts vary by state and are updated periodically, so verify current figures with your state Medicaid office before relying on any estimate.

What to do if you find problem transfers

Stop further transfers immediately. Create a transfer ledger documenting the date, amount or value, recipient, reason, and what proof exists. Collect all evidence: bank statements, canceled checks, deposit records, deeds, closing statements, sales contracts, and any written family agreements. Preserve originals and keep certified copies.

Some transfer problems can be corrected; others must be planned around. Remedies may include clarifying documentation, correcting ownership records, negotiating care timing, or pursuing appeals. Because mistakes here are costly, transfer situations are one of the clearest reasons to consult a Medicaid-focused attorney before filing.

Common reasons for denial—and how to fix them

Many denials are fixable, and many are avoidable when your packet is built with verification in mind.

No itemization or service dates: Request an itemized bill or provider letter showing dates and services rendered. Payment proof doesn’t match the bill: Provide a receipt or bank line that clearly identifies the provider and amount; add a brief annotation tying it to your ledger. Patient name mismatch: Request the provider re-issue the statement in the applicant’s name, or get an account printout showing patient/responsible party. Missed document deadlines: Calendar deadlines immediately, submit targeted responses, and keep delivery proof. Misfiled expenses (wrong period): Rebuild the ledger using your county’s date-of-service rules and submit with clear notes.

Before you submit, verify

Confirm every ledger line has a readable supporting document. Verify totals add correctly and align with your budget period. Check that the applicant’s name and service dates appear on key pages—don’t assume the reviewer will infer anything.

If you’re denied

Request the written denial reason and appeal deadline. Respond with documents that cure the exact deficiency—not a disorganized re-submission. Include a short cover note: “This submission addresses denial reason #__ by providing __.” If the issue involves transfers, household rules, or category selection, consider professional help before resubmitting.

When professional help makes the difference

Many families handle straightforward spend-down filings on their own. Professional guidance becomes valuable when facts are complicated or stakes are high.

Consider getting help if: transfers, gifts, or property changes occurred and long-term care Medicaid is involved; your assets include trusts, certain retirement accounts, or business income; you can’t obtain required documents quickly; you face a hospital discharge or facility admission deadline; or you’re getting conflicting information from different offices.

A qualified professional confirms the correct Medicaid program category and budget-period rules. They estimate spend-down exposure and identify the cleanest expenses to use. They flag transfer risks before you file. And they build a reviewer-friendly packet while handling communications and appeals when needed.

When evaluating help, ask whether they regularly handle Medicaid spend down in your state and county. Ask what deliverables you’ll receive after the first engagement (eligibility estimate, document checklist, packet preparation). Ask how they handle transfer analysis and whether they assist with appeals. Ask what you should bring so the meeting is efficient.

If your main worry is “I can’t afford care and I’m scared of making a mistake,” this is exactly where focused Medicaid planning reduces stress—matching the right strategy to your timeline, your county’s procedures, and your documentation reality.

How NY Wills & Estates can help

Our support is designed to reduce delays, prevent avoidable denials, and make your submission easier for the agency to approve. We help with preliminary eligibility reviews for NY and NJ (including county-level procedure differences), documentation audits and organization, transfer and penalty risk assessments for long-term care cases, preparation of clean submission packets, and agency follow-up and appeal support when needed.

Common deliverables: An annotated document checklist, a cleaned-up spend-down ledger, an application-ready packet structure, and (when needed) a memo outlining transfer risk, timing concerns, and recommended next steps.

Our approach: Practical and low-pressure. We focus on giving you clarity quickly—what matters, what doesn’t, what’s missing, and what your fastest compliant path looks like.

Why families choose NY Wills & Estates: We focus exclusively on estate planning and Medicaid planning—not general law—and we’re licensed in both New York and New Jersey. That dual-state perspective matters when families live in one state but have parents, property, or care needs in the other. We understand that rules, terminology, and local processing expectations differ between states and even between counties. We meet clients at our Manhattan office (450 7th Avenue) and Hackensack office (15 Warren Street).

Preparing for your first consultation

Good preparation makes your first meeting faster and more useful—especially when deadlines are tight.

Documents to organize

Bring bills organized by month (itemized invoices plus EOBs), proof of payments (receipts, canceled checks, bank lines, premium proofs), an income snapshot (Social Security, pension, wages), resource documentation (account balances, ownership records), a transfer ledger if applicable (dates, amounts, recipients, documents), and a one-page timeline of major medical and financial events.

Questions to ask

What program category is most appropriate, and what’s the budget period? What are the top two risks in my file (documentation gaps, transfers, household rules) and how do we address them? What’s the realistic timeline from today to submission and decision, given my county’s application process?

Sharing documents securely

Send PDFs through secure methods when possible and avoid emailing full account numbers. Flag “red items” upfront—transfers, real estate changes, missing POA, facility deadlines. Decide on your meeting goal before arriving: eligibility estimate, full packet preparation, or transfer analysis.

Frequently Asked Questions

• Which medical bills count for spend down in NY or NJ?

  Commonly usable medical expenses include hospital and physician bills, licensed home care or facility bills, prescription drugs, hearing aids, eyeglasses, medical supplies, durable medical equipment, and health insurance premiums—when properly documented and tied to the applicant. Verify using the line-item proof test: patient name, provider, service dates, description, and amounts. When in doubt, request an itemized statement on provider letterhead and confirm the category with your local Medicaid office.

• How does Medicaid spend down work?

  The spend-down process lets you qualify for Medicaid coverage even when your income exceeds the standard income limit. You demonstrate that your excess income goes toward qualifying medical expenses. Once your provable medical costs equal or exceed that surplus income, you’re treated as eligible for the coverage period. This bridges the gap between what you earn and what the Medicaid program allows.

• How are spend-down amounts determined?

  Generally, it’s the amount your countable income exceeds the program’s income standard, measured over the applicable period. Allowable medical expenses offset that gap. Some programs also require reducing countable resources if you’re over the asset limits. Document your inputs (income, category, period) so your estimate can be explained and corrected if needed.

• Can I use unpaid bills from previous months?

  It depends on your state, Medicaid category, and local processing rules. Some situations allow older unpaid medical bills if clearly documented; others are stricter. Confirm with your local Medicaid office before relying on older bills, and get current statements showing balances still owed.

• What if I don’t meet spend down this month?

  You generally won’t be eligible for that period, but you can often qualify in later months once you incur enough qualifying medical expenses. Keep strong documentation so you can prove expenses when you reapply. If you’re in a discharge or facility timing crunch, ask about interim steps, waiver programs, or alternative coverage options, and document every communication.

• Can I use another person’s medical bills?

  Generally, spend-down expenses must be for the Medicaid applicant. Limited exceptions may exist depending on household rules and program type—verify your program’s household definition and don’t assume another person’s bills will count.

• How do transfers or gifts during the Medicaid look-back period affect long-term care Medicaid eligibility?

  If long-term care Medicaid is involved, transfers can trigger penalty periods. Stop further transfers, gather documentation, build a transfer ledger, and consider professional advice before filing to avoid unnecessary delays or denials.

• When should I seek help from a Medicaid expert?

  When there are transfers, real estate issues, trusts, unusual assets, missing documents, conflicting guidance, urgent care deadlines, or a denial/appeal situation. Getting help early often saves time and reduces risk.

• What is Medicaid estate recovery?

  After a Medicaid recipient passes away, the state may seek reimbursement from their estate for certain Medicaid benefits paid on their behalf. Estate recovery rules vary by state and depend on the type of Medicaid received. This is an important consideration in long-term planning and should be discussed with a qualified professional if relevant to your situation.

Take the next step

If you’re trying to qualify for coverage, avoid delays during a discharge or facility admission, or reduce transfer-related penalty risk, a focused legal consultation can help you identify the most reliable path—whether that’s a spend-down submission, a resource strategy, or longer-term planning.

Call NY Wills & Estates today at 516-518-8586 to protect your family’s future.

You’ll get clear answers about which program pathway fits your situation in New York or New Jersey. You’ll understand exactly what documents you need and which missing items cause the most denials. You’ll identify transfer and penalty risk early, when you still have options. And you’ll leave with a practical action plan matched to your timeline.

Official resources

• New York State Medicaid: health.ny.gov/health_care/medicaid/
• New Jersey Medicaid: nj.gov/humanservices/dmahs/clients/medicaid/
• NY Local DSS Contacts: health.ny.gov/health_care/medicaid/ldss.htm
• NJ County Welfare Agencies: nj.gov/humanservices/dmahs/staff/resources/countyboards/

Helpful search terms: “Medically Needy,” “non-MAGI Medicaid,” “income standard,” “resource limit,” “spousal impoverishment,” “county welfare agency Medicaid application,” “LDSS Medicaid forms.”

About this guide

Last updated: February 16, 2026.

This guide is maintained by the NY Wills & Estates team, focusing on Medicaid and estate planning matters in New York and New Jersey. We cross-check key references (state agency pages, local office resources, published program materials) and update sooner when major policy or procedural changes occur.

Important: This article is for consumer education and practical planning purposes only. Medicaid rules are technical, vary by state and county, and can change; outcomes depend on your exact program category, local practices, and documentation. This is not legal advice. If your situation involves transfers, real estate, trusts, or urgent long-term care needs, seek individualized guidance from a qualified professional.

If you spot an error or change, please send us the page/section, what you believe changed, and your source with date. We maintain an internal editorial log and aim to review credible updates promptly.

 

References & Sources

1. 1

   Pedranilaw. (n.d.). Understanding the New York State Medicaid Look. Pedranilaw.

   https://www.pedranilaw.com/understanding-the-new-york-state-medicaid-look-back-period

   Accessed: 2026-02-16

2. 2

   The Chamberlain Law Firm. (2023). What Is a Medicaid Spend Down?. The Chamberlain Law Firm.

   https://www.thechamberlainlawfirm.com/blog/what-is-a-medicaid-spend-down/

   Accessed: 2026-02-16

3. 3

   tdelia. (n.d.). Medicaid Announces Decreased Penalty Divisor for 2025. Vanarellilaw.

   https://vanarellilaw.com/medicaid-announces-decreased-penalty-divisor-for-2025/

   Accessed: 2026-02-16

4. 4

   Matus Law Group. (n.d.). How to Avoid Medicaid 5. Matus Law Group.

   https://matuslaw.com/how-to-avoid-medicaid-5-year-lookback-penalties-in-new-jersey/

   Accessed: 2026-02-16

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