Medicaid spend down announced by state

Medicaid spend down announced by state

Nashville – The TennCare Standard Spend Down program will open enrollment to new applicants on Tuesday, Feb. 22. 

Standard Spend Down is available through a waiver to the Medicaid program for a limited number of low income individuals, or those with high, unpaid medical bills who are aged, blind, disabled, or the caretaker relative of a Medicaid eligible child. 

Eligible individuals must have enough unpaid medical bills to meet the “spend down” threshold to qualify for their coverage.

“The opening of Standard Spend Down is part of a collaborative effort among several entities including TennCare, the Tennessee Department of Human Services (DHS), the Tennessee Hospital Association, advocacy groups and the federal government. 

“I am pleased that we are once again able to offer this additional assistance to qualified low-income individuals or those with very high medical bills,” said TennCare Director Darin Gordon.

A special call-in phone line through DHS has been set up for interested applicants. The only way to request an application is by calling the toll-free number – 1-866-358-3230 – which will be open between 6:00 p.m. and 8:30 p.m. CST on Feb. 22. 

The phone lines will be open from 6:00 p.m. to 8:30 p.m. on subsequent weekdays until 2,500 interested applicants call in.  

Prospective applicants are encouraged to check eligibility qualifications before calling in. More information on Standard Spend Down program and more detailed eligibility criteria are available on TennCare’s website:

The toll-free number system is used to ensure equal access to Tennessee citizens interested in this program. After the first 2,500 calls are taken, the phone lines will be closed. 

The Tennessee Department of Human Services will send applications to the first 2,500 individuals who are not already on TennCare and will review their eligibility for any open Medicaid categories and the newly opened Standard Spend Down category.  Advanced notifications will be made to the public and other stakeholders prior to subsequent openings of the application request line.

Recent legislation called for the “expansion of the Standard Spend Down category for TennCare enrollment up to a maximum of seven thousand (7,000) individuals in FY 2010-2011.” The program will continue to open and close on a rolling basis. The Standard Spend Down category first opened to applicants on October 4, 2010.  All 2,500 calls were received in about an hour. Applications were sent to all callers that were not already on TennCare. Of those, 1,821 applications were returned to DHS and are being processed to determine eligibility. 

Standard Spend Down Eligibility:

• In addition to being aged (65 or older), blind*, disabled,* or a caretaker relative, a person must meet certain income restrictions, or be able to “spend down” qualifying unpaid medical bills to that limit. (*To be considered blind or disabled, an individual must meet standards set by the Social Security Administration.)

• Applicants also must not have resources that exceed $2,000 for a family of one and $3,000 for a family of two with an additional $100 added per additional individual in the family. A person’s unpaid medical bill must have been accrued within the past 90 days.  Medical bills paid by the applicant within the past 30 days may count towards meeting an applicant’s spend down requirement.

• Pregnant women and children still are eligible for the Medically Needy Spend Down program which has never closed and does not have an enrollment cap.

Remember, the ONLY way to request an application for the TennCare Standard Spend Down Program is through the toll free number (1-866-358-3230). 

People wishing to apply for other TennCare categories should contact their local Department of Human Services county office, call the Family Assistance Service Center at 1-866-311-4287 during normal business hours, or visit 

wcp 2/15/11

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