This chart identifies states that offer Medicaid “medically needy” or “spenddown” programs, which allow individuals to qualify for coverage based on high medical expenses.
For more information, visit our Medicaid Topics Page.
| State | Does this state have a Medicaid "Medically Needy" Program? | What is the name of the Program? | What are the eligibility requirements? | |
|---|---|---|---|---|
| ALABAMA | ||||
| ALASKA | ||||
| ARIZONA | ||||
| ARKANSAS | Yes | "Medically Needy" or spend-down coverage | https://humanservices.arkansas.gov/divisions-shared-services/medical-services/frequently-asked-questions/ | Individulas who have an income over the medicaid limit but have high medicall bills they're responsible for. |
| CALIFORNIA | Yes | Medi-Cal Medically Needy or Medically Indigent (MN/MI) Program | https://www.dhcs.ca.gov/formsandpubs/forms/Forms/MCED/PUB10.pdf | Children under age 21 and pregnant women. Families with children under age 21. people who are 65 years or older, blind or disabled, and have too much income for other Medi-Cal programs. |
| COLORADO | ||||
| CONNECTICUT | Yes | Medicaid "Spend-Down" Program | https://uwc.211ct.org/medical-spend-down-program/ | Meet eligibility requirements for Medicaid except the income limit and amount of medical expenses owed is greater than the amount the individual is above the medically needy income limit. |
| DELAWARE | ||||
| *DISTRICT OF COLUMBIA | Yes | Medically Needy Spend-Down Program | https://dhcf.dc.gov/service/medically-needy-spend-down | Individulas who have an income over the medicaid limit but have high medicall bills they're responsible for. |
| FLORIDA | Yes | Medically Needy or "Share of Cost" (SOC) Program | https://www.myflfamilies.com/sites/default/files/2025-05/2024%20Medically%20Needy%20Brochure%20-%20English.pdf | Individulas who would ordinarily qualify except for their income is too high and meet the "share of cost" amount determined by household size and gross monthly income. |
| GEORGIA | Yes | Medically Needy Program | https://pamms.dhs.ga.gov/dfcs/medicaid/2150/ | Aged, blind, or disabled individuals who would otherwise qualify for Medicaid except their income is too high. Individuals can either exceed the ABD Medicaid income limit but fall under the Medically Needy limit or exceed the Medically Needy limit and have a spend down for the difference. |
| HAWAII | Yes | Med-QUEST Medically Needy Spenddown Program | https://medquest.hawaii.gov/en/members-applicants/get-started/programs.html | Children under 19, pregnant women, aged, blind, or diabled individulas who incurred medical expenses to qualify for medical assistance but are ineligible for a Medicaid coverage group. |
| IDAHO | ||||
| ILLINOIS | Yes | Family Health Spenddown | https://hfs.illinois.gov/info/brochures-and-forms/brochures/hfs591sp.html | Individuals who would otherwise qualify for Medicaid except their income or assets are too high and have incurred medical expenses above their monthly spend down limit. |
| INDIANA | ||||
| IOWA | Yes | Medically Needy Program | https://hhs.iowa.gov/media/13048/download?inline | Pregnant woman with family income greater than 300% of the federal poverty limit and family resources not more than 10,000. People under 21 if family income is over the income limit for medicaid. Aged, blind, or disabled who would be eligible for Suplemental Security Income except their income or resources are over the limt. Adults who care for children under 18 or 19 and in school and their income or resources are over the medicaid limit. |
| KANSAS | Yes | Medicaid "Spenddown" Program | https://khap.kdhe.ks.gov/kfmam/main.asp?tier1=02000&tier2=02210 | Pregnant women (including 12 months postpartum if met medically needy requirment during pregnancy). Children up to 18. Individuals 65 and older. Disabled and blind under SSA standard. |
| KENTUCKY | Yes | Medicaid-Medically Needy | https://www.chfs.ky.gov/agencies/dms/dpo/epb/Pages/enroll.aspx | Individuals who qualify for Medicaid but their income exceeds the $217 income limit or $2000 resource limit. |
| LOUISIANA | Yes | Medically Needy Program | https://ldh.la.gov/assets/medicaid/MedicaidEligibilityPolicy/H-1000.pdf | Individuls who catigorically are eligible for medicaid but their income is at or above the medically needy income eligibility standards. |
| MAINE | Yes | MaineCare Spend Down or Deductible Program | https://www.maine.gov/dhhs/oms/mainecare-options/older-adults-and-adults-with-disabilities | Adults over 65 and adults with disabilities, who qualify for MaineCare but are over the income or asset limit. |
| MARYLAND | Yes | Medicaid Medically Needy Program | https://health.maryland.gov/mmcp/eligibility/Pages/incomelimits.aspx | Individulas who would ordinarily qualify except for their income greater than the eligibility limit. |
| MASSACHUSETTS | Yes | MassHealth Family Assistance | https://www.mass.gov/files/documents/2016/07/vv/aca-1-english-mb-mh-family-assistance.pdf | Individuals who does not qualify for MassHealth Standard, has an income at or below 300% of the Federal Poverty Level, and is a nonqualified person residing under the color of the law (noncitizen who is lawfully present). |
| MICHIGAN | Yes | MI Choice for long-term care services | https://www.michigan.gov/mdhhs/assistance-programs/medicaid/health-care-programs-eligibility | Individuals under 21, pregnant women, and aged, blind or disabled individuals who otherwise qualify for medicaid but are above the poverty limit. |
| MINNESOTA | Yes | Medical Assistance (MA) with a household deductible | https://hcopub.dhs.state.mn.us/epm/2_2_3_6.htm | Individuals who would otherwise qualify for medicaid but their income is too high. |
| MISSISSIPPI | ||||
| MISSOURI | Yes | MO HealthNet Spend Down Program | https://mydss.mo.gov/spend-down | Individulas who have in income above the limit to qualify for Medicaid and are above the age of 65, blind or disabled. |
| MONTANA | Yes | Montana Medically Needy Program / Medicaid Spend Down | https://medicaidprovider.mt.gov/docs/training/2024Training/MedicaidEligibilityRefresher9.2024.pdf | Children, pregnnat women, and aged, blind or disabled individulas who are catigorically eligible but are over the income limit for Medicaid. |
| NEBRASKA | Yes | Medically Needy Program | https://dhhs.ne.gov/Documents/Share%20of%20Cost%20Brochure.pdf | Individulas who are over the income requirments for medicaid but have medical expenses higher than the difference between their monthly income level and the medically needy income level |
| NEVADA | ||||
| NEW HAMPSHIRE | Yes | Medically Needy Medicaid Assistance (MAM) | https://nheasy.nh.gov/forms/E/77J.pdf | Individuals meeting all requirements for Medicaid coverage but their income is greater than the coverage limit. |
| NEW JERSEY | Yes | Medically Needy Program | https://www.nj.gov/humanservices/dmahs/clients/medicaid/medically_needy_fact_sheet.pdf | Individulas who would qualify for medicaid but their income is greter than the limit but below the medically needy limit. |
| NEW MEXICO | ||||
| NEW YORK | Yes | Medicaid Excess Income Program | https://www.health.ny.gov/health_care/medicaid/excess_income.htm#eligible | Individuals who would otherwise qualify for medicaid but their income is too high. |
| NORTH CAROLINA | Yes | Medicaid Deductible/Spend Down | https://medicaid.ncdhhs.gov/documents/files/basic-medicaid-eligibility-chart-2019-0/open | Individual/family is ineligible for Medicaid due to income over the income limit but may become eligible by meeting a Medicaid deductible. Individuals who are aged, blind, or disabled who have income that exceeds income limit but may become eligible by meeting a deductible. All deducitble cases have a resource limit. |
| NORTH DAKOTA | Yes | Medicaid Client Share (Recipient Liability) | https://www.hhs.nd.gov/sites/www/files/documents/fact-sheet-medicaid-recipient-liability.pdf | Individuals who would ordinarily qualify for Medicaid but their income levels are greater than the limit. |
| OHIO | ||||
| OKLAHOMA | ||||
| OREGON | ||||
| PENNSYLVANIA | Yes | Medically Needy Pathway or "Spend-Down" Program | https://www.pacodeandbulletin.gov/Display/pacode?file=/secure/pacode/data/055/chapter181/s181.42.html&d=reduce | Individulas who are aged, blind or disabled. Individuals between 21 and 65 who are caring for a dependant child. Pregnant women 21 years or older. Parents of a dependant child. Individuals must have an income too high to qualify for traditional Medicaid. |
| *PUERTO RICO | Yes | Medically Needy | https://www.macpac.gov/subtopic/people-with-disabilities/ | Individuals with disabilities who have an income higher than the Medicaid eligibility amount. |
| RHODE ISLAND | Yes | Medically Needy (Medicaid Spend-down) Program | https://eohhs.ri.gov/Consumer/AdultswithSpecialNeeds/Healthcare/AdultswithDD/ABDMPPP/ABDEligibilityPathways.aspx | Individulas who would qualify for Medicaid but their income is above 100% of the federal poverty level. |
| SOUTH CAROLINA | ||||
| SOUTH DAKOTA | ||||
| TENNESSEE | Yes | TennCare Medically Needy Spend Down | https://www.tn.gov/content/dam/tn/tenncare/documents/MedicallyNeedySpendDown.pdf | Individuals who would otherwise qualify for medicaid but their income is too high. |
| TEXAS | Yes | Medically Needy with Spend-Down Program | https://www.hhs.texas.gov/sites/default/files/documents/texas-medicaid-chip-reference-guide-15th-edition.pdf | Families with children 18 years old or younger and pregnant women who do not qualify for traditional Medicaid. |
| UTAH | Yes | Spenddown Program (Medically Needy) | https://medicaid.utah.gov/spenddown-program-medically-needy/ | Individuals who would otherwise qualify for medicaid but their income is too high. |
| VERMONT | Yes | Medically Needy (Medicaid Spend-down) Program | https://info.healthconnect.vermont.gov/compare-plans/medicaid-and-dr-dynasaur/medicaid-spenddowns | Individuals who would otherwise qualify for medicaid but their income is too high. |
| VIRGINIA | Yes | Medically Needy Spenddown Program | https://www.dss.virginia.gov/files/division/bp/medical_assistance/intro_page/more_facts/d032-03-0836-04-eng.pdf | Individuals who would otherwise qualify for medicaid but their income is too high. |
| WASHINGTON | Yes | Washington Apple Health for the Medically Needy and Spenddown | https://www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/apple-health-medically-needy-and-spenddown-overview | Individuals who would otherwise qualify for Medicaid but have in income above the Medicaid eligibility limit and below the Medically Needy limit. |
| WEST VIRGINIA | Yes | Medicaid Spend-Down Program | https://dhhr.wv.gov/bcf/Services/familyassistance/PolicyManual/Documents/Chapter%2016/ch16_4%20.pdf | Individulas who would ordinarily qualify for Medicaid except for their income greater than the eligibility limit. |
| WISCONSIN | Yes | Medicaid Deductible Plan | https://www.forwardhealth.wi.gov/WIPortal/Subsystem/KW/Print.aspx?ia=1&p=1&sa=48&s=6&c=38&nt=Spenddown+to+Meet+Financial+Enrollment+Requirements | Individuals who would otherwise qualify for medicaid but their income is too high. |
| WYOMING | ||||
| GUAM | ||||
| LAST UPDATE | 3/29/2026 |