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Second Wind Lung Transplant Association

Medicaid Coverage

Medicaid often provides coverage for outpatient medications. There are several ways to become eligible for Medicaid benefits.

There are two possible categories of need under the Medicaid program.

  1. Categorically Needy – Individuals who fall below the income and resource level designed as the “poverty line” by their state must be covered by Medicaid for their health care, assuming all other eligibility criteria are met.
  2. Medically Needy (Spend Down) – In some states, individuals who are above the income and resource level designated as the “poverty line” may be eligible for Medicaid through the medically needy program. States that offer the program, allow individuals to “spend down” their excess income (but not resources) to the “poverty line” over time. The spend down, is like a deductible. It is the process of using medical expenses to reduce the income of an individual to the level of eligibility for Medicaid.