If you need to go into a long-term care facility, such as a nursing home, in West Virginia, one of the biggest obstacles is usually affording the cost. This type of living situation is quite expensive, and many seniors cannot afford it without the help of insurance. Medicaid is a common choice, as it provides the best coverage option. However, this program is income-based, so you may have to make adjustments to qualify. 

Medicaid spend down is the process you will use to get your income to the qualifying level, according to U.S. News and World Report. If you have too much income, you will need to spend the excess income to meet Medicaid requirements. Typically, what happens is you will apply for benefits and then receive a notice that you must spend down to be eligible. 

The notice 

If you get a notice, you must spend your excess income to reach the right income level or else face penalties. If you fail to spend down enough, the state can penalize you for several months. During those months, you cannot get Medicaid coverage, and you will have to cover all your medical expenses on your own. 

Spending down 

The most common way to spend down is to pay medical bills. You will generally know how much you need to spend each month, so you can set that aside to pay past due bills or for your current healthcare needs. The important thing is that you spend it and keep the receipts. Medicaid will insist on verification of how you spent the money. 

You may also have to get rid of some assets. As a single person, you may have $2,000 in assets. If you have more than that, you will need to either sell or transfer them to someone else. Do note that many assets will not count for Medicaid purposes. This may include your home and vehicle. 

Qualifying for Medicaid is often the only way you can afford long-term care. This program is incredibly helpful but does require being cautious about your income and assets.