What does it mean when a patients balance is SPENDDOWN UNMET when having medical insurance??

Question

what does this mean for a account balance to say that????

Answer 1

It means in order for the insurance to cover care a certain amount must have been paid by the patient - it is just like a deductible.  Usually the term is used when the insurance is related to income.

Let's assume a person has a $200 spenddown.  That means they must spend the first $200 for covered medical supplies, drugs or services (usually each month) then the insurance will pay the balance.

Senior citizens on home care frequently have a little too much income to qualify for assistance, but they need the service, so they have to "spenddown."

If you think this is an error, contact the insurance company, provider of service (who may not have reflected payments properly) or the social worker if one is involved.