Updated August 27, 2026. Quick answer: Illinois runs spenddown under the MANG rules, and long-term care gets its own clock: “A one month eligibility period is used for persons receiving long-term care services”. Income and excess resources are then “Nonexempt income and nonexempt resources over the resource disregard are applied toward the cost of care on a monthly basis”.
What Illinois requires
| What the state sets out | What it says |
|---|---|
| Illinois’s name for it | spenddown, under MANG (89 Ill. Adm. Code 120) |
| The AABD rule | For AABD MANG, if a person’s countable nonexempt income is greater than the applicable MANG standard and/or countable nonexempt resources are over the applicable resource disregard, the person must meet the spenddown obligation determined for the applicable time period before becoming eligible to receive medical assistance. |
| Long-term care period | “A one month eligibility period is used for persons receiving long-term care services” |
| What happens to the money | “Nonexempt income and nonexempt resources over the resource disregard are applied toward the cost of care on a monthly basis” |
| Resources have their own section | “Section 120.384 Spenddown of Resources” |
| Where the standard lives | “Section 120.20 MANG(AABD) Income Standard” |
How it works in practice
- Illinois is one of the states where excess resources can also be spent down, under a separate section of the same Part. That is not true everywhere — the District, for one, excludes over-resource applicants from spend down entirely.
- For long-term care the monthly figure is the cost-of-care contribution, not a deductible to clear before coverage. Income over the standard is applied toward the cost of care each month.
- The AABD rule triggers on either test: countable income over the MANG standard or resources over the disregard put a person into a spenddown obligation.
The mechanism itself — why an income cap exists and what the trust must contain — is explained on the income-cap and Miller trust page. This page is the record for Illinois.
Optional next step
Want help with Medicaid planning?
Ask an adviser how this rule fits your family’s plan for long-term care costs.
- No fee to request a match
- No obligation to hire
Expect questions about your situation, your name, email and phone, and phone verification by text. A match is not guaranteed.
The form is run by Kapitalwise, our advisor-matching partner. Kapitalwise sends your details to advisers who pay for the introduction, so expect calls and texts. Clear Money Guide is paid when you submit the form, whether or not you ever hire anyone. This is free to you and there is no obligation to hire anyone.
Opens here. Nothing loads and nothing reaches Kapitalwise until you press the button.
How our partner relationships workWhat this page does not settle
- This page reads the administrative code, which sets the mechanics. The MANG dollar standards live in Sections 120.20 and 120.30 and are not reproduced here.
- This page reads one source: 89 Ill. Adm. Code 120, Medical Assistance Programs. It is the state’s own publication on this rule, but no state puts its whole treatment of excess income in a single document, and a detail that decides your case may sit in one this page did not read.
- A spend-down fixes an income problem and nothing else. The resource test, the level-of-care test and the transfer-of-assets look-back are separate hurdles, each decided on your own file, and meeting this rule does not clear any of them.
- Every quotation here was read against the source on August 27, 2026. States revise these rules, and a figure or a section number can move without the page around it changing. Open the source before you rely on a detail.
Eligibility is decided by the state agency on the whole file, not by one rule on one page. Nothing here is legal advice, and no one should move, retitle or assign income on the strength of a web page.
Figures verified against 89 Ill. Adm. Code 120 (ilga.gov JCAR) on September 29, 2026; the comparison to the District of Columbia was not re-checked.
Sources
The source above was retrieved and read against the state text on August 27, 2026. Every quotation on this page was checked against those bytes.
Spending down to the income limit is only half of what Illinois Medicaid can do for a household that is already providing the care itself, and getting paid as a family caregiver in Illinois names the Illinois program that pays one and answers the family-member and the spouse question separately.
This page covers what happens to income above the eligibility standard. What Illinois actually uses as that standard, and the state document it comes from, is on Medicaid nursing home income limit in Illinois ($1,330/Month).
Related: Illinois’s Medicaid home equity limit for a single applicant with no spouse or dependent child at home.
Related: Illinois’s Medicaid Personal Needs Allowance; the amount a nursing-facility resident keeps from their own income each month.
Related: use the Medicaid spend-down calculator to estimate how much you would need to spend down to qualify for long-term-care Medicaid in your state.