Updated August 27, 2026. Quick answer: Washington gives the applicant the choice, in the rule: “A person who applies for Washington apple health (WAH) and is eligible for medically needy (MN) coverage with a spenddown may choose a three-month or a six-month base period.” That choice changes the size of the obligation, because “A base period is a time period used to compute the spenddown liability amount.”
What Washington requires
| What the state sets out | What it says |
|---|---|
| Washington’s name for it | spenddown (WAC 182-519-0110) |
| The rule title | “Spenddown of excess income for the medically needy program.” |
| The choice | “A person who applies for Washington apple health (WAH) and is eligible for medically needy (MN) coverage with a spenddown may choose a three-month or a six-month base period.” |
| What a base period is | “A base period is a time period used to compute the spenddown liability amount.” |
| Consecutive months | “The months must be consecutive calendar months” |
| Retroactive base period | “A person may request a separate base period to cover up to three calendar months immediately before the month of application. This is called a retroactive base period.” |
How it works in practice
- Three months versus six is a real decision. A shorter base period means a smaller total to meet but a sooner repeat; a longer one means a larger single obligation but a longer certification.
- The retroactive base period is separate and can be requested for up to three calendar months before the month of application — old bills from that window are what usually fill it.
- Months must normally be consecutive, and the rule then lists the specific circumstances in which a base period may vary from that.
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 Washington.
See how the income side fits the rest of the money
Where income sits relative to a state limit changes what happens to savings, to a spouse’s position and to the order things are best done in, and an adviser can look at the whole picture rather than one rule at a time.
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What this page does not settle
- This is the mechanics rule. The medically needy income level that produces the excess is set elsewhere in the WAC and is not reproduced here.
- This page reads one source: WAC 182-519-0110, Spenddown of excess income for the medically needy program. 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.
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.
This page covers what happens to income above the eligibility standard. What Washington actually uses as that standard, and the state document it comes from, is on Medicaid nursing home income limit in Washington ($2,982/Month).
Related: Washington’s Medicaid home equity limit for a single applicant with no spouse or dependent child at home.
Related: Washington’s Medicaid Personal Needs Allowance; the amount a nursing-facility resident keeps from their own income each month.