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> When you hear about a “Medicaid spend-down”, it’s all about reducing an elderly persons assets so that the state sees them as poor and Medicaid will pay their Long Term Care (nursing home) expenses.

Correct.

> Medicare has almost nothing to do with the Medicaid spend-down strategy that I know of.

Basically. Medicaid will pay Medicare premiums for dual-eligible beneficiaries, and many states have special coverage plans for the dual-eligible population, so there is a Medicare-related impact of the spend-down, but it has nothing to do with exhausting Medicare lifetime benefit limits (which do not exist, also, under the ACA, do not exist for other insurance, either.)



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