Medically Needy Program, Utah Medicaid. The "Spenddown" Program. 

Some people applying for Medicaid meet all conditions to qualify, except their monthly income is more than the Medicaid limit. In this case, the eligibility worker will determine if the person can qualify for the Medicaid Medically Needy program. The program is also referred to as the “spenddown” program. Not all Medicaid programs allow spenddown.

To qualify for Medicaid, the person agrees to “spend down” his or her monthly income to the Medicaid income standard. The person has a choice of how to pay the amount above the Medicaid income limit. The person may choose to either pay “excess” monthly income to the state or to pay a medical provider for one or more medical bills. The client signs a Medicaid form that states the amount owed. Then the medical provider is notified of the patient’s agreement to pay medical bills.

See also, Utah Medicaid Provider Manual, SECTION 1, Chapter 6 - 8, Exceptions to Prohibition on Billing Patients, item 2.