[Code of Federal Regulations] [Title 45, Volume 2] [Revised as of October 1, 2006] From the U.S. Government Printing Office via GPO Access [CITE: 45CFR400.91] [Page 364] TITLE 45--PUBLIC WELFARE CHAPTER IV--OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PART 400_REFUGEE RESETTLEMENT PROGRAM--Table of Contents Subpart G_Refugee Medical Assistance Sec. 400.91 Definitions. For purposes of this subpart-- Medically needy means individuals who are eligible for medical assistance under a State's approved Medicaid State plan in accordance with section 1902(a)(10)(C) of the Social Security Act. Spend down means to deduct from countable income incurred medical expenses, thereby lowering the amount of countable income to a level that meets financial eligibility requirements in accordance with 42 CFR 435.831 (or, as applicable to Guam, the Virgin Islands, and Puerto Rico, 42 CFR 436.831). Applications, Determinations of Eligibility, and Furnishing Assistance