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us medicaid spend down

us_medicaid_spend_down
Read-only

US nursing-home Medicaid, 2026: savings above the state asset limit (the spend-down), what a spouse at home keeps (CSRA $32,532-$162,660 by the state rule) and their monthly income allowance (MMMNA $2,705-$4,066.50), months the savings pay for care, the look-back penalty (gifts ÷ the state penalty divisor, part months kept), the month Medicaid starts and what the person pays on Medicaid (income less the personal needs allowance, spouse allowance and premiums). State figures are each state’s own (marked official or check); where a state figure was not found, the result says so and the caller can pass it.

Tool call template

Replace each placeholder with a value matching the input schema. Only required parameters are included; add optional parameters as needed.

{
  "id": 1,
  "jsonrpc": "2.0",
  "method": "tools/call",
  "params": {
    "arguments": {
      "state": "<state>",
      "assets": "<assets>",
      "incomeMonthly": "<incomeMonthly>"
    },
    "name": "us_medicaid_spend_down"
  }
}

Input Schema

NameRequiredDescriptionDefault
stateYesTwo-letter state code
assetsYesCountable savings and investments, USD (a couple: both together; not the home)
waiverNoA Medicaid waiver pays for assisted living or home care
marriedNoA spouse still lives at home
careTypeNoType of care
assetLimitNoState asset limit, if known (overrides ours)
costMonthlyNoNursing home cost a month, USD (default: the state’s penalty divisor)
incomeMonthlyYesThe person’s gross income a month, USD
penaltyDivisorNoState penalty divisor a month, if known (overrides ours)
giftsInLookbackNoGifts or below-value transfers in the look-back, USD
premiumsMonthlyNoHealth insurance premiums a month
spouseIncomeMonthlyNoSpouse’s own income a month
spouseShelterMonthlyNoSpouse’s housing costs a month

Schema Changelog

Changes observed during successful MCP inspections.

  1. Added

TDQS

A3.8/5.0
Behavior3/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

With readOnlyHint and openWorldHint already declared, the description adds genuine context: state figures are tagged official versus check, and when a state value is absent the result says so and the caller can pass their own. That provenance and fallback disclosure is the kind of thing annotations cannot carry. It stops short of describing result shape or ordering of the derived figures, so a 3 rather than higher.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness3/5

Is the description appropriately sized, front-loaded, and free of redundancy?

The purpose is front-loaded, but the whole definition is a single run-on sentence stitched together with parentheticals and commas, which makes it hard to scan for the parameter that matters. Every clause carries information, yet restructuring into discrete statements about inputs, outputs and state-figure caveats would cost nothing in length.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness4/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

For a 13-parameter tool with no output schema, the description does the necessary work by enumerating the computed results (spend-down amount, CSRA, MMMNA, months of care, penalty, start month, patient pay) so the caller knows what comes back. It also handles the missing-state-data case explicitly. What is left implicit is how waiver, careType and married interact with the asset limit and penalty inputs.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters4/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema coverage is already 100%, so the baseline is 3, but the description earns more by explaining how inputs feed outputs: gifts divided by the state penalty divisor with part months kept, and patient pay as income less personal needs, spouse allowance and premiums. It also pins down what 'savings' means (a couple's combined countable assets, excluding the home), which sharpens the assets parameter beyond its schema text.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose5/5

Does the description clearly state what the tool does and how it differs from similar tools?

The description names a specific program and outcome set: nursing-home Medicaid spend-down, CSRA, MMMNA, months of care covered, look-back penalty, Medicaid start month and patient pay. That is a concrete verb-and-resource statement no sibling in the list shares, so an agent can distinguish it from uk_care_home_fees or the can_i_retire tools on jurisdiction and program alone.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines3/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

Usage is only implied by the domain ('US nursing-home Medicaid, 2026'); there is no explicit when-to-use, when-not-to-use, or named alternative among siblings. The one routing hint given is that callers may supply a state figure themselves where ours is missing, which is useful but is a fallback rule rather than selection guidance.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

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