After you "spend down", will you be eligible for Medicaid to pay the premium for your Medicare Part B policy? I don't know a lot about this situation - I have a couple of acquaintances who have been on disability since their teens. The have both Medicare and Medicaid, and Medicaid pays their Medicare Part B premiums.

It may vary from state to state whether Medicaid will do that. Also, I think their income is just below the poverty line, not just above it.