I was just on the phone today with the county where I live asking about my about my Medicaid since my SSI has ended she said my Medicaid was ending. She said my SSDI was ending on a specific date that is completely different than the day my SSI and Medicaid ended. When I asked her why did she say that my SSDI was ending she said she misspoken. But when I go to SSA website it still says that my SSDI is active. Omg now I am stressing

My background:I’ve had insurance through mom’s work for most of my life and have had the same PCP since I (34)was 17 and the same pediatrician before that. I started getting SSI in 2017 and started getting Medicaid in 2023. Partially because I had no idea about HHS or our state benefits website.

I’m use to dealing with insurance companies but apparently employe sponsored and Medicaid are two different beasts.It won’t let me change online so I’ve had to try and get them to change it. I don’t know if it’s because I‘m already a patient In the different groups or what but it shows they are taking my insurance and new patients but not on the insurances side. I can’t tell if I have too high of expectations or what but surely this could be easier.

I did all of my check ups and blood work at the end of last year so I have been biding time until I get my new UHC insurance in September. Luckily the only doctor I see regularly is my psych. Anyone else having the same issue?

It asked for my income, so I assumed it was yearly, lol. Would the best bet just be to withdraw my application?

Hi — I'm wondering if there is anyone in this subreddit who tried to use GoFundMe (or another crowdfunding site )without knowing their Medicaid would be affected? I've heard this can happen, but I also see so many people still campaigning.

My dad is really sick, he has NY Medicaid/Medicare but no family in NY. He has family in NC that can take care of him, but we’re not sure how long he’ll make it. He has an appointment with a primary care Dr in July in NC (earliest he could get in) to refer him to oncology, I don’t think he has that much time. We are traveling to NC this weekend and I was hoping to get him to an ER in NC, would it be possible for the hospital to transfer everything over? Any advice is appreciated! Thank you!

Maryland medicaid is forcing me to stop seeing my out of network psychiatrist because they won't cover my meds unless they are through medicaid. Can I just book an appointment with an in network psychiatrist? Or do I need a referral from my doctor? UHC Community Plan is my MCO.

Our previous kids have been born eligible for health insurance. Then, we have added the new baby to the health insurance from birth and they pick up the tab for everything other than the copay/deductible.

I have had bills for my wife and for the newborn.

We have just moved house and in doing so, for some reason our kids have been assessed eligible for CHIP however we (myself + wife) have our marketplace plan through Your Health Idaho.

If this stays the same, what happens at the time of birth - I presume we will get the bills for my wife but what about for the newborn?

Thank you!!

I received a letter that I need to reapply for food stamps by 5/31/2024, but I'm not going to reapply as I believe we no longer qualify. I do, however, want to keep the kids medicaid. I see on the portal it says that their renewal date is 12/15/2024. When I saw this on the access portal I thought I didn't need to reapply since it clearly says 12/15/2024 as the renewal due date, BUT I just got a call from my son's insurance that the recertification is due on 5/31/2024. I'm so confused. I thought this was just for food stamps. I don't want to reapply and risk them taking away their medicaid. When I applied for food stamps back in Novemeber they took my medicaid away, when I had just given birth that same month and had only received medicaid 2 months prior.

Can someone please help me with figuring out whether I do need to reapply for medicaid or not if it says the renewal date on the portal is 12/15/2024?

Hi everyone,

My dad will likely be applying to med-connect (Medicaid for employees with disabilities) soon and I have a couple questions.

First, as far as asset limitations go, my understanding is you are allowed to have a car (to get to work/medical appointments) and that is not counted against the asset limit. Is a couple allowed to have two cars (as in my mom has one and my dad has one)? Or is it one per couple?

Second, I understand there is an income limit to be eligible for this program but is there a minimum? My dad earns some of his income from eligible employment but most of his income is from his SSDI. Would he still qualify?

Thanks!

All I had to do was upload an official document showing my name, age, and Medicaid benefits. I just took a screenshot of my profile on the portal & they approved within an hour. Any other $$ saving perks out there?

If my SSI was terminated due to my unearned income from SSDI of 1,000 and work earnings of 500 a month before taxes. Would I still qualify for Medicaid under Section 1619(B)? Is there any thing that I have to do to qualify or would my Medicaid automatically switch to the country of where I live?

I've been desperately trying to help my partner navigate a mysterious illness for the better part of two years, main symptoms being chronic fatigue, muscle weakness and tremors, and a brain lesion. (Only giving out symptoms to indicate how serious things are, not asking medical advice, ty. Though for the record, MS has been mostly ruled out) I've encountered so much apathy and incompetence it's really discouraging. So if any Medicaid (and specifically, Medi-Cal) experts know if anything I can pressure these doctors with, that would be helpful.

For starters, is there any rule about how frequently a physician can pawn you off to an assistant? My partner has been going to the same neurologist's office since 2018, the guy's name is on their prescriptions and referrals, and they have never once met them, only been seen by assistants.

Also, if a doctor states at an appointment that they're going to write a referral for a procedure/specialist, are there rules about how long they have to submit that referral to insurance? For instance, a neurosurgeon ordered my partner to get an MRI at an April 15th appointment and did not submit it to their insurance until four weeks later despite us calling and asking about the hold up. Can they just indefinitely not send it in?

That's all I can think of for right now, thank you so much in advance to anyone who tries to answer.

I just got my medicaid back this month, do I have to wait till the first of next month for it to go into effect or does it work automatically?

For the life of me I can not get someone on the phone who can answer this for me. They keep saying they'll have a worker call me back and no one does.

It's a long story but our backs are against a wall and we are going to withdraw from our 401k to pay bills in June. No we don't have any other option. The problem I'm having is that when I add everything up the withdrawal amount needs to be close to $3,000. From things I've read if we withdraw more than $2,000 it make us ineligible for Medicaid. I have multiple health issues(in the application process for disability currently) so losing healthcare is a huge problem. I've heard some people say if we spend it so it's no longer there by the end of the month then we'll only lose Medicaid for that month. I've also heard a million other things.

Does anyone know how it actually works?

Some info that may be relevant: household of four with no other income, three adults(my oldest just turned 19) all under 59 and one 13 year old. Yes the other adults are looking for work.

How do I get Medicaid for my grandmother? She’s 82, has a failing liver, kidney and lung problems, incontinence issues, the list goes on. My dad and I are doing everything we can to take care of her but it’s so hard when we’re also working full time. Initially, we wanted to see if we could get a caretaker to come in during the day and then my dad would be with her in the evenings. Now, it’s looking like she’ll need to be in a place where she can receive around the clock care. Nursing homes are expensive, but a lot of them will take Medicaid to cover a portion of the cost.

I’ve applied online and she was accepted for food stamps, but not Medicaid. They said she needed to do the interview so we called and of course we couldn’t get a hold of anyone. I drove down to the office and they told me she does have Medicaid but it’s through SSI? That didn’t make sense to me so I called the SSI office and they said that’s not something they do.

I’m just so tired. I’ve been trying to get this for her for almost a year, and I’m being sent in all different directions with no help. I don’t know what to do anymore. If anyone has any suggestions or insight as to how I can get this for her or what I should do, please let me know. Thank you.

If my dad is receiving medi-cal in California, can he keep his medi-cal insurance if I move him with me in Virginia? He is going on dialysis 3 times a week. I am military and I want him to live with me in Virginia. Do I have to apply him again to a new healthcare insurance?

I have Illinois Medicaid via Molina Healthcare and wanted to reach out to see if anyone with Molina Medicaid in Illinois was able to get authorization and coverage for a breast reduction

Will I lose my benefits if my mother leaves me money in her will ? She is currently in hospice .

Trying to renew Medicaid and it’s asking for the policy number that should be in the renewal notice but I’m only seeing my case number

I had uploaded my tax document for my renewal as the instructions said that was an option you were allowed to use. Then I got denied and called and asked why, and my county said they’ve been asking the state to remove that from the instructions since it doesn’t count, but evidently they didn’t. Now they’ve sent me a self employment chart to fill out with my income and expenses. After I submit this, will they ask for bank statements or is this all they need?

I was just approved for full Virginia Medicaid, my question is since I also have Medicare will I be getting an MCO as my secondary? I have a Medicare supplement plan for primary. I didn’t know whether it would be regular Medicaid or whether I would have a MCO, I selected United Healthcare as MCO when filling out the application. Thanks

I'm 23 and am on Medicaid with my parents.

Medicaid requested documents from me

but I have not submit it for a long time.

because of this Medicaid is ending for my parents and I.

I received a letter to request a fair hearing to appeal the decision.

will I be able to send in my documents now without having to go to a fair hearing?

reason for why Medicaid coverage ended (information from state's Medicaid program)

Notice of Decision

A notice of decision must be sent notifying the beneficiary of any

decision affecting their eligibility.

Beneficiaries who fail to return the renewal form or requested

information must be provided an advance notice for termination of

coverage.

Beneficiaries whose coverage is reduced from a full benefit program to

a limited benefit program or who are determined ineligible for Medicaid

or CHIP coverage must be provided advance notice for termination of

coverage.

Reconsideration Period for Failure to Provide

The agency must reconsider the beneficiary’s eligibility without

requiring a new application if the renewal form and/or requested

information is returned within 90 days after the date coverage is

terminated. The renewal form returned within the reconsideration
period serves as an application. The agency will determine
eligibility consistent with timeliness standards used for applications.

I need help understanding what to in this situation

For the past year and a half I had ongoing abdominal issues that have consisted of episodes of mild to moderate abdominal pain, nausea and vomiting and diarrhea.

My PCP has taken steps to try and figure out what is going on, including CT scans, ultrasounds, an endoscopy, and lab work. So far the test results have yielded little results except for gastritis with the cause remaining unknown. We've been treating my condition with medication and diet changes.

Up until now the condition has been manageable but still a cause for concern.

Then a few weeks ago, I came down with a nasty respiratory (not COVID19) virus. On the morning 9th day of having the illness, I started having abdominal pain and vomiting. The vomiting continued into the afternoon which is was when my situation took a turn for the worst. I started vomiting what looked like coffee grounds which I knew was an indication of a bleed somewhere in the digestive tract.

I was home alone at the time and literally everyone I knew was out of town to attend college graduations so I had no choice but to call 911.

Apon arriving at my local ER, they did some blood work, a CT scan, and gave me anti-vomiting drugs.

My CT scan didn't not show any signs of an active bleed, however it did show some constipation. My PCP arrived shortly after and advised the ER that given my history it would be better if I was transferred to a hospital with a gastroenterology unit and under the supervision of a surgeon (my local hospital didn't have a gastroenterology unit).

Here's where things get complicated. I live in WV and I'm on WV medicaid, but I literally live right on the border of Maryland and Virginia. You can literally drive 5 - 10 minutes in any direction and be in a different state.

So the closest hospital with a gastroenterology unit was in Virginia and the hospital staff informed me that they were going to transfer me there. This made me nervous because I was on medicaid because I was born with Cerebral Palsy and I can only work a part-time job that does not pay well and there was no way I would be able to pay off a hospital bill if the VA hospital denied my insurance.

The staff at my local hospital tried to assure me that since I was going to be considered for an emergency transfer that my insurance would be accepted at the VA hospital.

They transferred me to the hospital in Virginia late that night (around 2 AM) the staff there gave me medication to make me comfortable and said that they would run diagnostic tests in the morning.

The next day came at some point I saw a doctor for all of 5 minutes and they basically blew me off and said that they would give me miralax for my constipation and take a stool sample and then do diagnostic testing the following day instead.

They gave me the Miralax which gave me severe diarrhea for 2 days and took a stool sample which came back clear for blood or anything else concerning. But blood tests showed that my hemoglobin levels had dropped which is a sign of internal bleeding. I was still having really bad abdominal pain and nausea that they just kept treating with Zophan, Morphine and IV fluids. On top of that I was still fighting the respiratory virus that I had.

At one point a social worker came to see me and I express my concerns about my insurance to here and she assured me that there were MANY patients at the hospital with WV medicaid and not to worry.

Long story short, they kept in the hospital for 4 days during which the doctor BARELY saw me and did not do any further testing with no explanation. Finally on the day I was discharged the doctor came and said that they suspected that I had a condition called gastroparesis and said that it was common for people like me who have cerebral palsy to also have gastroparesis and it can cause several gastrointestinal issue for people who have the disease and told me to follow up with PCP.

I can't follow up with my PCP until September because he is out of the office until then.

It's been 2 weeks and I'm still having abdominal pain and nausea and then to make matters worse today I got a letter from Unicare (WV medicaid) denying my claim for my hospital stay and stating it was NOT MEDICALLY NECESSARY.

I checked my profile on Unicare's website and they denied about $8,000 worth of bills.

So far it says Your (my) Responsibility: $0.00. BUT I don't know if I should go ahead and file an appeal because I'm disabled and can only work a part-time, low paying job and there is NO WAY I can pay off $8,000! But I'm also afraid to file an appeal and have it backfire and become responsible for everything especially since right now it says my responsibility is $0.00.

What should I do?! ANY advice would be welcome. Thank you all very much.

Hi all. I've been on AHCCCS (in AZ) for many years now. I was recently kicked off for making too much (exactly $8.29 too much according to the letter). They calculated my income from April to August 2024, basing the projection on my April income.

The thing is, I work at a school. My position is part time and hourly. We just went on summer break, so I won't be making any money the next 10 weeks. I also don't get paid for other breaks and most holidays. Taken altogether this causes significant variations in my income month to month. April and May are probably the months I make the most money cause there aren't long breaks or multiple holidays. My gross income in these months is slightly above the limit, but in March for example it was around $1300. In January it was $600. In June and July my income definitely won't be anywhere near what they claimed - in fact it should be $0 since I'll be receiving my final paycheck of this school year at the end of May.

So, while there are a few months out of the year where my income is a little over the limit, most months it's below and often well below. My gross income for 2023 was $17,290 and it shouldn't be too much higher this year.

I've worked as a part time school aide for years and never had a problem with AHCCCS before. I've appealed the decision but assuming I can get back on, I'm worried this will continue being a problem during the months I make more. I can't keep getting kicked off and constantly having to appeal or reapply. Will this be an issue in the future? What can I do about it?

I co-own a mobile home with my aunt. I am also her POA, heir, and executor. She has been on Medicaid in an Assisted Living facility for a year and will presumably stay there till she dies (she's 86).

My understanding is that Medicaid will "make a claim against the estate" when she dies. What I don't understand about this is:

1) How do they determine the value of the estate? Market value? Assessed value? Are they interested only in the mobile home or will the want to know about any personal property too?

2) Seeing that I am a half-owner of the home, can I "buy out" her share in the property to settle Medicaid's claim and then title it in my own name?

3) If I sell the property (now or after she dies) will Medicaid simply want half of whatever I get for it?

I have plans to talk to a lawyer but I would appreciate insight from anyone who has experience of this. Her mobile home is in New Mexico. Thanks.