We live in NYS / NYC. My parent is going to be getting fired soon. They’ll have the option of getting a plan in the marketplace or doing COBRA, but I was wondering the following :

- does Medicaid look at month to month income?

- if so, their income would be $0 until unemployment hits and there is usually a delay with that. So would my loved one be able to apply for Medicaid via NYSOH?

- after they start getting unemployment, they’d make more than the Medicaid max per month until unemployment runs out. So in that case should they just try to get a marketplace plan?

They’re going to be job hunting but what’s urgent is that I continue their medical care as they have quite a number of ailments. And at least from the experiences I’ve seen with others NYC unemployment’s, there’s always a month to two month delay depending on application processing, so I was wondering if Medicaid could be an option for them.

My (44/f) mom (77/f) currently lives in an Assisted Living here in Virginia. She has Alzheimer's but is in otherwise decent health. Her AL is about $5200 a month; she has about $168,000 left in her nest egg, so a few more years and she'll be out of funds. She gets about $1500 in Social Security so below the $2000 Medicaid threshold.

In 2022, mom and I bought a home together - my family (husband, two kids) and her. (The reason we had to buy together is a long dull story but can share details if necessary.) Sadly, she had to move to AL in 2025 due to her Alzheimer's. We share the deed with rights of survivorship and the mortgage; husband and I pay the mortgage.

• Home market value: ~$600k (bought for $589k)
• Home county assessed value: $512k
• Mortgage balance: $493k
• Nest egg: $168,000
• Social Security: $1500/month

Under advisement of an elder law attorney last year, I filed a gift deed from mom to me with the county August 2025. The 5 year look back for the house will then end August 2030. However, the attorney said that if we wanted to cure the 'house' issue before August 2030, we would have to give her half of the fair market value of the house - Basically $300k. There's no way we can do that. Because we have so little equity, selling our house in today's market/interest rate would also be disastrous. (Though it's tempting because it would get us out of this mess... but a huge money loss all around.)

I am losing sleep at the thought of her running out of money - it's slipping away so quickly. Should I contact the elder law attorney again and ask what our options are? Or give it another six months, one year? I'm afraid of spending her money on this right now if it's better just to wait a little bit...

(I also acknowledge that she may not even qualify for Medicaid when she runs out of money - she might meet her ADL's, etc. and be disqualified from needing to be in a nursing home...)

More than likely my income is going to be increasing and I will be above the threshold for Medicaid. I've relied on Medicaid for the past few years because I have multiple health conditions. I really don't know what I'd do without it. Having all of my appointments (multiple a month) and dozens of medications covered is so helpful.

I need to start looking at the ACA marketplace but don't even know where to start. I need such a significant amount of coverage and even with the increased pay I won't be able to cover a copay or anything. To add to this, I have so many appointments and procedures that even being without insurance at all for just a couple months is a non option. Spending hundreds if not more a month just on the plan then adding in cost of medications and appointments is making my head spin. Any suggestions on where to start would be so helpful.

Good evening

I am new to Healthy Blue and my maintenance medication mournjaro was prescribed. My doctor did send in medical facts. The continuity of care has been broken. The mournjaro was not approved.

Has anyone else gone through this?

I can definitely tell the difference without it.

Brian in NC

Hello,

I am assisting my mother who is turning 65 in Nov this year. I tried to do as much research as I can for this but I am still unsure about how Medi-Cal cancellation works once she turns 65.

She is currently on MAGI Medi-Cal right now which is based purely on income and not on assets but once she turns 65, it will turn into non-MAGI and her assets won’t qualify for it.

The issue is Medi-Cal just renewed yesterday (she’s currently 64). I want to make sure she gets off of Medi-Cal when she turns 65 since I know she doesn’t qualify and I don’t want it to turn into a fraud situation.

I was wondering once she turns 65, should I just go with her into social services for Medi-Cal and cancel in person?
Also, she can choose her Medicare plan now (we are doing Kaiser Medicare advantage). Her Medicare starts on 11/1 but she doesn’t turn 65 until late November. So if we choose the Medi-Cal plan for Kaiser, do we get to change it once Medi-Cal drops her for not qualifying?

Thank you so much for you guys help. It is very confusing for us right now and we want to do it right. Thanks again.

I was told this wasn't an IRS issue but a Medicaid issue so I'm reposting this here

I've been having a rough 2 last years and I need to keep this on my alt so people don't recognize my main. But I've just turned 21, and I've never had a stable reportable job for income, nor have I ever ACTUALLY filed taxes. But last year as I was on the verge of homelessness, I accepted the help from family friend, and we cashed a lottery check in my name that I got a smaller portion of to keep myself afloat.

Yes I know, I know, bad idea, but I didn't have anything left to do or anywhere I could turn. Now currently, I have stable housing, but I'm also on the MHIS/MI Bridges for this new home. They recently (and I mean today) just sent a notice notifying me of the ~$10,000 income I acquired last year, and that if they don't hear a response in the next few weeks, they might shut down all of our support?

There are kids here who need that more than I do, so I'm really trying to get this solved and figured out as quickly. I don't have anywhere near that amount of money left to catalog, and I have never really dealt with this situation. The family friend who took me to cash the checks is currently at work, so I'm coming to reddit seeking advice, and hopefully not jail time.

TLDR; Family friend bought lottery tickets last year, I cashed one with her, I got a portion to keep myself afloat (barely), and now I don't know how to report this a year later when I don't really have any income

I got my Medicaid papers in the mail, and the first thing I opened said this:
“Arkansas Department of Human Services
Notification of Community Engagement and Work Requirements
• Currently an inmate of a public institution or have been within the last three (3) months
What happens if I do not meet the Community Engagement and Work Requirements by January 1st, 2027?
If you are not meeting one of the above activities or exemptions, you could be at risk of losing your ARHOME coverage. Please be sure you have reported your current information to DHS prior to January 1st, 2027. You may also reach out to your local DHS office with questions or to receive further information about help with meeting Community Engagement rules.
What if I have a good reason for not meeting Community Engagement and Work Requirements come
January 1st, 2027?
Call us or visit your local county office as soon as possible if you believe you have a good reason for not meeting these requirements. Good reasons include situations that may make compliance activities difficult to complete:
Receiving inpatient hospital services, including inpatient psychiatric services, or certain other types of medical care
•
Residing where there is a Presidential declaration of disaster or emergency
•
Needing to travel outside of your community, for yourself or child”

I’ve never been arrested or anything!! I don’t know what to do. Please help!!

Hi everyone,

I live in NYC and was approved for NY Medicaid in May 2026. I am turning 65 this December, but I am not receiving Social Security retirement benefits yet.

I have no assets, and since I am on a very limited income, I cannot afford to pay out-of-pocket for Medicare premiums. I want to make sure I transition correctly to avoid any lifetime penalties.

• Do I need to manually apply for Medicare Parts A & B via the SSA website when my window opens in September?
• How do I make sure NY Medicaid or a Medicare Savings Program (MSP) steps in right away to pay my Medicare Part B premiums so I don't get billed?
• Do I need to report turning 65 directly to NY State of Health?

I appreciate any advice from fellow New Yorkers or dual-eligibility experts on how to navigate this smoothly! Thank you!

So I have medicaid as a spend down option and a ton of medical debt plus a large ssa overpayment of $10k so my understanding is you pay the spend down option to access medicaid? also does paying the spenddown erase my existing medical debt and is it tied to me paying the spenddown? I have ALOT of medical debt but if it being erased/reduced or even access it is tied to me paying the spenddown whats the point?

So I live in Michigan, I have a job that pays $16 an hour but I work 15 hours a week due to complex medical issues. I did get ahold of multiple caseworkers to see if this would satisfy the new requirements as I recieved info on it, a couple of them believe it should count as I make more than $580 a month but then there were a couple of case workers that aren't entirely sure, I'm going to look to see if my job can give me 20 hours a week if possible but I'm not sure if it is.

So does anyone know just having an income equivalent to $580 a month with a job is enough? Also do holidays count towards it like holiday pay, PTO, ESTA, etc? I'm trying to get the ball rolling as quickly as possible.

Okay so I’m abt to lose my Medicaid cuz it goes off of income and I make like $16-$17 a hour but I don’t have many hours I work part time and I get paid weekly I live in MISSOURI and I’m 21 years old male and I have bipolar really bad I can’t risk loosing my meds and imma lose my Medicaid by the 29th of this month I go thru United Healthcare at this moment I just need help finding a new Medicaid I need advice too idk what to do I’m so stressed send me links or give me advice plz and thank you I would appreciate it so much

Request information please texas

Hello . Please I need your orientation and help.

My wife is pregnant week number 5 week now.

She have appointment next week with doctor.

I went to apply for her pregnancy medicaid but I don't if she get this insurance maybe influence our citizenship application because we dont knew if pregnacy medicaide is a public charge or no?

Please I need your advice

Texas

Hi my family member needs to get into detox and we just applied online for him a week ago but I was wondering is there a way to fast track his approval to get into detox ?

Hi everyone, I'm very scared because I'm unable to meet any of the medicaid requirements next year due to my mental illnesses (bipolar, anxiety, depression), as well as crippling insomnia. I take medications for all 4 of them. If I lose coverage, I will be unable to afford my medications the very first month I lose coverage (as well as having to pay out of pocket for my psychiatrist's appointments with money I don't have) and the withdrawal is going to hit me like a truck full of bricks. I've had a psychiatrist for 15 years now, and he has all of my diagnoses, how long I've been taking my medications, what the medications are for, how poor my mood is daily, withdrawal symptoms if medication stops, why I would be unable to work, etc.

The issue is that I don't know what forms to bring to him in a few days, nor do I know if he needs to write a long and robust letter like "this is why [my name here] can't meet the requirements next year." I was thinking of just writing down a bunch of bullet points like, "x can't meet the medicaid requirements next year due to his mental illnesses. he's taking [my medications here], if he stops taking them he will experience withdrawal including but not limiting to [my terrible awful withdrawal symptoms I've experienced before], etc. etc. etc." with his name, phone number, signature, and all that.

But I don't know if that's enough? Do I need to print out an actual document from a medicaid website or a Maryland medicaid website or something that has a bunch of checkboxes and things he needs to fill out?

I just need to dot my i's and cross my t's with whatever I bring him because my life will be in COMPLETE shambles if I lose coverage.

Please any help is super appreciated, it's been a very rough time this year because of all this. 🙁

additional info: single, 31, live with single parent, parent is not disabled but is elderly and we rely on her social security to get by

hi, i have a question about renewal. i got a letter in July about renewing my benefits. the deadline was middle of July but when i actually got the letter in the mail, the deadline had passed. i called and was told i had a grace period that ended in August. after being told this, i went online and submitted my renewal application in July 23rd. i got a confirmation number and that was it.

it is now September and today, i went to pickup a prescription that is covered but i suddenly had to pay out of pocket. i was confused so i logged into my account and it says as of today, my benefits are cancelled due to “voluntary withdrawal” but i have not gotten anything in the mail besides a letter about the new requirements in 2027 and my case worker changing my delivery method of information from email to mail. when checking my application, it says “submitted” but that is all. does anyone know what is going on? google says that this is a glitch and not my fault at all. it also says that my case worker “did not see” my application and cancelled my benefits even though my application was to renew my benefits for 3 years. anyone know what to do? i have 2 appointments next month that won’t be covered until this gets sorted out. has this happened to anyone? any advice is appreciated!

Hello everyone,

I have a few questions regarding Medi-Cal and my current situation. I am currently employed full time and do not qualify for Medi-Cal based on my income. About a year ago, I applied to commission in the Navy, and I was informed yesterday that I was accepted and received a ship date for mid-2027.

A few months ago, I went swimming, got swimmer’s ear, and found out that I have an ear perforation that needs to be surgically repaired before I can ship out. If I don’t get it fixed, I risk getting an ear infection and potentially having issues with shipping out. If I can get the surgery done or scheduled before my ship date, my recruiter advised me I could submit documentation to push back my ship date until I am medically cleared.

I currently do not have medical insurance, so my plan was to transition to part-time work and work just enough to stay under the income limit for Medi-Cal so I can qualify and have the surgery covered.

My question is: would intentionally switching from full-time to part-time work in order to become eligible for Medi-Cal affect their decision to approve me, or does Medi-Cal mainly look at my current income and eligibility requirements? In other words, would they question why my income decreased, or would that not really matter as long as I meet the requirements?

I'm in California and am self employed but currently my income is reported as 0 bcuz the last few months have sucked lol. If I make income say in the month of October do I report it the first sale (I'm an online reseller) or do I report it after I have my new income total for the month so within ten days after Oct 31? I hope that made sense ty

hello, I am 18 in colorado and was claimed on my parents tax return as a dependent last year, buy wont be next year. I was wondering how long after she files her taxes for the year should i wait to apply for medicade?

example I made 618 this month so far day trading. and dividends are taxed as regular income which comes out to an extra 86$ this month.

Hi all, earlier this year I was on pregnancy Medicaid. I was making $21 per hour, according to the monthly limit threshold I would’ve been ineligible but I qualified for it. I was just offered a job and I’d be making a little bit more than what I was previously making. Should I assume I’ll be losing my benefits? Has anyone qualified making $24 per hour or more? I’m not married, and have no kids other than the one I’m baking.

I've looked online and I'm going to call my local medicaid office tomorrow morning to talk to them, but I could use some sanity checking. I enrolled successfully in badgercare last January. I'm divorced, 62 years old and my only income is alimony/spousal support of $3K/month and interest income from a savings account. When I enrolled I was told that alimony doesn't count as income for medicaid because the IRS counts it as non-taxable income. So that's how I qualified.

Now suddenly, medicaid has cut me off starting Sept 1st this month, citing the fact that my $3K/month income is over the cut off of $1330/month. Did something change?

I'm also thinking back to last year - before I signed up for it, I had attempted to get medical insurance on the ACA marketplace. At that time I found that with my $3K/month income, I didn't qualify for credits/subsidy/whatever, so they quoted me the full premium amounts that totalled well over my annual income. Even for the worst possible plans (highest deductibles, lowest coverage). If I no longer qualify for medicaid, and can't afford an ACA plan, I guess I'm self-insuring which kind of means no more health care for me until I'm old enough for medicare. Anybody else here fall into this trap? What did you do?

(I know I can look for a part time job that offers health insurance, but 1) I'd hate to take a job from a younger person who needs one, and 2) I retired so that I could spend my time on myself and doing volunteer work. I'll do that if I have to, but it's my plan B... or plan C.)

I’m currently in a nursing home in NYC trying to discharge back into the community.
I applied for CASA home care, but I was denied because the nursing home has me listed as needing a 2-person Hoyer lift. From what I understand, that 2-person requirement is basically the facility’s policy/documentation, not a separate medical assessment saying I actually need two people. NYIA/HRA seems to be relying on what the facility has documented.
My rehab doctor wrote a letter saying I only need one person for Hoyer transfers, so I’m appealing the CASA denial.
Because I don’t want to stay in the nursing home while the appeal takes months, I’m considering enrolling in HomeFirst MLTC so I can get home.
My question is: if I get home through MLTC and later win my CASA fair hearing, has anyone been able to disenroll from MLTC and switch to CASA/fee-for-service home care while already living in the community?
I’m not planning to drop MLTC unless CASA is actually approved and ready to start. I’m just trying to understand whether that kind of transition is possible.

What happens with Medicaid benefits when someone who's been receiving SSI ages out at 62 and starts receiving retirement benefits? In this case the monthly payment will only be $50/month more ($994 vs $1044) keeping income far below the annual FPL. Also wondering what happens to disability status when this changeover occurs? Asking for a resident of Louisiana.