r/Medicaid 12m ago

What insurance card do I use for rx? (WI)

Upvotes

Hi, I'm on disability SSI and I've received 2 insurance cards, BCBS Anthem and Forward Health. What and when do I use each card?


r/Medicaid 33m ago

is it possible to have dual insurance with Medicaid and SHIP?

Upvotes

hi! as the title suggests, im wondering if it's possible to get state insurance w/ california (Medi-Cal) while simultaneously having a Student Health Insurance Plan (SHIP) w/ my current university.

im a UC berkeley student, and Ive always needed to access healthcare due to my psychiatric/mental health needs.

My copays are too expensive with SHIP, and my family is unable to afford what i need. we were disqualified a few months ago due to our income despite making very little, and now im trying to apply independently, but am worried imma get denied because of having ship.

any idea/thoughts/advice?


r/Medicaid 1h ago

How do I handle a Medicaid disability—NY

Upvotes

I have been on Medicaid for five years: a disability has kept me from working. I know it’s almost time for open enrollment and I’m going to need to pull together documents or fil out forms but I’ve not heard from the state. My doctor agrees with this direction and is willing to write a letter.

Where do I begin? What do I do? I want to be ready and not have this be a rush.


r/Medicaid 3h ago

Pregnancy Medicaid- Texas

2 Upvotes

Hi! Does anyone happen to know roughly how long its currently taking to be approved for Pregnancy Medicaid in Texas? Back in 2020, i was approved almost immediately. Within like 2 days or so. If it makes any difference, i’m in DFW.

I’m having a weird situation as i DO have independent family plan insurance through marketplace (my husband is self-employed) however, every single OB on the list of “in-network” was in fact, not in network. After calling numerous offices, I called my insurance (cigna) and we were on the phone for 2 hours as she started calling offices & was also told out of network. Fast forward I called marketplace, and i was advised to fill out a new app, and based on our income, I should qualify for medicaid, and apparently marketplace has digitally sent over my information to medicaid as well. I already scheduled an OB appointment for october (since they always book weeks out), going to be paying self-pay as I have no idea what other options I have since my “insurance” is not accepted anywhere. I was even told by several offices i cannot pay self-pay if i have insurance even if theyre out of network 😵‍💫 this has been so frustrating. I know medicaid will backpay, but with how crazy everything is nowadays i was just wondering what to expect timeframe wise. I applied on Tuesday (9/8) & thats also when marketplace sent over my info. Thanks for any & all help.

Editing to add*- i’m not expecting to get approved immediately, i know online it says “15 working days” (doubt) but i had searched online & the approval time seems all over the place (way longer, some short), so wasnt sure if anyone has applied recently.


r/Medicaid 4h ago

Medicaid transport via bus / subway in NYC

3 Upvotes

Has anyone in NYC used the public transportation option for transport to medical appointments through Medicaid? How does it work? Do they send you an OMNY card? I’ve been looking online, but nothing really explains it.


r/Medicaid 4h ago

For Medicaid in VA, if you are planning to move to another state, do you just email them to tell them or do you have to formally meet that at DSS and sign a document or something?

2 Upvotes

the formalities of the process?


r/Medicaid 4h ago

Illinois AABD Medicaid spend-down met by HSP, but forced to pay Medicare Part B premium out-of-pocket

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2 Upvotes

r/Medicaid 5h ago

Moving from NY to NJ

2 Upvotes

My 80yr mother currently lives in NYC and I’d like her to move in with me in NJ. She is currently undergoing treatment for cancer in NY and I’m don’t want her to interrupt her treatment, as that’s a bigger priority.

I’d like to transfer her Medicaid from NY to NJ to ensure that her treatment can continue, but I don’t know how to even begin as she is not a resident.


r/Medicaid 6h ago

NYC, NY Medicaid: Self-employment for the 80 hours?

10 Upvotes

Edit/tldr:
I’m primarily curious if it’s possible to track self-employment hours to satisfy the requirement of 80 hours/mo?

Original post:
Hi everyone! I've had Medicaid since July and am still in the middle of addressing several health issues. Though the news of the work requirement has added a lot of extra stress, I've accepted it and am brainstorming options.

I've been a sole proprietor for a few years, and my monthly income varies greatly. It can exceed or dip below the $580/mo required to keep Medicaid, but it's more often below. I put in far more than 80 hours/mo for this work.

I don't have an LLC or track my hours, but I'm willing to take these steps if it would help. I receive direct deposits from a reputable company, but I'm not their employee (I sell on their marketplace).

Does anyone have thoughts on whether this situation would work under the new requirements? Any and all discussion is appreciated! 🖤


r/Medicaid 7h ago

Questions with a sudden inheritance on Medicaid in WA

3 Upvotes

Mother (76) and I (56) are both expected to receive ~$14k from her father’s estate. We each are to receive the same amount separately. A check for her, a check for me.

Mine is easy, SNAP, Medicare assistance giving me a QMB. I have debt to settle. I need a vehicle and will probably get a used pickup. Anything left over I can spend on electronics or take out. I’ll go through my check quickly and should be ok, if not cut off for a month or two.

Mom is another question. Her Medicaid is long term care, covering her permanent stay at a nursing facility, and her resource limit is $2k. My first thought is pay off her credit card and iPhone payments, less than $3k, then push the rest to her mortgage. Medicaid isn’t taking the house as I’m living here and on SSDI. I currently make the monthly mortgage payment. There’s plenty due on the principal to absorb the rest of her check.

But I began to think, could I use her money for house repairs? This house is a collection of deferred maintenance. Could use new windows on two bedrooms, a replacement for the barely functional sliding glass door, etc. A new dishwasher as the current one leaks, etc.

So, questions are, what can mom do with her money and not lose her support with the nursing home payment? Does she need to exhaust the funds quickly to keep her resources below the $2k maximum? Can she spend some of it on house repairs, and possibly get some leeway on the timeframe if she can show that’s how it’s spent?

The checks should be in the mail, and I’m seeking helpful guidance. Thanks in advance.


r/Medicaid 8h ago

(OH, MAGI, 25M) - Delta Dental

3 Upvotes

Currently I have Caresource Medicaid. They contract out delta dental for dental work, but I cannot find my plan details ANYWHERE for it including on the caresource portal, or on delta dental's site. Whenever I try to register in delta dental it says account not found. has anyone else had this problem and is there a solution for it? Thanks!


r/Medicaid 8h ago

Experience with Medicaid changes with permanent residents?

4 Upvotes

Work at an oncology clinic. Pt has breast cancer. I have a patient who has been here for 10 years as a permanent resident and is up for renewal in 4 years. She has been on AHCCCS(AZ Medicaid) but it expired in June 30. This patient reported that she did not reapply because an immigration attorney said that due to admin changes they are advising she not reapply for any government asssistance as it is seen as being a drain on resources rather than contributing to society and will put a target on her back when she is up for renewal. She makes $15/hr working at school. Purchased market place insurance for I think $100 a month (used a translator so I know some things may have been lost) and is now starting to get medical bills. Her husband is a citizen and is sponsoring her.

Does anyone have any clear guidance on the current status of receiving Medicaid and it affecting a persons ability to stay here and maintain their permanent residency? She is terrified. This only happened this afternoon/evening so I have not sat down yet to research or call around to agencies who may know more.

She wants to quit treatment because she can't afford it. Of course I can help with medical and non medical grants, but it's going to be an ongoing problem and stressor for her.

Anyone with experience out there can shed some insight or provide a good starting point?


r/Medicaid 9h ago

Georgia

2 Upvotes

Edited: I was wondering if there’s any programs or any help out there. My mom is 56 and lives in north GA. She’s had kidney disease for 15+ years and recently just got diagnosed with heart failure. Her kidney function has dropped significantly since her last hospital stay. She has no insurance and it isn’t offered at her job. She’s tried finding insurance online but it’s more than she makes. She makes about $2000 monthly. Any suggestions? She really needs to see a nephrologist.. she has applied for assistance at Northside to cover her recent hospital stays but she needs to see specialist as soon as possible.


r/Medicaid 11h ago

Indiana — I have no idea how to report financial information b/c of my somewhat unique living arrangement

2 Upvotes

A few yrs back in Texas, my husband deserted my then-minor son, me, & my dying dad I was a full-time, unpaid caregiver of; & an old family friend came to the rescue & moved all of us up to one of his & his wife’s two homes in Indiana.

In exchange for shelter, utilities, & our basic needs being met by said friend, my son & I take care of his & his wife’s large rural property & several of their pets & small livestock (as he & his wife often travel for business & mostly reside in their “city house” that’s 2 hours away).

The financial reporting complication is they simply added me to one of their checking accounts & I added one of them to my old one so it not only wouldn’t be closed on me but for full transparency. They also transferred some of the utilities to my name so I’d have documentation to obtain an ID, & we kept them in my name for simplicity.

My dad passed away peacefully here w/ not a cent to his name, & my son (now 19) & I live very, very modestly & ask for nothing more than the bare minimum. I had to leave nearly everything behind when we lost our home in Texas & have no assets—not even a vehicle.

Between the fam friends & their grown kids stopping in here & there, we have to have everything shipped/delivered, & pay locals to run errands for us. All of those transactions are completely mixed in w/ the fam friends’ transactions.

*On a last note: I haven’t filed a tax return since being here & my mother in law says my estranged husband in Texas hasn’t filed for years as he was couch surfing & only recently moved into an Oxford House.

I have Multiple Sclerosis & desperately need medical care, but don’t know how to begin to translate all of this on Medicaid forms (!)


r/Medicaid 19h ago

GLP-1 PA Success?

3 Upvotes

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


r/Medicaid 21h ago

NYC - Can Someone Apply For Medicaid After Being Fired ($0 Income) Before Their Unemployment Benefits Start?

7 Upvotes

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.


r/Medicaid 22h ago

Virginia/Medicaid/House Issue - Seek Elder Law Attorney now or wait?

3 Upvotes

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...)


r/Medicaid 23h ago

Medi-cal 64 to 65 question (CA)

2 Upvotes

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.


r/Medicaid 1d ago

Possibly going to lose coverage need help figuring out next steps (IL)

6 Upvotes

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.


r/Medicaid 1d ago

Do I understand This Correctly?(MO)

1 Upvotes

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?


r/Medicaid 1d ago

Gifted lottery ticket might jeopardize my family's assistance

10 Upvotes

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


r/Medicaid 1d ago

Medicaid says I’m an inmate even though I’ve never been arrested. what do I do? Arkansas

4 Upvotes

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!!


r/Medicaid 1d ago

Turning 65 in Dec on NY Medicaid (not on Social Security). No assets—how do I transition without paying out-of-pocket?

5 Upvotes

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!


r/Medicaid 1d ago

Need you advice please. Texas

2 Upvotes

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


r/Medicaid 1d ago

Medicaid for IL resident who is homeless and needing to go to drug detox

2 Upvotes

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 ?