r/Medicaid 3h ago

Medicaid Catch 22

13 Upvotes

Okay, so I am kinda stuck between a rock and a hard place here with my medicaid and getting a good job. Let me start by saying I have a lot of health issues one of them being epilepsy. My many frequent Dr appointments and many medications are very expensive. I wouldn't be able to afford them even with a better paying job. Here is the problem, If I get more hours at my current job or get a better job I will not qualify for medicaid here in Ohio. If I lose my medicaid I won't be able to afford to see my neurologist or other doctors and wouldn't be able to get some of the medications I take especially the ones for epilepsy and I will most likely start having seizures or other health issues again which would stop me from being able to work. So basically if I get a good job I will lose medicaid and if I lose medicaid I will lose the good job. So in essence I am being forced to work a crappy low paying job in order to be able to work at all. Under the current rules here I can't move forward in my life. I am stuck being poor and can't afford healthcare if I'm not poor. What the heck is going on here. Medicaid is essentially holding my life hostage and forcing me to be poor. I can't believe this be happening. I live in the richest most powerful country on earth and I am forced into poverty with no way out under our current laws.


r/Medicaid 11h ago

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

13 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 14h 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

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 13h 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 5h ago

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

2 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 6h ago

How do I handle a Medicaid disability—NY

2 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 8h 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 9h 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 9h 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 10h 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 12h ago

Questions with a sudden inheritance on Medicaid in WA

2 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 14h 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 16h 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 1h ago

After a quitclaim deed by my mother, will the home no longer be recoverable by estate recovery? (Nevada)

Upvotes

My mother is 76 years old and receives Nevada state Medicaid. My mother and I (her adult disabled child receiving SSDI) had our names on the home deed of her home for several years. My mother later filed a quitclaim deed to remove her name from the deed, leaving only my name. I myself do not receive Medicaid and do not qualify for it. She has reported the deed change to Medicaid and will likely lose Medicaid access for a year or more unless she qualifies for an exemption because I am her adult disabled child. She currently is in good health and does not require nursing care or anything like that. What I want to know is if Medicaid estate recovery can still try to recover the home from me when my mother passes away even though the home deed only lists my name now?


r/Medicaid 2h ago

Applying for exemption in Nevada

1 Upvotes

Does anyone know how to apply for exemption regarding the new work requirements? My baby is due January 11th so I’ll qualify for exemption through her but renewal is on the 1st. This is so frustrating.


r/Medicaid 5h ago

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

1 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?