r/Medicaid

We have applied for renewal last month and this month we were approved. Me and wife were approved for medically needy and my son for Medicaid. It appears my sons Medicaid is expiring this month. The case worker had a mistake on their end and they have to fix it. All I am hearing is wait for 5 days, we have escalated to the case worker but nothing happened. I am tired of calling and running behind of this

I received a letter today in the mail that my Medicaid was cancelled because my 1580 a month with 2 people doesn't qualify me under the income limit of 2146. I don't understand how my income being 566 less than the max for 2 people would make me disqualified. I have called cause they also lowered my food stamps by 400 when there has been no change in income or expenses. I am stressing out cause I have Medicare, but with my prescriptions, I would have to pay 900 next month just for my prescriptions, and I won't be able to pay any bills if I have to pay that. Can someone help me understand this, please?

For context: I am disabled. My husband and I live alone. There are no children. I am 47, he is 39. He is my caretaker. I receive SSDI of 1580. No taxes are taken out. I have been on both Food Stamps and Medicaid for years, and this isn't the first time they have messed it up. I have disabilities that require very expensive medicines. I rent at 330 a month, power is 300+ a month, I have medical expenses of several hundred, and with Medicare coming out, my income is very limited. 6 months ago, my renewal was approved, and I was given $546 in food stamps and continued my QMB Medicaid coverage. Just a week ago, they reapproved me, and now they have denied me. Medicare is 208 this year. If I lose my Medicaid, my prescriptions will be more than half my income. One prescription alone is 900.

Any other questions

update: I called my insurance company, and they said I can keep my plan for 6 months, so I won't have to worry about a new plan till the end of the year, but my premium will start coming out, which is going to seriously hurt my bills. I will have to move out of my home and live with my family

My mom has been disabled and on ssi/medicaid for over 20 years now. She recently reached age 65 and was forced on to Social Security and Medicare. Now NV Medicaid is going to cut her off and to top it off they're taking her food stamps from almost $300 to $24!

She can't afford her medications and thought because she was permanently disabled she qualified for Medicaid once on social security.

She's divorced, drawing SS from her divorced spouse's # (found that out when she was recertifing her food stamps). She also has part of his retirement from the divorce (less than $200/mo)

Is there any way she can still qualify for Medicaid? The drop in food stamps wipes out the difference she makes going from ssi (whatever is the one that pays less) to Social Security and now having to pay for meds she just can't afford it and is freaking out.

Thank you for your time.

I live in Michigan and I get around $1,500 a month in survivors benefits. Why am I still getting QMB when my monthly income surpasses the $1,350?

my 19 year-old lives at home and earns about 6K at a part-time job. She is not a student. ChatGPT just told me that she would likely qualify for Medicaid, which is news to me. I do claim her as a dependent on our tax form. ChatGPT also says that the criteria for tax households are different than healthcare insurance households. Anyone know if this is all correct?

here’s the quote from chatgpt:

“For the New York State Department of Health eligibility system:
👉 Young adults with very low income can often qualify for Medicaid even when parents do not
This is because Medicaid rules:
treat low-income individuals separately in many cases
especially ages 19–20 (and sometimes up to 20 or 21 depending on category rules)”

Just short of a month ago, my child applied and was approved for Medicaid bc they are being kicked off my insurance next month when they turn 26. Their Medicaid ID card has still not come in the mail. We had Medicaid almost 20 years ago before I had this job and insurance. I didn’t think we still had the ID cards around, but to my surprise apparently I DID save them and found them last night in my dresser! The ID number on their newly created account matches the ID number on their card from 20 years ago. So I’m assuming the reason the state hasn’t sent a new card is because they assume we have the old one, which I honestly can’t believe I saved lol but I’m glad I did. BUT the back of the old card is signed by me since they were a small child back then. Can/should they still request a new card be mailed to them or could they really use that old one?

Hi everyone. I am on SSDI, 41, single (divorced) and I live with my parents.

I am looking at the application and it asks for my household. The application states to include (besides spouse and dependents), "all parents living with their children."

This is confusing to me because I saw another government website stating that I do not need to include them in my application, as only my income will be counted. Is this a physical household? A tax household? I am not claimed as a dependent.

Please advise.

I care for both my mom and my mother-in-law full time at home. I have not worked in six years due to their schedule and needs. I have attempted to go down the "getting paid to care for them" rabbit hole but only get so far in the process or researching what options are available that it hasn't yet resulted in anything. I have people telling me all the time, they know someone who gets paid for their parents but either they live in another state or their exact situations aren't what we are dealing with. Both of the moms have Alzheimer's and although they have been moderately functioning, my mom in particular has started to decline more rapidly now and in addition to getting resources lined up in advance of getting the help that exceeds my pay grade and capabilities, I want to figure out if indeed I can qualify for anything that would allow me to save for retirement or offset the fact that I don't have an actual employer contributing to my Social Security... Anyone in Virginia who does get paid for caregiving for family out there...?...and what can you suggest? I mean, I might not outlive them anyway due to the stress, HaHa...but if I do get a few more years after my watch is over I'd like to worry less about my own retirement. Thank you.

Hi everyone, I am 23 yrs old I have schizoaffective disorder. I currently live in Maryland.

Currently I work remote full time and I have been for the past year, but I am having a lot of trouble maintaining my employment and have been hospitalized for mental health 3 times since last June and over 20 times throughout my life, and I have been to the emergency room many more times due to my mental health. My job encouraged me to go part time last year due to my hospitalizations however I couldn’t because I would not have enough money to support myself.

I had a therapist who told me that she cannot see me any more because of my diagnosis but told me that I can get on Medicaid for disability and get community based programs. Medicaid for disability told me that I make too much money, and also my assets are over the limit due to my savings account. The past five therapists I have seen have not wanted to see me due to my diagnosis so I am currently not receiving any treatment.

I have a significant amount of medical bills that I accrue due to this situation, even though I work full time it is a strain to pay these bills and also not receive a lot of mental health support. It is already a strain to keep a job in general and I am just unsure what to do. I have private insurance but they do not cover things in full so I pay part which adds up.

There are a lot of specialized community based programs for people with serious mental illness however I know that you have to be on Medicaid for it.

My questions are, does anyone know what is the best thing for me to do in this situation to try to get the mental health support that I need? What do people do who make too much to be on Medicaid but do not make enough to pay for the healthcare that they need because of their disability?

About to turn 62 and living off savings/investments. My total annual MAGI has always been under the threshold, however I am starting to get capital gain distributions which are out of my control. If I go over one month but stay under the limit annually, do I report that, get kicked off for the month and then reapply? Considering the backlog wouldn't there be a couple months before I get approved again?

Starting Dec 2027 I will start taking RMD's from an inherited IRA and that will definitely put me over the top for that month and possibly the entire year. Is it best to just estimate my income the best I can and apply for ACA and hope I get the final income close as to not pay back the ACA credits? I'm currently in NM but will probably be moving to IL if that changes anything.

Hello everyone,

I am looking for any wisdom anyone can share. Or ideas of how to qualify for Medicaid. I am struggling and devastated.

I live in Hawaii and am in the process of applying for SSDI. I am married to my husband, who is not disabled and works full-time. He is my financial, emotional, and physical support person. I saw that Quest (Hawaii's Medicaid) has a Long-term care program, and from what I read, you can apply if you meet the qualifications for in-home care-based services. The woman I spoke to at the medicaid office told me I need to require 24/7 care like admission to a nursing home. Thank heavens I am not there at this time. But I am not independent either.

I cannot perform IADLs (cooking, cleaning, running errands) and have a real hard time washing my hair and maintaining my hygiene. I have POTs, ME/CFS, Fibromyalgia, and other conditions. ME/CFS (chronic fatigue) in a few people continues to worsen over time, and I feel sadly I am in that boat, so I am trying hard to plan ahead.

Like, I need help. I need Medicaid. I need help at home, I need nutritional assistance, and I do not use a walker or a cane. I am young, so I think most people do not believe I am as disabled as I am. :( My husband is 51 and ultimately no matter his age this level of stress on him and how much he has to do in a day is not sustainable.

Again, any suggestions/wisdom/advice are welcome.

Casey-Lee

Hello hope all is well, thanks for any help in advance.

If I was to receive a cash gift from family to assist me while I'm out of work, will that disqualify me from Medicaid in NYC?

The IRS declares that gifts below $38,000 in a calendar year are tax free.

If my family were to 1) Give me $38,000 in cash 2) Make me an authorized user of a bank account that is loaded with $38k or 3) zelle, or wire, or bank transfer the gift amount of $38k to my checking account

Would this disqualify me from medicaid in NYC?

Thank you!

I applied recently and received a latter that I got denied due to income which hasn’t changed. After calling the dcf office, the agent let me know that we could actually do a phone interview which we did. She then proceeded to ask me questions that were not part of my application. Now i have to submit proof of rent, light and water bill including a statement from my children’s daycare stating that I pay X amount monthly, also a statement from my child’s father stating he supports me with X amount of money monthly. But no paystubs. I’ve never been asked for these documents before. Has anybody else had a similar experience?

I live in Maryland and I am trying to find this number. I need this number for my Insurnace to cover my prescription. I tried to transfer the prescription to a new pharmacy they still need this number.I called multiple Medicare helplines numbers and none of them are any help they never heard of this number. It’s not my Medicaid ID and it’s not my member ID there is no number that is on my card that could be this. I don’t know much other then this number also start with a 4. Any help ???

I need an employment verification form filled out by an employer that I stopped working with two years ago. Do I need to take it directly to my old boss or sent it to HR? If I need to send it to HR, do I use the envelope they gave me to do that?

Something went snap in my back over the weekend and I've been unable to sit for more than 5 min since... I'm also in pain when I walk or stand.

Was laid off from work months ago so I'm on Medicaid. Unemployment is about to run out so just my luck that I hurt myself. I'm absolutely terrified I won't be able to sit for long periods to do any work. Have no family left and am on my own.

Called the primary care doctor I was assigned to by my plan this morning to try to set up an appointment. Was told he could see me tomorrow and I was so glad! Until I told them they were the primary care doctor on my medicaid. That's when they said Oh... sorry... earliest appointment was going to be in 2027. What????

Obviously that won't do. I'm in pain and can't work until this is resolved. I think I need a scan of my back or something. What do I do? Am I allowed to just look for any doctor and ask them if they take my insurance even though it's not my primary doctor?

please help.

Hello!

Under 65 married couple in NY (NYC, if that matters). I was sole earner and got laid off last year. I pay ~$1850/month for COBRA for the two of us. Trying to figure out what our options are, if any.

Medicaid and ACA are both on the "NY State Of Health" site. If I put in my expected income for the year, it's very low because it's only the 6 months of unemployment I can claim. The way the NY site works, as soon as you put in an income that's low enough, you are redirected to the Medicaid application instead of the ACA marketplace.

Having read the NY State Of Health site documentation and started the application, I'm confused on a few points.

1. Do I have to include my current COBRA under "existing insurance?" I'm trying to figure out if I can discontinue COBRA and switch to Medicaid, but I'm not clear if that's allowed. Am I required to avail myself of COBRA in order to apply for help from the state?
2. I did include my existing COBRA details in my application to see what would happen, and there was a message to the effect that the state might be able to subsidize my COBRA premium. But I can't find any documentation about what the requirements are for this.
3. On the final page of the application, I have to agree to a bunch of things. For example, "I know that if I qualify for Medicaid, I must choose and join a Medicaid Managed Care Health Plan" and "I know that if I qualify for the Essential Plan, I must choose and join an Essential Plan health plan." Does this mean I can't just submit an application to see what I'm qualified for? By submitting the application am I committing myself?

Thanks for any help! Cheers!

Hi all, I have a quick question. My mom has alzheimer's and is needing increasing aide care. As many of you know, aide care absolutely blows through money. She meets the income level to qualify for the PA Waiver for home care assistance, but she has squirreled away savings over her lifetime, and the minimum is $9k in PA, which she is above (~200k in savings excluding her house which is valued at ~300k). In another lifetime I imagine she saved this for her children, but the reality is we need this for her care over the next few years. We prefer to have her stay at home rather than an assisted living situation, because she would rapidly decline there.

My question is, HOW can families wait until savings gets THIS low ($9k) to apply for the waiver? That is dangerously low and wouldn't support her in an emergency, plus it takes time for the paperwork to go through. I was told on the phone we can transfer "some funds out" and provide a justification as to why when we apply. How much out?? I googled around and Medicaid doesn't want to see more than 19k transferred out over a 5 year period.

What is the minimum in savings one should have to apply for the medicaid waiver for in-house assistance? We can spend down what she has, and then apply, but I need to know when that should happen.

Thank you all so much. I am desperate here. I have spent thousands out of pocket over the past year because I didn't want to dig into her savings, only to realize that we need to spend down her emergency/retirement funds completely. She has been rapidly declining and will probably burn through this savings pile quickly. If we spend down EVERYTHING, how will we fund anything going forward? clothes, food, etc? I am so confused 😞

A family friend recently had a major medical emergency and now has a 500k hospital bill without insurance. We’re already talking to the hospital financial assistance team and now it is down to 150k, but we’re trying to figure out who else we should reach out to in Jacksonville or Florida for help.

Are there nonprofits, patient advocates, legal aid groups, churches, government programs, or other organizations that help with situations like this? Any advice from people who’ve been through something similar would really help.

Thank you.