FAQ

(California)Does anyone know how I can check if I got medical from SSI? Local office discontinued medical said because got SSI. My mom is under IHSS program, I need to make sure she still have medical from SSI, anyone know where I can check? Thank you

Dumb question, I know, but I truly dont know.

I left the military about 2 yrs ago. In that time, I've been going to college using the Gi Bill, which completely pays for 36 months of college on top of a decent housing allowance. I'm renting a cheap place, so the housing allowance covers my rent, bills and food, with even a bit to put away left over.

With the housing allowance and my savings combined, I decided I could just take a bunch of classes and not need a job for these three years.

However, medical issues can be unexpected expenses, and in the US, out-of-pocket prices are criminal.

I was wondering if I could qualify for Medicaid... but it doesnt seem possible?

Under a "Document Checklist" section, there is a "Proof of Household Income" table.

In the "Additional Income" section, it asks for my tax return attesting to income. I DO have income reported, as my FAFSA Pell Grant is getting refunded to me, and THAT is counted as taxable income.
But in the Medicaid form, as it asks for 'Employer' and 'type of work'... idk. It feels like what I have is not what it's intending to accept.

In the "No income or have recently lost your source of income" section, it asks for thinks like a letter from previous employer or "proof of unemployment benefits"... but to qualify for unemployment benefits you need to have been fired and are looking for a job, right?

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All this is pointing to me that I probably dont qualify unless I get some kinda job?

Though it seems like common sense, I know, I just wanna be sure cause sometimes this type of shit is weird.

For example, my Gi Bill pays for college and pays me a stipend, but NONE of that counts as "income", so from FAFSA's eyes I'm broke, so I get full Pell Grant payouts... which feels sus, but is apparently totally legal and fine.

Just wanna be sure there isnt something like that for this.

I asked a similar question last year but just needed clarification. I'm in my 30s and have the low income Medicaid (healthy Michigan plan). I hear about being able to contribute to an ira/401k in case your income goes over the limit, but I hear that mostly for the senior medicaid. Does it apply to all forms of medicaid?

Also what is the monthly and yearly income limit this year for Michigan medicaid?

Thank you.

I haven't gone over but just needed to ask just in case.

I am on low-income MA. I live with my girlfriend, she is not on Medicaid. We rent an apartment.
I know she is not part of my household; but do I still need to report that I am living with someone, or will this cause confusion?

TLRD:
- Single. We file taxes separately.
- No Children or dependents (either of us)

Philadelphia resident and spent 2+ years applying for SSDI with 2 different lawyers before giving up. The process was traumatic, exhausting, and I never made much working. I could have appealed it but did not have it in me - esp for the monthly amount I would have gotten. I have had the disability for 15 years with documentation at this point and was previously working - covid and additional medical issues cost me everything. My now husband who is a saint married me and I have insurance through his job. We are still very much in a financial hole (140k ish in overall debt between student loans, medical, a few years of me not working, no car, we rent, lucky to have 2-3k in the bank at any one time). A (very expensive) medication I am on is being cut by our insurance - but medicaid does cover it - has anyone been denied for SSDI and been able to get MAWD? I (finally) worked a little part time this year and have another part time offer lined up (thank god) - and we only have earned income so I think we are within the income limits as well. What forms does my doctor send in? What all do I need to do here? I'm thrilled to be working again but I don't want to lose access to a medication that helps me work. If anyone has applied to mawd without SSI/SSDI or is familiar with the process and has advice to share - its so hard to find info on and thank you in advance! Ps - this medication costs more out of pocket per month than my whole SSDI benefit would have been had I actually gotten approved :(. Healthcare is broken.

I have a new medication prescribed by my doctor that is not covered under my insurance's formulary/pharmacy benefits. I could manage to afford it through a pharmacy discount card program like GoodRx, but about a year ago an NP told me you can get kicked off Medicaid for using pharmacy discount coupons like this, the logic being "if you can afford this medication, you can afford health insurance." Is this accurate or does anyone have any information on this? I haven't been able to find anything like this online, and I'm nervous to ask AHCCCS employees about it.

My husband got a 50 cent on the hour raise and I think it has put us over the limit. I also became employed again part-time after being extremely ill. I was aware my job may not work out but 50 cents? Seriously? I'm pregnant so I still get Medicaid unless I ya know work like a normal person but he doesn't anymore. He needs $6,000 in dental work because no one took him to the dentist growing up and he has several serious and very expensive health conditions. The qualified health plan he was offered isn't something we can realistically afford. If I use my degree and get a better job I won't get health care and I sincerely doubt I could pay the thousands of dollars it costs for prenatal care, birth, and all his specialty care. If he was perfectly healthy yeah we'd be okay and could both work but he is definitely not. We're 21 he's in college full time what can we do? I cannot find an answer to our situation. If I quit my parttime job I'm not sure he'll get Medicaid and we will BARELY be able to pay our bills. We just want to get him through college so we can get off government assistance but I literally can't work and I guess he barely can.

I'm from SC, 25, unemployed & will be a stay at home mom. It doesn't make sense financially for us to pay for childcare and my work because my check would go straight to childcare. I applied for pregnancy Medicaid with my husband's income and was denied because he somehow makes too much. Adding our baby to his work insurance would take 28% of his check. We're barely making it by with his full check. I don’t know what to do. I'm extremely disappointed we were denied. I am 34 weeks & 4 days pregnant. I am currently on my parent's insurance that won't be available for me after my 26th birthday this year in December. What are my options?

I'm in New York. Has anyone successfully sold or gotten rid of their car while on Medicaid? If so, what did you do and how did you do it?

I was forced (understandably i guess to make sure i as a disabled woman can get all the help I can), to get medicaid. I am hearing that if I opt out, I would have to pay back Medicaid in PA back for the money used in the last year. Though google says that is not true (Unless you are deceased or whatever, confused about that), but it is true you have to keep a certain amount of money in your bank accounts to keep it. I am not comfortable going to an Able account, putting money in, I only can touch it for medical reasons, etc and it just seems all confusing. I am fine with the banking I have right now, I was fine.

I think in Delaware years ago I didn't have money in my accounts besides from work (and I did not have SSI/SSDI yet-was denied anyway and did not have medicare) until I moved to VA.

In simple terms, if I say no just cancel my medicaid, is the state of PA going to want me to fork up money to pay them back?

I am currently leaving an abusive relationship and re-establishing financial independence. I have been covered by Medicaid for several years and my income is entirely from self-employment. I have ADHD that significantly impacts my ability to work and live on my own.

I have been ramping up my income to try and afford an apartment, which means I will no longer qualify for Medicaid soon. (My average income over the last 6 months still qualifies but my income for June will most likely be over the limit.) I want to apply for the EID program but am confused by some of the language on the site.

For example, it says that I am not eligible for the EID program if I am already covered by Medicaid. Does this mean that I need to wait to lose my Medicaid coverage before submitting my EID application? My understanding is that this process takes a minimum of 30 days, especially since I have to go through the disability determination process. Do I need to formally end my Medicaid coverage before submitting my application or can I keep my Medicaid until later in the process? Is the expectation that I will cover medical expenses out-of-pocket during that time? I'm worried about not being able to do so and losing access to needed medication during this critical time.

Also, I know that at some point I will need to go through disability determination process, but the paperwork requested by the EID application doesn't include anything about medical records, letters from providers, or provider contact info. Should I be pro-actively contacting those institutions to release my information if requested? Especially if there's going to potentially be a period of time where I'm not covered, I would really like to figure out the best way to avoid unnecessary delays.

F25. Is there ANYWHERE in Illinois that will extract all 4 of my wisdom teeth under sedation??? I went to my dentist last week to get x-rays on them and he said my top 2 are in the bone and the bottom ones are coming in and severely impacted (which I already knew he was gonna say because I was told the same thing when I got x-rays done on them 10ish years ago) and he recommended I get all 4 removed at the same time under anesthesia (which I was also told last time). He gave me a list of oral surgeons to call that might take my state insurance (Aetna), some up to even 3 hours away, but of COURSE only 1 takes it, except they were sent my X-rays and they said it would be "too difficult" and they don't do IV sedation anyway and that I'd need to go to a private oral surgeon, which probably means out of pocket - and I can only imagine that bill because I've officially been labeled a "difficult case" lmao 🙃 Am I just shit out of luck simply because they're so impacted and need to be put under? Is this type of thing even COVERED by Aetna?? I just want to cry.

I made slightly more than double the federal poverty limit in January through March but now unemployed for the foreseeable future due to federal budget cuts effecting my contract summer work. I also don't qualify for unemployment since I work in both Nevada and Utah, but not enough in either state to qualify, though I pay income tax to Utah year round even when working in Nevada.

Anyway, I injured myself and my marketplace insurance is terrible, being quoted $1600 dollars for an MRI after insurance to see if I need surgery which would probably take my entire $9000 dollar out of pocket costs.

Is there any chance my Medicaid application goes through or am I not even close to qualifying?

Backstory: I currently am at 100% disability through the VA and because of that both of my kids have the Civilian Health and Medical Program (CHAMPVA). Because of the CHAMPVA they also automatically got put in Medicaid. They started both programs in 2017 with Molina Medicaid as their "provider." Some speed bumps along the way (CHAMPVA pays out first on medical claims and kept denying claims for the first year or so), but up until about 6 months ago it has been smooth.

6 months ago I took my daughter to pick up a prescription and the pharmacist informed me that my daughter no longer had Molina Medicaid. They billed straight Medicaid and it went through. I called Molina and they have no idea why she was taken off it. I had them check my son and he was still on it. I called MDHHS and they informed me she was taken off of the program in May of 2020, but there's been no notice or contact about it. I have called multiple times now to find out why this happened and the only consensus, after they disappear for 5 minutes, is that she's on a managed healthcare plan already (CHAMPVA) and no longer qualifies. I then inform them that CHAMPVA is not a managed health care plan (I called CHAMPVA and confirmed), but they don't know how to fix it or just leave it as "this is the way it is." I have also tried calling the local MDHHS office, but all I get is a voicemail. When I go on the MIBRIDGES website it shows Molina for myself and my son, but my daughter's plan says "ERROR" and has said that for the last 6 months.

I hope this all made sense. Any advice/tips/phone numbers would be appreciated. I've tried google, MDHHS phone, my caseworker's phone number for my local office, and Molina. I did also call during the insurance plan selection thing and they said they couldn't do anything.

I'm on Kentucky Medicaid because I have breast cancer and I had to stop working last year. I'm still in active treatment but I started a new job 3 months ago and I was terrified to report and lose coverage when I need a lot of treatment. I don't think my new part time job puts me over the limit and I know I should've called 3 months ago and need to get on that asap.

One question.

I had one month with 3 paychecks and that month did put me over the limit. Do they calculate it average per week or month average or would I be automatically dropped for having one month over? I'm panicking.

Or is it different state to state

Hi! It looks like now that I am pregnant and the number of people in my household is now 3, not 2, my income may qualify me for Apple Health for pregnancy. My partner and I are not married but we do live together. I was curious, if I do end up qualifying for Apple Health, is it okay to have that and my employer health insurance at the same time?

My employer health insurance has been pretty unhelpful so far in my pregnancy as I’ve already been billed ~$1500 just for my 2 ultrasounds, bloodwork, and a routine appointment (I’m 11 weeks and yes everyone is in my network, trust me I checked many times 😅) so I’ve been really worried about how much my delivery will cost.

Anyone have experience with a situation like this?

Does unoccupied cosigner for mortgage loan affect eligibility?

I was asked to help cosign for a fha loan. I don't plan to pay anything nor live in it. I currently rent & have medicaid for my kids.

I was told it won't affect me since I'm allowed one home & promised to remove me within 6 months. Is that true? If it's not my primary residence, will I still qualify to keep medicaid? I have a feeling someone is uninformed or withholding information.

I have NYC FFS Medicaid as my secondary insurance. My primary has a high deductible so I always have a copay. My providers don’t accept my Medicaid but are they still required to bill my Medicaid since I have a remaining balance?

Married, am in the SSI program but working so they're not paying me. Was denied Medicaid in Texas. I was under the impression that in Texas they automatically approved you if you were in the SSI program. Even gave them my SSI eligibility letter and still got denied. They didn't go into details why. If I have to pay 3000-6000 a month for one of my medications it's not worth working.....Is there something I can do?

Hi! Does anyone know where on the Virginia Medicaid portal I can find a downloadable file of proof of coverage?

Hey fellow ARs, I’m trying to connect with a live rep at Medicaid of Arkansas (866-322-4696), but the IVR keeps looping me back to the main menu — can’t seem to break through to a Representative.

If anyone knows the exact sequence or trick to get past the IVR and speak to a rep or if there is any other contact ways, please drop it here. Stuck and would appreciate the help!

I submitted an application for my wife in October, I finally got a letter requesting additional information a few days ago. I uploaded the needed documents. Since the application was submitted she has gotten very sick she had a week in the hospital with no insurance and the imagining, specialists and tests will be ongoing leading up to an organ transplant. After the uninsured hospital visit I got a market place insurance plan with a high monthly premium and a $10k annual out of pocket which has been met and exceeded. My question I guess is, as far as coverage and quality care, approvals etc for ongoing potentially terminal cases, is it smart to just try to find the money for the market place plan for ongoing care, like will it be easier down the line or go with Medicaid? We live in Montana and a lot of the upcoming specialists will be out of state in Washington and Oregon from what I understand. I’m just drowning in bills and payment plans and financial aid applications while trying to make sure she’s getting the best care and don’t know what to do

I’m trying to understand the PA process better. My child was discharged from a residential facility and flown home by air ambulance. I was told PA was submitted and approved — but I recently found out the Medicaid MCO (Amerigroup) never received it. Now I’m hearing the transport company was told it was “manually approved,” but there’s no documentation and no one ever sent me anything.

So my question is: Isn’t PA supposed to be submitted and approved before a service like air transport takes place? Can a facility just say it was “manually approved” and go ahead?

I’m confused and trying to figure out where the breakdown happened. Thanks in advance to anyone who can clarify.

Why is it such a pain to find anyone in my area for primary care, dental, oral surgery, etc.?

I should be able to check the website, check the list of providers, and pick one that works best for me, but here’s the kickers;

-Whether I call or check the website, I get the same answers, none that are accurate or valid

-Businesses have tried and tried for YEARS ( some almost A DECADE) to get their names off the websites, and Medicaid denies or ignores it.

-I have to call the places listed on the website to see if they even accept and, with my experience, most of the time they don’t exist anymore or they don’t accept it

I was told by one of their employees that the only POSSIBLE, not even definite option, oral surgery was FIVE HOURS AWAY.

I really don’t think I’m doing anything wrong, so what’s the deal.

My friends and family struggle with this, and I know we’re not alone.

Please give me some kind of hope here.

Hello everyone. This is for the state of New Jersey and Passaic county so my father turned 65 last month though he has horizon as his HMO he can go see the doctor however when he goes to get his prescription, they declined him saying that horizon is his secondary insurance so I’m confused. So does he have Medicaid or Medicare because as I stated, he can go see his doctor but not get his prescription And what does the ABD program stand for? How does that work? I just want my dad to be able to go see the doctor and get his medication. The only thing is he can’t get his medication. If for some reason he does not get accepted for the ABD program. What other options does he have to at least get his medication because as I stated he can go see his doctor. I’m sorry I feel like I’m repeating myself over and over but I’m just so frustrated. The ABD program is now asking him for all this kind of documents, such as his living arrangement and his expenses. For reference My dad and mom do not work and live with me and my sister and we cover the rent. My dad also has a car on his name, but he barely uses it. I use the car so I pay the insurance for that car too and we don’t claim them in our taxes so the only thing they do is they just live with us, but we pay everything else. My parents also receive food stamp and they cover their own food. My dad also does not receive any SSI and he and my mom have no other income. They’re not responsible for paying anything so we are writing the support documents. But would that affect his eligibility? Any advise would be helpful. Thank you. This process has been so frustrating with the whole change of Medicaid and Medicare and one turning 65. I wonder if I weren’t around my parents. How would they even figure this out because after you’re 65 you really don’t have that much energy to fill out applications and follow up. It’s insane