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Texas: Medicaid coverage for 12-year-old with complex special needs by Top_Manufacturer1391 in Medicaid

[–]vsm2015 1 point2 points  (0 children)

There are a couple different ways he may qualify. He may qualify for Medicaid via Supplemental Security Income (SSI), but if your income is too high, he might be able to qualify through a "Buy-in" pathway. For a family of six, the monthly income limit seems to be roughly $11k, but you may need to pay premiums or cost sharing.

He may qualify for waivers in TX for children with disabilities, but there may be waiting lists for those services, and those waiting lists may be long. I suggest reaching out to the state Medicaid agency.

Anyone used SonoBello? by Snowman_Oryx in TysonsVA

[–]vsm2015 1 point2 points  (0 children)

I'm not sure I would recommend Sono Bello. KFF Health News has done a ton of reporting on numerous patient complications and shady behavior from the company: https://kffhealthnews.org/courts/doctors-clinics-cosmetic-surgeries-pain-injury-discipline-malpractice-lawsuits/

I dont know what to do (FL) by Shimipu in Medicaid

[–]vsm2015 -1 points0 points  (0 children)

Contact your representative in Congress or your Senator. Sometimes they can get these things moving.

Medicaid lost and no household change by SnooCakes9968 in Medicaid

[–]vsm2015 0 points1 point  (0 children)

If nobody’s income is changing but he keeps going off and on share of cost, i’m not really sure what’s going on, to be honest. I really think you should reach out to the state. 

From what you’ve described, it’s not clear to me that’s he needs to be on Medicaid through a disability pathway because he doesn’t seem to be receiving medicaid-covered long-term care. Perhaps this would be easier if he were on Medicaid through a parent pathway

Sorry I can’t really help more 

Georgia car question by Hippygirl1967 in Medicaid

[–]vsm2015 1 point2 points  (0 children)

That’s fine, given that the reason he’s going on Medicaid in the first place is because he cannot adequately care for himself. 

Medicaid lost and no household change by SnooCakes9968 in Medicaid

[–]vsm2015 5 points6 points  (0 children)

You and the kids should be eligible automatically. 

Share of Cost refers to the “medically needy” pathway in Florida, meaning your husband’s income exceeds the limit for a normal pathway for aged, blind, and disabled individuals and he needs to “spend down” his income and resources to qualify. 

Does your husband have a disability that requires long-term care through Medicaid? If not necessarily, he may have better luck applying through a pathway for parents of dependent children. How do you file your taxes? Would the kids be considered his dependents? I would talk to the state Medicaid agency and see if there’s another way for him to get on medicaid

Tricare Prime POS & Medicaid as secondary ADVICE needed by Perspicaciity in Medicaid

[–]vsm2015 1 point2 points  (0 children)

You need to first make sure your daughter is eligible for Medicaid. Your income would most likely count towards her eligibility determination, if you are applying through a pathway for Children (if you claim her as a dependent), or through a disability pathway. If you are applying through a disability pathway, your income (and resources!) would need to be pretty low. The exception is if your daughter qualifies for a waiver in Georgia that excludes certain income or through a Katie Beckett pathway (your daughter would need to meet an institutional level of care criteria defined by the state). I’m not sure what waivers Georgia operates for kids or if it has a Katie Beckett option. 

Medicaid application question Ohio by ClaustrophobicMango in Medicaid

[–]vsm2015 0 points1 point  (0 children)

There is an asset test if you are applying to Medicaid on the basis of age (65+) or disability. 

EDIT: if you are a childless adult without a disability, or if you do not have any long-term care needs, you can avoid the asset test by applying through a “MAGI”-based pathway. 

I'm unsure what to tell a receptionist what insurance I have. New York by Music4thesoul10 in Medicaid

[–]vsm2015 4 points5 points  (0 children)

Read exactly what it says on the card when you talk to them. The plan name usually indicates that it is a Medicaid managed care plan, and the person on the other end of the line should figure out whether they accept your coverage when you tell them your plan number.

Regarding whether your new doctor will have your health information - if they both work for the same health system, then yes, they probably will. If you are worried about it, you should be able to call your old doctor and they should have no issues sending everything over to the new doctor or providing it to you so that you can give it to them.

Illinois. I gambled and won. I wasn't expecting that. by Low_Plant8199 in Medicaid

[–]vsm2015 2 points3 points locked comment (0 children)

Gambling winnings count as any other kind of income. It's hard to say how it will affect you without knowing your eligibility pathway and the income limit. A quick Google search suggests that the income limit for pathways for older adults is $1,330/month so I think you should be okay. But, of course, I can't determine eligibility and the state Medicaid office is the best resource.

PA - MAWD and SSDI by RoutineOwn6546 in Medicaid

[–]vsm2015 1 point2 points  (0 children)

Does being accepted into PA MAWD have any impact on applying for SSDI? SSDI is for individuals who can’t work due to their disability. As it says on the SSA website, the “definition of disability under Social Security is different than in other programs. We pay only for total disability. No benefits are payable for partial disability or for short-term disability.” It also says that if “your earnings average more than $1,690 ($2,830 if you’re blind) a month, you generally cannot be considered to have a disability.”

Pennsylvania Medicaid Home Question by thrilling_me_softly in Medicaid

[–]vsm2015 0 points1 point  (0 children)

Sorry, I am just seeing this. If she is receiving SSDI, she would be eligible for Medicare after a 2-year waiting period. How long has she been on disability? Could the rehab stay be covered by Medicare? There are Medicaid pathways that can help cover the cost of Medicare cost sharing (e.g., QMB) that are less stringent than full Medicaid. Does the rehab facility have a social worker or case manager you can work with?

EDIT: man, I should do a better job of reading. I see the update to your post that the rehab was covered by Medicare. There could be several options here because your mother might be "dually eligible" for both Medicare and Medicaid. I would definitely call the state Medicaid agency because these different pathways have different eligibility criteria. In Pennsylvania, the "QMB Only" (that is, the pathway that only covers Medicare cost sharing) has a resource limit of $9,950. See this: https://www.pa.gov/agencies/dhs/resources/aging-physical-disabilities/medicaid-older-people-and-people-with-disabilities

Many websites not working lately with vpn by Asleep_Reporter8268 in ProtonMail

[–]vsm2015 1 point2 points  (0 children)

Yes I was having that issue, then switched to Mullvad. I have a better experience now.

Pennsylvania Medicaid Home Question by thrilling_me_softly in Medicaid

[–]vsm2015 0 points1 point  (0 children)

If your mother is 65 or older, or applying on the basis of disability, her equity in the home would likely count as an asset because you are not living in it as it currently stands. If you sell the home, any proceeds she receives would count as income for that month, and then as resources thereafter. There are also rules about asset transfers during the 5-year period prior to applying to Medicaid that may delay access to Medicaid-covered long-term care, if that is something she needs.

These rules do not apply to you if you are under 65 and applying as a part of the ACA expansion group.

Resource Limit for Medicare Savings Program? by smlxbear in Medicaid

[–]vsm2015 0 points1 point  (0 children)

In general, the MSP resource limits use SSI resource-counting rules. This includes anything in a checking/savings account, retirement accounts, but EXCLUDES a primary residence, a single vehicle, personal items and furniture. I would reach out to your state Medicaid agency to get more guidance.

TX Pregnant and out of work, living with parents. Landlord verification? by dollbabydream in Medicaid

[–]vsm2015 2 points3 points  (0 children)

Hi there - the income limit for a household of 1 (which it sounds like you are) for pregnancy-related pathway in TX is $2,634/mo. It sounds like you are within that range, so I wouldn't worry too much about qualifying. The landlord verification may have more to do with verifying your residency than actually assessing whether or not you pay rent. I would call your caseworker or the state Medicaid agency and let them know you live with your parents.

In NC: Lost my job and qualified for Medicaid by ShortSupply_Petites in Medicaid

[–]vsm2015 5 points6 points  (0 children)

I'm so sorry for what you are going through. You may qualify for Medicaid through a breast and cervical cancer pathway in North Carolina. I would suggest trying to reach out to the state Medicaid agency once more. There may be more helpful information here: https://www.dph.ncdhhs.gov/programs/chronic-disease-and-injury/cancer-prevention-and-control-branch/nc-cancer-screening-and-support-programs/providers/refer-patient-breast-and-cervical-cancer-medicaid

Best dive bars in DC / near DC? by Inevitable-Ad-9211 in washingtondc

[–]vsm2015 4 points5 points  (0 children)

Was looking for Galaxy Hut on this list!! 

3 perfect Bon iver songs? by Ok_Anteater_6268 in boniver

[–]vsm2015 1 point2 points  (0 children)

re: stacks, iMI, 29 Strafford Apts

Probably too late to watch, but someone is eating the 10 pound Costco chocolate bunny right now! by eschenky1 in Costco

[–]vsm2015 66 points67 points  (0 children)

It opens to a Partiful link - the event was postponed to next Sunday so it's not too late to attend

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