Question about Medicaid

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Does anyone know if families on Medicaid have to re-apply every year? Or do they just verify that your income is within the limits every so often?

Also, can they deny a claim if they find out your income exceeds the limits? Say a person gets a raise while they are on Medicaid?
 
Medicaid is administered at the state level. The rules and procedures vary by state. The best thing you can do is make an appointment to talk to your state or county health and human services representative and ask your questions to them. They will know all the rules and procedures in your state.
 
Does anyone know if families on Medicaid have to re-apply every year? Or do they just verify that your income is within the limits every so often?

Also, can they deny a claim if they find out your income exceeds the limits? Say a person gets a raise while they are on Medicaid?
I’m not sure how income verification works from state to state, but yes, if your income exceeds the said limit, you will be denied Medicaid coverage.
 
You technically just give them an update. The rule in my state used to be that you gave an update once a year. If in that year your income changed all you would do is update that and if you were over the limit for it you just didn’t get it the next year.

However, that is changing for a lot of states. In mine I have to let them know if my income changes by $150 for 2 or more months.

Each state is different. My suggestion is to call 211, this will give you information for your local area about any services. They can give you the numbers and websites to visit for your location.
 
My family is on Medicaid now, but my husband just got a raise that puts us over the limit. I think we should tell them since we are now ineligible based on an increase in income. My husband thinks it’s not our place and we shouldn’t say anything and just wait for them to find us ineligible when they verify our income at the renewal period. I think that is dishonest. What should I do?
 
Report it asap. Of course it is your place to do so.

I was a Medicaid intake eligibility worker in California in 2005 (called MediCal in California). It is administered by counties here, but goes by state and federal laws. So I worked for county government. Even though cases I approved were then sent to a “continuing worker” (aka carrier worker), I was required to know the county, state, and federal reporting requirements and to have my client sign a form that states those and to give them a copy as well as a list of responsibilities. Your situation falls under federal reporting laws.

The answers to any questions about reporting requirements are on the paperwork you received when applying or when approved. If you no longer have your paperwork, or have misplaced it (which is probably common), you need to call your worker and ask what to do. Your approval letter or notice you received after your case was approved should have your worker’s phone or a central number.

I can tell you right now, though, that no matter what state you reside in, an increase in salary MUST be reported as soon as it is received. This reporting requirement is based on federal law. You should call your worker and report that your husband’s income is expected to increase, the amount, and when the first paycheck with the increase is expected. The worker will follow their required procedure, which will likely to be to request proof. Then after you send a copy of his paycheck reflecting the amount with the increase to the worker, they will go from there according to the state requirements and possible county procedures. I suspect that what follows is adjustment of the household budget to find out if you are still eligible, eligible with a “share of cost”, or discontinued. (I have never been a continuing worker, so not sure.)

If you don’t report the increase in his income, you will likely be subject to a penalty for hiding it. It was stated in your paperwork. States have databases with income reports. My office had the office assistants run them once a week and send them to the workers. Because of heavy caseloads, it can take a while before workers check all of them, so covering up an increase may seem to work fine for awhile, but eventually the truth will be discovered. They only way to not get caught is to be paid “under the table”, which, of course is lying to the IRS as well and making him ineligible for unemployment insurance.

Because of the Affordable Care Act and my lack of income, I am now receiving Medicaid. So my knowledge is more current than 2005, having received my paperwork when applying.

Good luck and I hope you end up eligible for at least a share of cost. Make sure you have also reported any acceptable living expenses that can help balance out your case (rent increase, ulitity increase, for example).
 
Taking a government handout (which is shameful to begin with) when you’re not entitled to it is theft.
 
Taking a government handout (which is shameful to begin with) when you’re not entitled to it is theft.
The first part of your post is untrue. There is nothing shameful about being poor or accepting available help for being poor, whether it is from the government or not. That’s what it’s there for.

The second part of your post is accurate. I agree with the OP’s sentiment that waiting for Medicaid to find out is dishonest, and to go ahead and report the change. If you wait it out, you may even be legally responsible for paying back the coverage you weren’t entitled to.
 
Taking a government handout (which is shameful to begin with) when you’re not entitled to it is theft.
What is shameful is the way the poor or struggling in America prior to government “handouts” had to live and die. Read Grapes of Wrath and brush up on your history. There was a time in this country we let people starve, live with disease, spread disease and die unnecessarily.

There is no shame in getting help when you need it and many need it.

As I previously described, an eligibility worker will make a determination based on both income and expenses. That is not a determination that any of us can make or should make. It is possible the OP can still qualify for benefits with a share of cost. If it is necessary for their benefits to be discontinued, the worker can still help through referrals.

I have Medicaid and am not ashamed. I know what it is like to be without medical insurance. It is a great blessing to have it and I thank God.
 
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