My mother died 2 months ago. Her house became mine via a transfer on death deed. I was going to close on the house today, and found out from the title company that medicaid put a lien on her home.

My mother had private insurance and was a fulltime employee when she died. She had medicaid briefly in 2019, and then she had it over 20 years ago and has had 2 of her children on it when they were minors (me being one of them and I'm 35yrs old now).

She was 56 years old when she died. Apparently, the Medicaid Estate Recovery Program goes into effect after someone turns 55 years old. Based on the language on the in.gov website, "The Estate Recovery Program will seek to recover the total amount Medicaid has paid on behalf of recipients after they turned 55-years-of-age, and in certain other limited circumstances." This is stated a couple other ways too, but it always reads like they are seeking repayment for services that occurred AFTER the person turned 55 years old. My mother last had medicaid when she was 53 years old.

I received an itemized bill from them. The services they are seeking repayment on are from 1994 to 2019. Lots are in the 90s and early 2000s, then a jump to 2019 and then no more.

Clearly, they do not see it as repayment on services that happened after 55 yrs old. If they did, they wouldn't be making the claim on services from when she was 26 to 53 years old. I just think it's insane they can do this. They never notified her that she owed them money, at least not in the last 5 years. I was told they don't have to notify you. The only way to know is to seek them out and inquire. The person from FSSA said "the people usually don't know", like this is common to just have a medicaid lien appear. I would guess that most people were actually ON medicaid when they died, though.

I emailed FSSA department, and I'm planning to fight this. My next steps are to contact congress people in my state. It's not just what has happened to me that is a problem, it's that they are allowed to do this without having to notify anyone. I never even received a letter from them like I've seen some people on here say they got. We ran the title 2 weeks ago- no lien showed. Day of closing it gets run a final time- suddenly there's a lien from an insurance she hasn't had in 5 years and hasn't been contacted about owing at all.

I don't have a question. Just sharing and seeing if anyone has suggestions or information to share on this.

I received a message that at the beginning of next month (January 1st) my health care coverage will end and the reason stated is that "the person that applied did not give proof of identity". I don't know Why this has come up. I had no previous messages before this. And I have been to various doctors appointments and such. Any idea what this means or how to fix this? I have insurance through ForwardHealth and Anthem Blue cross blue shield medicaid.

So as the title suggests, I forgot to update medicaid about my sons daycare expenses.

I'm moving out of state and already requested them to close my case as I no longer will need the benefits.

My question is though, can I still claim the daycare expenses on my taxes or should I not. Never had an issue with this since it's just a bill.

And if I do, will I get into any type of trouble?

TIA.

Hi all— I have been in this whirlwind with an aging loved one that will need Long Term Care by the end of January 2025. She applied for Long Term Care through Washington State but was denied due to having too many resources. She is not what you’d call a wealthy person but to qualify for Medicaid (same as Long Term Care), one can’t have more than $2,700 or so in the bank. My question is, what if all of her accounts are joint with a loved one but only she is interested in Long Term Care? The spend down would drain the funds of the healthy person. Has anybody seen a positive outcome where the State considers this?

I am trying to see if I can find coverage details for elective induction at 39 weeks. I have Priority Health Medicaid of MI, I looked through all the plan documents and can't find anything. I have found articles talking about Medicaid not covering before 38 or 36 weeks unless medically necessary, but nothing after 39. We live over an hour from the hospital and I had a very quick labor last pregnancy so hoping to avoid a car birth!

Last time I called the plan directly for a simple coverage question it took an hour and then they ended up calling me again because they told me incorrectly, so trying the internet first...

I have severe gastroparesis. I have a peg GJ tube. I use a kangaroo omni pump. They sent me the single bags. Is there a way to get Medicaid in PA (UPMC FOR YOU) to cover the double bag sets that do automatic flushes so I don't have to set alarms all night?

Tips and tricks appreciated!!!

I am 27/single/NC/currently enrolled in a medicaid managed care plan. I’m transferring from a community college to a university where I will taking out student loans on top of the usual Pell grant. Before this, even with the Pell grant, my income was below the requirement. Now, with my students loans, it might be a little bit above it (or right at that point).

I am also worried as my understanding is that medicaid eligibility is determined by monthly income. With the FAFSA, I receive everything all together at the beginning of the semester, but will not be receiving any income for the rest of the semester.

I am confused because I saw in one place on healthcare.gov where I interpreted that these loans will not count toward income, but it seems like some people are saying they do.

If they do count as income for medicaid, do they also count as income towards one of the marketplace plans?

Thank you for any info/help interpreting/experiences you can share!

Hey, I live in Indiana and I have a Medicaid. I’ve been trying to get medication for weight loss. Of course I know that they are saying that things are not on the formulary so they are not covered. Any idea of how I could get Zepbound Ozempic Wegovy or any other medication approved. I have high blood pressure. I’m prediabetic. I have PCOS. Just had to have a lung surgery and I’m obese. I’ve tried three of the medication in the past. I’ve also seen a dietitian. I also tried to lose weight on my own self. This is so frustrating because they would rather do the surgery then to cover medication, which makes no sense to me.

If I'm on SSDI, do they count my IRA and savings account as an asset for Medicaid?

It would really help if I could get my state to cover my part B.

My grandfather is using Medicaid for the assisted living facility he is staying in (rural northeast Oregon . He has recently received some checks from his tribal corporation in Alaska that will put him over the asset limit. Are there any exemptions for funds like this? Recommendations on who to consult with?

Admittedly, I didn’t realize I was still eligible for Medicaid from my pregnancy until I went to the er and never saw a bill. I knew my daughter was eligible but I was unaware I was. I have been struggling to pay out of pocket to my doctor for over a year before I even realized I have it ( I have been signing release forms stating I don’t have it) I am worried my doctor will get in trouble but I don’t know what to do! Yikes! Does anyone know what happens if they find this out ?

My mom has Medicaid in Indiana and is moving to be closer to family in New Jersey. She will probably stay with us in NYC for a few months while seeking a full time residence in New Jersey.

From what I’ve seen online, we will need to:

-contact all her providers and make sure she receives her prescriptions for the next few months -cancel her Indiana coverage -apply for ACA insurance in New York while she looks for a permanent address in NJ (or should we just rely on the retroactive Medicaid coverage in NJ?). I am not sure if this is allowed given she won’t have a permanent address in nyc, she’d be staying with us. -once she has a permanent address in NJ, apply for Medicaid

Do those steps sound correct? Am I missing anything? My mom has a few chronic conditions so I just want to make sure there’s no gaps in coverage. Thank you in advance!

I will be inheriting a large amount, around $100K or more, sometime in the near future. I am in Texas and have only been receiving benefits for 4 months. I am 43. I am concerned about how this will affect my SSI and Medicaid benefits. I don't want to spend all that money as I have a Schizophrenia and will need access to that money, so I don't want to tie it up, but I have been reading that the only way to not get my benefits revoked. I currently live with my family so I don't pay for much. Does this situation warrant an attorney or can my family open something to keep this money safe. I only have a mom and sister as beneficiaries. Thanks for help!

I’ve been waiting to get approved and I finally did I find out I have been approved through my local welfare website does anyone know how I can access the info? I would really like to visit the doctor today if possible

WA State is that matters.

I have been disabled for roughly a decade and receive SSDI. filled out the Normal yearly disclosure paperwork and stated I then had 2500 in my bank account. This was due to recieving an unexpected $1100 medical refund check, from a surgery bill I had been making payments on, that I shouldn't have been billed since may. Just got the letter stating (on Xmas eve) my medical was bring denied for 2025 due to having 2500, 500 over the limit. Am I really going to lose my medical coverage? I have multiple serious conditions, and see 5 doctors regularly, and have 2 upcoming surgeries already scheduled. Most that money is already gone, on paying over due bills. I also have never received any other state service like food stamps, housing assistance, section 8, bill relief ect. It says I can file an appeal, but how long will that take, and what are my chances. I guess you get punished for honesty. That'll teach me. Keep in mind a studio apartment in a bad area around here is around $1500, so that extra 500 will sure get me far.

Hi my friend family members just come to the usa from Vietnam she don’t have a ssn number yet but soon she a green card holder can she apply for Medicaid to see doctor etc Philadelphia pa or NJ any advice thank you so much

After yrs of trying to keep on Medicaid, now I can't seem to get off it despite being over the income limit and age limit for PA's MAWD Medicaid plan. Despite calls to them, they keep sending letters saying I still qualify. I've been on Medicare since last month!

Does PA Medicaid charge recipients premiums? I read something online that said they charge $10-35 a month. When my family was on it temporarily a few years ago, I never got a bill for premiums ever.

I was approved for Medicaid in NYS on November 29th 2024 and it begins on January 1, 2025. It is through Health first.

I realized that I put the incorrect income information. I put an estimate of 17k but that was my take home pay. My gross income was actually 21k this year, which is a little over the limit for a single person. I didn’t mean to put my take home pay, this was my mistake.

I heard that they check monthly income, and right now I’m only making around 1k to 1.5k a month. Earlier in the year, I was making a little more money (over $1677/m) but I’m working less now due to being a full time student. Starting next year, I’ll also be making less because of school. Should I call them to correct the income mistake? Will I lose my coverage since my gross income is a little over the limit? I was thinking, since I’m making less now and also will make less next year, that I should be fine. But I’m not sure and I don’t want to get into trouble.

We have already sent in the annuity surrender forms and I spoke the annuity company this morning and they said they received them Dec 23rd and that they are in process but it could take 5-15 business days to process before the payout check mailed.

Technically her 100 days under Medicare under short term rehab do not end until Feb 5th but the people at the rehab facility expect that Medicare will end her coverage around mid January based on recent progress assessments although nothing is official. Problem is we need to get that annuity money in and then paid to the mortgage company before the facility files the Medicaid paperwork since that annuity balance will take her over NY Medicaids resource limit of $31k. I know we can file a fast appeal to Medicare so she can continue to the short term care since she would have about another 3 weeks left of the 100 days in order to give us more time to get the annuity thing settled but not sure of the logistics of that or how likely it will be that the appeal will be excepted but those 3 extra weeks should be plenty to get the annuity payout check received and the money sent to the mortgage company.

If in the end they do cut her off before we have annuity payout is in our hands and pay the mortgage how will that effect Medicaid eligibilty. Should we just not present the annuity when we hand in the paperwork for proof of income and assets to the facility to file since sometime shortly thereafter we will indeed be paying the mortgage with it and Medicaid allow for using personal financial resources to pay down personal debts.

We don't want to jeopardize her getting Medicaid and we do not want to lose the annuity to Medicaid. Any advice?

Was approved for Florida Medicaid back in June. Have called several times and they say they will send the cards but they have never come. I continue to pay out of pocket for my medication which I shouldn't have to do. Not sure what else I can do to get the Medicaid card sent to me in the mail. The temporary ones printed out online are not accepted by the pharmacy nor doctors office. Was curious if anyone else experienced this and any suggestions. Thanks

Hello!

I was unemployed from winter 2023 until this summer. After getting a health policy from my new employer, I have made SEVERAL attempts to cancel my Medicaid coverage… unsuccessfully.

United Healthcare said that I need to call Cover Virginia because it’s a Medicaid policy and they cannot cancel it, and then Cover Virginia told me to call to call my “agent” (I think that’s the word they used?). They gave me their first initial, last name, and told me to leave this agent a voicemail with my request. I did that, and my policy is still active. Just kind of blown away how difficult this is and how much conflicting info is out there.

If anyone has tips to canceling Medicaid coverage in Virginia, I would greatly appreciate it !! Worried this may affect my taxes …

About a month ago I posted here about my Medicaid being cancelled as a result of a clerical error. It was appealed and reinstated. About 10 days after it was reinstated, it was canceled again. What the heck? Case worker isn't returning my calls. I go over her head to her supervisor. They won't return my calls either. Medicare is tapping out my bank account because they are now double dipping on their payments over part B. And nobody i call will speak to me. Everyone points their finger at someone else and round and round we go. The answer lies with the case worker. Who hasn't returned a single phone call in over a year. Her supervisor also won't return any phone calls. If I call the head office they just tell me I have to call the case worker. I'm getting nowhere with these people. I'm to the point where I'm ready to take legal action because I don't know what other options I have. Any advise you can give would be appreciated.

Effective January 1, 2025, Collegium Pharmaceutical, Inc., the manufacturer of Nucynta, Nucynta ER, and Xtampza, will terminate its participation in the Medicaid Drug Rebate Program (MDRP). This change means that these medications will no longer be covered under Medicaid, potentially affecting their availability and cost for Medicaid beneficiaries.

See more at r/PriorAuthorization

Hi everyone

I submitted my redetermination for snap and health on 12/16 it said my redetermination date would be the next day but it’s already 10 days later

Every time I try to call I’m on hold for 1 hour than it hangs up even tried different options

Anyone know If this wait time is normal for IL ?

Thanks