Hello, I have been asked to upload a pay stub for the last 30 days to verify my eligibility but I do not have a paystub to submit because I lost my job and income at the beginning of November. What exactly am I supposed to submit here if I do not have pay from the last 30 days? Should I just submit whatever the most recent one I have in October?

Hi all. I am in the trenches beside a loved one who is in a TCU for some epic bed sores (currently on a wound vac) and to receive some PT for a broken leg from a year ago. I understand from her policy that days 1-20 have a $0 co-pay and days 21-100 have a daily $200 co-pay but that her Medicare Savings Program (QMB) will be picking those up. After more than one hospitalization and now in her second SNF of the year, I am urged to look at LTC once Medicare decides to discharge her. If she is allowed to use up the 100 days, this would take her well into the end of January. At any rate, she qualifies for the QMB but not full Medicaid which would then enable LTC. What are cost effective ways to provide long term care? We are in Washington State. Thank you.

Hi everyone. It's been impossible to find this info. What is the asset look-back period for a senior that will apply to "regular" Medicaid for health coverage / insurance? PS. I did find the 5-year look-up for nursing home applications, but this is not what I'm trying to find. Thanks for any pointers.

Edit: this is for New York City (New York State | NYS)

Basically, my hours at work are going up based on my schedule for next 2-3 weeks (I can see hours in my work app). I haven’t been officially moved to full time but it’s in the works. I do still need to have an internal interview but my scheduled hours are already starting to go up.

Do I need to pre-report based on my projected schedule or do I wait until I actually have a paystub showing these hours?

Think, I’ll be going from 28 hrs a week to like 38 or something?

I don’t necessarily want to pre report because these hours are projected and haven’t actually happened yet and I also have not yet been offered anything officially. Obviously once I’m actually paid I’ll report and submit paystub. Any issues with this?

Is it ok for an elderly (65+) Medi-Cal recipient to be a dependent on someone’s tax return? They meet all the other eligibility criteria.

Is it even seen in the system that someone is someone’s dependent for tax purposes?

My question is primarily about how a potential income increase in the 3rd quarter of 2025 would affect Medicaid eligibility in the 1st half of 2025.

Here's my situation:

- 64, retired and not married

- Turning 65 in July 2025.

- Currently paying living expenses from sales of stock from a brokerage account (as planned).

- No other income in 2024. Not planning to collect Social Security until 67 or 70.

- I qualified for Medicaid in 2024 because the capital gains from the stocks I sold were under the Medicaid income eligibility limit. (This was a surprise!)

- I will sign up for Medicare in 2025 during my enrollment window.

My Medicaid enrollment has been carried over to 2025 based on my income estimate for 2025 being similar to 2024. However, there is a chance that my income will go up in the second half of 2025 and be above Medicaid eligibility limit. The income increase is not certain, but it is looking increasingly likely.

Question - How does Medicaid handle this? Do they decide a person's eligibility based on their yearly income - or is it done on a month by month basis?

Thanks!

Am I able to get insurance through the marketplace if my employer offers insurance? Insurance for me and my kids through employer exceeds affordability but individual coverage may be affordable for myself. I’m also pregnant, so would I be able get marketplace or Medicaid insurance for myself since I’m pregnant? My friend was able to but this was during the PHE. Not sure if same rules apply

My son who is disabled got approved for state Medicaid for only 4 months which is so weird like why is that. The SSI benefits ended and due to that the coverage for Medicaid also ended. I applied for state Medicaid but he only got approved for 4 months. Am I supposed to call them or reapply for SSI benefits?

My father is a New York State resident, 75 years old. His health has suddenly deteriorated and while he’s okay for now, we anticipate he will need nursing care at some point. He has a checking account with less than $20k and no other assets except a whole life insurance policy (total $200k) with a current cash value of $66k. From what I understand, that puts him over the asset threshold for Medicaid. Does that mean he would have to surrender the policy in order to qualify for Medicaid? (I know there are other income qualifications but we’re setting that aside for now.) Does surrendering it mean he takes the cash value and then spends it down until he’s below the threshold?

Is there any way to keep the policy? We looked into Medicaid asset protection trusts, but I think realistically he doesn’t have five years left (to overcome the lookback period). He is very disappointed that he paid into it for over 40 years to leave as an inheritance for me and it may be a barrier for healthcare.

Is it possible for him to transfer the policy to me and I give him the approx cash value, which he can then spend down and qualify?

My mom is 89, has multiple health issues and has started falling. We're hoping she never needs nursing, but it's not impossible that this could happen.

So, she's doesn't need to drive anymore and is aware (she's scared to drive at this point because she knows she's having difficulty). I know that she can't simply give the car to a family member or sell it for a token price without it most likely causing a Medicaid penalty if Mom does have to go to nursing. It will most likely look like a gift that has to be paid back before Medicaid would cover nursing, from what I understand. Mom has very little money in the bank and would very quickly run out of money if she needed to be in nursing, btw, so if she goes to nursing, she will definitely need Medicaid. She's in Alabama, the threshold is around $2K left in funds iirc.

Anyway, not sure the best course to take with this car. I think at this point it's probably to sell the car, making sure we get bluebook price. No one else in family has a clue about this and they were just gonna sell it cheap to a granddaughter, and while in theory I'm ok with that, that car is worth about $16K in bluebook and we can't pay that for her nursing care ourselves is mom ends up in a home. I told them no, it's probably a bad idea to sell it for less than FMV.

Option 2 was to just keep it, and I guess sell it after she passes. But I don't know how long that will be, the car will sit there and rot away and depreciate. My sister wants to let it sit, and not renew tags or pay insurance, which she says you can legally do if it's not being driven. This sounds like a bad idea to me, and also means it can't be driven even occassionally by a friend to keep it running well - it would just be letting it sit. That sounds like a bad idea to me. My family keeps coming up with these options that make no sense and I feel a little nuts being the only one saying that's a bad idea, but it makes you doubt yourself.

Option 3: Sell it now, put the money in her bank account, and I think, encouage her to use some of it for things she needs (like hearing aids). Maybe not spend it all, as we're not trying to do a Medicaid spend down right now -- we don't know for sure if she'll ever need nursing. But if she does, the money from the sale of that care will pay for a few months nursing and be gone, so she should probably use it for things she could use but simply can't afford right now or is trying not to buy because she has so little cash in the bank. She also needs work done on her trailer that she can't afford, though I'm not sure if it's wise to recommend she put money from the car sale into that, because what if she spends thousands and ends up in nursing next year and isn't living in the home anymore, anyway? Hmm, but maybe she should go ahead and get those things fixed, it would make things easier for her at home, I think.

Answer: I think it might be to sell it now, but only if we can get fair market value as noted on kelly bluebook. We would probably sell to Carmax - do we check for the personal sale value or trade-in value? I guess personal sale?

As an aside, what the heck would happen if we ended up in a medicaid penalty and she was in the nursing home and they denied coverage because she did sell that car for like $100 to a granddaugher? And they said ok, you have to pay $15,900 worth of care before Medicaid will cover? Let's say that was enough for 90 days of care. Could a family member take her home for 90 days and try to care for her, and then the Medicaid kicks in? Or is it a matter of the first 90 days of care would have to be paid by someone before Medicaid would kick in, doesn't matter if you took her home for a while or not? I'm not advocating they do this, but I am curious what the hell people do when they get in the situation of a Medicaid penalty and no one has the money to pay the penalty period. I'm trying to keep it all straight, but there are other family/friends involved her live closer to her and are with her a lot, doing stuff for her, and they aren't really clued in on concerns on Medicaid lookback.

So I recently just applied for full coverage medicaid in South Carolina. According to what I’ve researched online.. I’m not sure if I should give them a call back, and tell them that my mom took me off medicaid at 18? I had full coverage back then but they took me off of it and trying to get it back. (Im 23 now) I’m also not sure if I should tell them I’ve recently had many ER visits and doctor visits payed out of pocket due to severe anxiety and panic disorder along with ptsd. (I do know I’m officially diagnosed with anxiety disorder per old primary care physician.) I wish I could post images on here but I’ll just copy and paste what I googled: -“Yes, it is important to mention on your South Carolina Medicaid application that your parents removed you from Medicaid before you turned 25, as this could potentially impact your eligibility and may be considered when reviewing your case, especially if you are applying based on a disability or other qualifying health condition that existed during that time” -“Yes, Medicaid applications in South Carolina consider a five-year look-back period that includes recent doctor visits and other factors”

Any insight would be greatly appreciated!

I live in Illinois never lived or applied for Medicaid in California and somehow California system automatically enrolled me in California system for Medicaid. Fraud department in California told me it was system issue and that happened with lot of people. Did anyone got the same?

I need Medicaid so bad. My health issues are about to keep me from working. I can’t live off of $1,200/month. I earn about $1,200 a month working part time. I have a very long list of health issues sadly, and am 43. I have googled til I about drop about 2025 requirements for Texas Medicaid. So one thing says $2900 max income but for nursing home Medicaid. Another says $900 something for Disabled adult Medicaid. I cannot find anything for something in between. Could anyone help, please?

My brother who is teenager used to get Medicaid from social security but his benefits ended when SSI or ssa stopped. It's been almost a year that he has not been able to go visit doctor and do routine checkup. We went twice to social security office but the lady over there was extremely so rude and unhelpful. She said you need to reapply for Medicaid and that takes up to an year to be approved so meanwhile you need to apply from state Medicaid. So I applied for my brother medicaid online on the my Access Florida. My mother is unemployed for 5-7 months now and they said you have to apply only on your brother so I did but I got letter today and it says mother is eligible for Medicaid needy program but brother is ineligible. Like what the heck is going on with this. I have no idea what to do right now. Mom doesn't speak English. Should I call state Medicaid or social security office.

I got a job at the end of April (part time) and my husband got a raise. I submitted check stubs to Medicaid. They took me and my husband off in May. But we technically make over the limit for the kids and they haven’t taken them off.

I submitted check stubs weekly for months. I called Medicaid and they told me to stop submitting stubs and to wait for renewal in April and they should be kicked off.

In June I went full time. By November I got insurance through work for my entire house. I submitted insurance cards to let Medicaid know my kids have primary insurance from my work.

Also do I need to report that my husband was given a house by his grandparents a few weeks ago? We just transferred it into mine and his name as well this past week.

Why aren’t they taking my kids off?

I need to add my medicaid online after going to the er. I'm not sure what that is because usually I'd just give my provider's number of my insurance. Is it the same number as the provider? I know for sure the hospital I went to accepts medicaid because they say it and I've used my medicaid there before too

I just gave in person and gave my provider's insurance last time, I'm not sure if it's in the system or if it changed because now online it wants to add my medicaid number and I'm not sure what that is.

I'm from pa and I have my state website for medicaid(compass) setup, it's just I can't seem to find where to find my medicaid number

I have a loved one who has been on the Medicare Savings Plan (aka Qualified Medicare Beneficiary) for over a year now, retroactive coverage starting in August 2023. Some people call it “partial Medicaid” I am always waking up at night in a cold sweat hoping that this (generous) program will cover all of her co-pays as she is in a SNF that would otherwise render a daily co-pay of $200. A ton of social workers and even customer service agents at her health insurance company seem to have no clue about this program and it’s frustrating because I don’t like surprise bills and claims take a couple months sometimes. As long as Medicare has sanctioned her to be at the SNF, am I to assume that MSP/QMB will cover all of these co-pays? I have never been this adjacent to such a seemingly generous state program. Thanks for your input!

So I may be in a situation soon where my husband's employer will be ending their health insurance plan and giving everyone "raises" to go get a marketplace plan. My family is very close to the upper limit of qualifying for Medicaid currently, so we wouldn't qualify for a Marketplace plan. If he gets any bonuses, federal refunds, or there is a 5th pay period in the month, we would be over the Medicaid limit for that month. Does this mean we would keep getting kicked off of Medicaid every other month that this happens and have to reapply the next month? I have 4 children and soon to be 5. I can't go without insurance every other month. Has anyone ever been in any of these situations and how did the County Assistance Office handle it?

hi everyone! i’m helping my grandparents apply for medicaid and food share in wisconsin. for medicare, they sent a letter asking to send proof of people living the home and examples are statement form landlord, affidavit or lease. my grandparents are living in a duplex (2 stories) that my dad owns- so they live there for free… except they pay for utilities.

what should i be sending in? just a normal letter that my dad writes? there’s no lease or anything.

i’m a first generation trying to help them- so i’m confused myself.

let me know! i’ll appreciate it :)))

if I were to qualify by meeting income limits from December for January coverage, but then go over income during January/February...

then March and April I take unpaid medical leave and don't make any money/barely any, how should I handle that with Medicaid? what would my coverage timeline look like ?

I'm on adult integrated Medicaid in Ut

Mom is in LTC nursing home on Medicaid since Nov 1 and her monthly SSA retirement check goes directly to NH. But she stills owns a house (which is up for sale) that has a monthly HOA fee. Should her SSA check be used to pay for the HOA fee before NH gets the remainder? I'm in NJ

I live in NY, I have Medicaid and my son is also on my plan. My boyfriend and I are getting married soon and I am wondering what if anything happens to your medicaid benefits when you get married.

I only remembered to report this to Medicaid Louisiana yesterday, and in a panic, I emailed five check stubs and a current revenue statement from the mineral lease, covering everything. I've had one routine doctor visit this year and one eye exam, which I paid for out of pocket, and I think I fully paid for my glasses myself. My one prescription, metoprolol for my hypertension, is free due to medicaid, and i think it is normally a $4 generic. As soon as I realized my mistake, I emailed them. I fully expect to be ineligible for Medicaid now due to the mineral revenue. Other than that, I have a 28 hour per week job at my local public library.

I am 58 years old now and have loud tinnitus and hyperacusis, which means I almost never leave my house except to go to work and buy essentials. I drive with ear muffs, and restrict my driving to short trips of about one mile, because of painful hearing sensitivity. But I've never tried to get on disability. My question is, am I in trouble? If they want me to repay anything, I'll be more than happy to do so.

Hello,

I am currently the age of 62, who is on medicaid. I do not work as of now, however I did invest about $10K I had saved about 4-5 years ago. Since then, the investment has rose to around $35-40k.

I searched online and notice for NYC the income limit is $1700 per month. Which would roughly put me at around $21k for the year.

As living expenses has soared I am in a situation where I need to pull some money to pay for my food and bills. If I sell all of my stocks, that would put me over the 21k limit for the year. So my question is, if I sell ALL of my stocks which would be around $25-30k (which would be the actual net profit since I invested 10k to begin with), does that mean I would no longer be eligible for medicaid? If so, would I no longer be eligible just for the following year, but able to received medicaid the year after that, assuming the money is all spent by then?

I called medicaid but they were very unhelpful and everyone had different answers, so Im not sure who else to ask but thought maybe someone was in my position as well here on the internet.

Any help and answers would be very much appreciated :)

Thank you

So weird trail of events.. but I’m trying to apply for Medicaid in South Carolina. I got evicted from an apartment complex.. became homeless for a few months. I am now “living” in the same complex, just different apartment number, with my boyfriend. But the apartment complex doesn’t know obviously.. and I’m not listed as an official resident here or even roommate. :/ Also as the title states I haven’t had a job in a while. Would I still be able to get Medicaid “family planning limited coverage” ?