Guest guest Posted May 16, 2002 Report Share Posted May 16, 2002 Beth, If your aunt needs the medical coverage but not the income that she would get from SSI (Supplemental Security Income), she could go to her local public aid office to apply. Otherwise, if she is trying for SSI, she would have to go to the Social Security Office. The quickest assistance would be Medicaid through the public aid office. She should call and make it clear that she is looking for Medical Assistance, only (if that is the case.) If she is needing hospitalization, the social worker or business office should be able to help her make that application. Eligibility for Medicaid (independent of SSI) is based upon income; each state has its own formula for determining eligibility. Sometimes there is a copay involved. Hope this helps. Marcia Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 16, 2002 Report Share Posted May 16, 2002 She has to file for SSDI first and that can take several months at the minimum to several years and SSI, once apporved for SSDI it takes 2 years before Medicare benefits begin. With SSI medicaid begins immediatly. SSI is based on total family income, which differs a tad bit by state, but generally you have to be close to the poverty level to qualify for SSI, can own only 1 vehichle and have less than either 2,000 or $1,000 in the bank. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 17, 2002 Report Share Posted May 17, 2002 Call your local welfare office or Senior and Disabilty services. They will have all the details. Usually, to qualify for state medical assistance, you must provide the last 3 months income. You may not be over a certain dollar amount which is depending on household size. You can get covered reletively immediately if your income is right. IF not, there are other options like Spend Downs, Safety nets, etc. File for SSI and SSDI because the SSI payments can begin from the date of filing once approved. Depending on the illness, she could be approved quickly. Also, She may qualify for retirement instead of disability payments due to her age. Call the Welfare office or the SDS in your area and speak with an intake worker. They can give you the names and numbers of who to contact if they can't help. Gotta play the game and jump though all the hoops. Hope this helps, Caroline. eg4@... wrote: Hi Gang- I have a question, my best friends Aunt was just diagnosed with a really bad illness and we are trying to help the family figure out how long it would take her to get on Medicare or Medicaid- she is 59 ----- if anyone is familiar I would really appreciate the help. Beth Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 17, 2002 Report Share Posted May 17, 2002 Beth, I believe for Medicaid she would have to prove financial need. I don't know if it's the same in all states, but in WA she would have to have less than $1500 or $2,000--can't remember which & I just went through that at the SS office--in assets (that includes ins policies, stocks, pensions, etc). She is allowed to own a home (I think, or maybe it's just the spouse can have a home--the state takes its portion of the home after both are deceased before the estate is probated) up to a certain value (in Florida I think it's unlimited value) and own a car. Also, if she gets rid of her assets by putting them in someone else's name or stating no claim or interest in them, it has to be done 3yrs prior to her application. As for Medicare, if she is approved for SSDI the normal waiting period is 36mo, but because she's 59 she might be able to get it sooner, but have to pay $300+/mo for it. I'm not sure, as there probably are all kinds of rules & exceptions to them. You might want to look at the SS website, your state's welfare/dshs site, and contact your state insurance commissioner. I've found the ins commissioner to be fairly helpful in the past. Also, there might be some other state program she's eligible for. I'll be praying things work out for her. Teri _________________________________________________________________ MSN Photos is the easiest way to share and print your photos: http://photos.msn.com/support/worldwide.aspx Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 11, 2008 Report Share Posted October 11, 2008 and others, I took the information I learned from this list last year and have spent the last 12 months trying to make changes in my state. My state was/is most definately violating EPSDT (and it certainly wasn't limited to HBOT denials). We now have a Medicaid lawyer ready to start a class action suit. I would like to hear opinions on how to proceed considering the dismal economic state of the country. Basically our state is slashing services to children with disabilities left and right, however, they are not attempting to cut the one service they are forced to provide because they already lost a lawsuit over it. They were forced to provide prescribed diapers to Medicaid recipients because not doing so is of course a violation of EPSDT. So what I am seeing happen is that, despite lack of funds, they are not limiting the amount of diapers a child gets in an attempt to balance the budget, instead they are limiting everything else (everything they can get away with). This makes me wonder what the state's responsibilty is to abide by EPSDT when they feel they cannot afford to do so? If they have no money, will going to court and winning force them to come up with the money (ie: reprioritize their spending) or are they at some point suddenly off the hook? Also will the state likely retaliate by changing the waiver and reducing the amount of children who are Medicaid eligible? Our state is currently generous in this area. Medicaid is granted to anyone in " immediate danger of being institutionalized " regardless of income. I know some states use income to determine eligibility and some even use a lottery system. I'm trying to figure out if initiating a class action suit that (based on EPSDT) we would/should win is worth the effort considering the state may have the power to insure it is a Pyrrhic victory! Those who have fought this battle, please chime in! Thanks, PS -- we are not only attempting to make Medicaid changes thru litigation, we are also working on legislation. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 13, 2008 Report Share Posted October 13, 2008 Does anyone have any thoughts on my question below? - > > and others, > > I took the information I learned from this list last year and have > spent the last 12 months trying to make changes in my state. My state > was/is most definately violating EPSDT (and it certainly wasn't limited > to HBOT denials). > > We now have a Medicaid lawyer ready to start a class action suit. I > would like to hear opinions on how to proceed considering the dismal > economic state of the country. Basically our state is slashing > services to children with disabilities left and right, however, they > are not attempting to cut the one service they are forced to provide > because they already lost a lawsuit over it. They were forced to > provide prescribed diapers to Medicaid recipients because not doing so > is of course a violation of EPSDT. So what I am seeing happen is that, > despite lack of funds, they are not limiting the amount of diapers a > child gets in an attempt to balance the budget, instead they are > limiting everything else (everything they can get away with). This > makes me wonder what the state's responsibilty is to abide by EPSDT > when they feel they cannot afford to do so? If they have no money, > will going to court and winning force them to come up with the money > (ie: reprioritize their spending) or are they at some point suddenly > off the hook? Also will the state likely retaliate by changing the > waiver and reducing the amount of children who are Medicaid eligible? > Our state is currently generous in this area. Medicaid is granted to > anyone in " immediate danger of being institutionalized " regardless of > income. I know some states use income to determine eligibility and > some even use a lottery system. I'm trying to figure out if initiating > a class action suit that (based on EPSDT) we would/should win is worth > the effort considering the state may have the power to insure it is a > Pyrrhic victory! > > Those who have fought this battle, please chime in! > > Thanks, > > PS -- we are not only attempting to make Medicaid changes thru > litigation, we are also working on legislation. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 13, 2008 Report Share Posted October 13, 2008 You may have already told me this before, and I apologize for not remembering, but what state are you in? DF [ ] Re: Medicaid Question > >Does anyone have any thoughts on my question below? - >> >> and others, >> >> I took the information I learned from this list last year and have >> spent the last 12 months trying to make changes in my state. My >state >> was/is most definately violating EPSDT (and it certainly wasn't >limited >> to HBOT denials). >> >> We now have a Medicaid lawyer ready to start a class action suit. >I >> would like to hear opinions on how to proceed considering the >dismal >> economic state of the country. Basically our state is slashing >> services to children with disabilities left and right, however, >they >> are not attempting to cut the one service they are forced to >provide >> because they already lost a lawsuit over it. They were forced to >> provide prescribed diapers to Medicaid recipients because not doing >so >> is of course a violation of EPSDT. So what I am seeing happen is >that, >> despite lack of funds, they are not limiting the amount of diapers >a >> child gets in an attempt to balance the budget, instead they are >> limiting everything else (everything they can get away with). This >> makes me wonder what the state's responsibilty is to abide by EPSDT >> when they feel they cannot afford to do so? If they have no money, >> will going to court and winning force them to come up with the >money >> (ie: reprioritize their spending) or are they at some point >suddenly >> off the hook? Also will the state likely retaliate by changing the >> waiver and reducing the amount of children who are Medicaid >eligible? >> Our state is currently generous in this area. Medicaid is granted >to >> anyone in " immediate danger of being institutionalized " regardless >of >> income. I know some states use income to determine eligibility and >> some even use a lottery system. I'm trying to figure out if >initiating >> a class action suit that (based on EPSDT) we would/should win is >worth >> the effort considering the state may have the power to insure it is >a >> Pyrrhic victory! >> >> Those who have fought this battle, please chime in! >> >> Thanks, >> >> PS -- we are not only attempting to make Medicaid changes thru >> litigation, we are also working on legislation. >> > > Freels http://www.davidfreels.com david@... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 13, 2008 Report Share Posted October 13, 2008 I am in Arizona. - > > You may have already told me this before, and I apologize for not remembering, but what state are you in? > > > DF > > > > > [ ] Re: Medicaid Question > > > >Does anyone have any thoughts on my question below? - > >> > >> and others, > >> > >> I took the information I learned from this list last year and have > >> spent the last 12 months trying to make changes in my state. My > >state > >> was/is most definately violating EPSDT (and it certainly wasn't > >limited > >> to HBOT denials). > >> > >> We now have a Medicaid lawyer ready to start a class action suit. > >I > >> would like to hear opinions on how to proceed considering the > >dismal > >> economic state of the country. Basically our state is slashing > >> services to children with disabilities left and right, however, > >they > >> are not attempting to cut the one service they are forced to > >provide > >> because they already lost a lawsuit over it. They were forced to > >> provide prescribed diapers to Medicaid recipients because not doing > >so > >> is of course a violation of EPSDT. So what I am seeing happen is > >that, > >> despite lack of funds, they are not limiting the amount of diapers > >a > >> child gets in an attempt to balance the budget, instead they are > >> limiting everything else (everything they can get away with). This > >> makes me wonder what the state's responsibilty is to abide by EPSDT > >> when they feel they cannot afford to do so? If they have no money, > >> will going to court and winning force them to come up with the > >money > >> (ie: reprioritize their spending) or are they at some point > >suddenly > >> off the hook? Also will the state likely retaliate by changing the > >> waiver and reducing the amount of children who are Medicaid > >eligible? > >> Our state is currently generous in this area. Medicaid is granted > >to > >> anyone in " immediate danger of being institutionalized " regardless > >of > >> income. I know some states use income to determine eligibility and > >> some even use a lottery system. I'm trying to figure out if > >initiating > >> a class action suit that (based on EPSDT) we would/should win is > >worth > >> the effort considering the state may have the power to insure it is > >a > >> Pyrrhic victory! > >> > >> Those who have fought this battle, please chime in! > >> > >> Thanks, > >> > >> PS -- we are not only attempting to make Medicaid changes thru > >> litigation, we are also working on legislation. > >> > > > > > > > Freels > http://www.davidfreels.com > david@... > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 15, 2009 Report Share Posted August 15, 2009 , My understanding of Medicaid is that you have to use doctors who accept Medicaid and your private insurance. The private insurance must pay first and only then will Medicaid pay the remainder. I'm pretty sure there is no way to file a claim with Medicaid yourself. The doctor must do it. By the way, you know about the HIPP program, don't you? marilyn Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 15, 2009 Report Share Posted August 15, 2009 , My understanding of Medicaid is that you have to use doctors who accept Medicaid and your private insurance. The private insurance must pay first and only then will Medicaid pay the remainder. I'm pretty sure there is no way to file a claim with Medicaid yourself. The doctor must do it. By the way, you know about the HIPP program, don't you? marilyn Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 17, 2009 Report Share Posted August 17, 2009 Won't you be my neighbor? , sure wish we lived a little closer along with several other who I just admire, such inspirational of circle of friends along this journey. But, in reality though it is spreading our wings were needed to have choices/options. In a way congratulations that your child is receiving the MDCP program. I may not be the best person to answer this as this will revolve " under " 21 y/o services in your case plus I had to deny it due to my son's name coming off the interest list onto the CLASS program at the same time. I hope you do look into the CDS options, if there is a Town Hall meeting near your area in regards to the Consumer Direct Options, highly recommend it. http://www.dads.state.tx.us/providers/communications/alerts/alerts.cfm?alertid=3\ 43 MDCP will help pay for any services " RESPITE " , this is where should you seek the CDS route could hire anyone of your choice to watch your child. Some families have also used funds according to the budget around your child like home modification, adaptive aids, then there is the Medicaid, could have a ST,OT & PT, etc. Now, will warn you here should you seek some specialize service that should you seek this route, I hate to tell you that you may be overqualified more than any of the therapist who contract with anyone who is contracted with the MDCP program. So this is where you could hire your own and knowing you, will probably end up training them to apply the services around your child's level of need. Ho hum, wonder how I know this? It would be great that you end up finding a therapist that is already knowledgeable and trained with individuals under the autism spectrum and thensome. But, we can dream or pray. Irma > > Yes Irma I also found some people who were getting Hbot covered by Medicaid. We have a chamber and I'd love of course to get it covered. Then I could offer it to others with a doctor's RX. I got medicaid through MDCP, it took us 5 years. Now I have it, I'm not sure how to use it. > > If anyone has ideas how I can use this to help lighten our load, please share. > > I will start filing with insurance company and then if denied I'll send to medicaid. Another full time job just to keep track of all the paper trail. > > Quote Link to comment Share on other sites More sharing options...
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