https://www.newsweek.com/medicaid-warning-issued-nearly-half-are-unprepared-for-new-requirements-12602433

I'll try to keep this short: I've never been anywhere near the income to be disqualified for Medi-Cal before. I'm going, this month, from being unemployed to full-time employed. So, I'll go from disqualified for one reason (next year, that is) to disqualified for another.

Will I have any grace period or will I lose it January 1st?
How often do I need to report my income?
Do I need to ask my employers to preemptively cut my hours?
Or is there some kind of legal loophole here?

I'm really lost; this job is barely above minimum wage, I can't afford insurance and I really can't afford to lose my insurance (it's been a literal lifesaver for me).

I'm a single adult, not pregnant, not a dependent, or have dependents. Let me know if there's any other pertinent information I should provide.

In NC. Just was added to my guardians insurance, sign the proof of income letter, waited and now I am reading that I was denied Medicaid due to having exceeded the income limit. Don’t know how else I’m going to get insurance. My current job doesn’t offer that many benefits as it is so I am sort of at loss. I only make $17 and hour and I didn’t plan to stay at that job for long. What can I do or how can I get access to health insurance??

i have bipolar 1 and idk what information im gonna need to give them to keep it. i haven’t been able to keep a steady job which is why i only worked about one month this year. i dont think ill find a job in time for the changes. this is how i get my medication. if i dont have my meds ill end up dead.

My husband’s salary is $83,000. We are a family of 6 (including my unborn baby.) I am getting mixed messages online if I qualify for pregnancy Medicaid. I see that a family of 6 has an income limit of $7321 monthly income, which we make about $400 less than that a month. I do have insurance through my husband’s work but it is very expensive. I figured I would ask here to see if it’s worth trying to apply.

Thank you!

My husband is currently taking this. It has been the only medicine that works for him. And he is on 2 days left of his samples. It is quite literally an emergency. Three months ago my mom passed away, we lost the house we were living in. He lost his job. And now, three months after all of this after things were getting better his dad is admitted to the hospital having multiple strokes/ heart attack and swelling on the brain. We more than likely are going to lose him and my husband will not make it through this without his mood stabilizer. I am absolutely panicking. We don’t have $1700 a month. What can I do????

I most likely will not be able to meet the work requirements and it says they go into effect in California in March of 2027. I am on birth control for medical reasons that my medi-cal fully covers. I am not even sexually active. It is purely for medical reasons. My natural period symptoms are so severe they are life threatening so I have to suppress them with birth control. If I go off it I will get severely sick again and I can die next time. I cannot afford to pay for it out of pocket. I am aware that programs exist to lower the price but even at a discounted rate I still cannot afford it. So without this medi-cal coverage my life is at risk. All I am doing is trying to figure out a way to delay this risk.

Currently I am on the depo shot I get it every 3 months and am getting my next one soon. So then my next one after this one would be due in January. And then my next in April. And then my next and last shot in July. in 2027. I was planning to switch after July 2027 to the implant to not be on it for over 2 years because of the permenant bone loss and brain tumor risks associated with long term depo use. I wanted to stretch it out and stay on it as long as I could because I really like depo so far. Haven't had any bad side effects.

but I am not sure now if I can because now I am not sure when my medi-cal coverage ends. My renewal was July. I got renewed for another year. Now I've gotten the letter about what's taking effect in March.

So, am I losing my medi-cal immediately in March of 2027? Or am I keeping it until my renewal period and not getting renewed in July of 2027?

Because I don't know whether I can stay on depo and make the switch until July 2027 or if I need to switch to the implant in January so that I'm able to stay on birth control. The implant works for like 3 years instead of months, so if I get the implant I won't have to worry about dying from losing birth control for years even after in the event that I lose my medi-cal. And in that time I don't know what will happen, so who knows, maybe I can figure something else out. But I am not going to be able to meet the requirements nor be able to afford private insurance or any doctor fees like copays at any point in the foreseeable future

But I'm confused because I don't know if I'm likely losing it in March or in July. I don't know when to switch to the implant because I don't know when I'm losing it.

My mother in law suffered a serious stroke at the beginning of April where she lost the function of the limbs on the left side. We applied for Medicaid at the end of May - early June and was medicaid pending until just now when we finally got notified of her approval.

Getting approved for Medicaid has been exciting news as she has been at a nursing facility under Medicaid pending status.

We want to circle back to her medical bills relating to the stroke which covers the hospital stay, acute rehab stay, and the skilled nursing stay. We were advised to hold off paying the hospital bills until we got a decision on her Medicaid application.

Now that she's got the approval, whats the next step to retroactively apply Medicaid benefits for her stroke related medical bills? Do we just contact the hospital/facility billing department and inform them of my mother in laws Medicaid approval status?

Edit: forgot to mention that we are in the state of Texas.

Asking for a friend who had open heart surgery, followed by a stroke that left him speech impaired. He is single and took early Social Security retirement this year. (He had applied for disability but was denied and has filed an appeal.) His early retirement Social Security benefit is very modest. But will it count toward the $580 monthly income for “community engagement,” so he can still qualify for Medicaid in 2027? The Ohio website and materials all seem to imply that the only income that qualifies for this purpose is work income. There is no clear definition provided for “monthly income” in this context. Has anyone received clarification on this?

I have been trying to do my medicaid renewal for a few nights in a row now but I cannot get past this screen online. It’s the one where you input your county, case #, medicaid renewal due date and SSN. It tells me “Oops! Something went wrong.
The information you entered does not match any individual in our records.” but everything is correct and my benefits are still active. I’m freaking out

My application was denied and I waited too long to reapply because im a pos. Am I boned? I already have massive bills. Would they allow me more leeway? Will go to the office this week with correct papers.

All 3 of our cases, my ma who is in a facility

My friend and I that are disabled

Have 6 month renewals

Why aren't they applying the disabled exemption to the cases and keeping it at 1 year renewals

New York City, Queens County, New York State

Hello! I am a medicaid recipient in Pennsylvania. My grandmother is leaving me her house split up between the rest of her grandchildren. When the house is sold, do I get to keep the money or does medicaid take it?
Thank you!

OHP medicaid (Oregon) is messing up our paperwork over and over in ways that don’t make any sense.

Something has to give with OHP. They have messed up our paperwork almost every time we have to reapply for the last 4 years, but my husband became self employed contractor this year and we can not get them to fix their computer issues that are arbitrarily rejecting us off of bunk math that makes no sense and we’ve spent the last 3 months trying to get this issue resolved with no success whatsoever. This is the worst it’s ever been.

The issue this week is that they are saying on this one piece of paperwork that we both make too much for standard OHP but not enough for the OHP bridge program. Hm, interesting. So if the cut off for OHP is you have to make less than $4449 a month which is $53,388 a year, AND you must make more than $51,456 a year to qualify for Bridge so there should be a $1,932 overlap in qualification. It is not possible to make too much for OHP but not enough for OHP Bridge, the overlap is there specifically to prevent coverage issues for people on the edge of the income requirements between the two. In the same letter they sent us claim that we make $4,744 a month but only 44k a year? $4,744 a month comes out to $56,928 a year, and 44k a year comes out to $3666 a month? It can’t be both! I’ll give them the credit that my husband makes a vastly different income every month because he’s a contractor so his income is completely dependent on what job he has lined up for the month, but come on, it is not that hard to do the basic mathematics it takes to get to a monthly average and I don’t understand how they are getting 2 totally different numbers. My husband did the math and our actual gross annual income depending on how the next couple months go, will be between 44k-48k which should come in at about 3.6k-4K a month. So we are right on the edge of the $4449 a month/ $51,456 limit for OHP but even then if we went over somehow we are still well below the $77k limit they told us for a family of our size for the OHP bridge program.

We’ve gone to the Human Resources office in person, we’ve talked to numerous case workers on the assistance line who keep telling us we just need to send in more paperwork and proof of income, which we do but then no one looks at it and we get another letter saying we are kicked off for not providing proof despite it literally being in writing, in their system that we have. We have talked to so many people trying to get them to resolve this and every time they tell us we qualify for either OHP or OHP bridge and that they will fix it for
us, but then a week later we get another rejection letter based on income numbers that don’t make any sense. The first rejection letter we got was because they were factoring in material costs from jobs into our income (Ex. If my husband gets a deck job and the wood costs 5k and he makes 3k for his wage, they were counting the entire 8k of the job) which isn’t how that works and they even told us as much and they fixed that mistake but now they just can’t seem to use a calculator to figure out what we actually make?!? We have now been sent like 5 different rejections letters that all claim we make completely different incomes ( 2 different ones on THE SAME PIECE OF PAPERWORK everytime). One of them tried to claim that we make 90k a year and 10k a month which also doesn’t math out correctly, but also is not even close to true and we can’t even fathom how they would get those numbers?!! They have all our income records and every piece of information we have so we can not figure out why this is happening? They’ve claimed that we make anywhere from 3k-10k a month and 40k-90k a year, those are pretty massive discrepancies. My husband has had to take significant chunks of time away from work to be on hold (usually takes 1-2 hours to get through to a person) and explain to whoever answers what is going on. He’s been trying to figure this out every couple weeks for the last 3 months. We can only assume that they are using their computer system to do all the calculations and it has a pretty major glitch, or that maybe they are relying on AI to read the information and aren’t fact checking the results at all.

How do we even resolve this when they are calculating two different incomes so they can reject us from OHP and OHP bridge for both making TOO MUCH AND TOO LITTLE and every time we try to fix it they don’t even process our paperwork before sending us another rejection letter?! We are at a loss for what to even do at this point. Anyone else dealing with this?!?

I just found out that the Pennsylvania department human service will be ordering the claims and it will take 5 days. I only went to the doctor once it was virtual and they gave me a 0 refill prescription. I know that they will see that but is any going through this and if so did Pennsylvania Department of Human services is taking 12 weeks to give them a Final Statement of Claims?

I was on Medicaid for about 8 months or so until I learned I "had too much $$"....in investments...so I canceled it....

Now i may make over 18k with a job promotion....will I be penalized?

My medicare will happen automatically because I am on early retirement. I am on MA health now (medicaid).

I know MA health will pay the medicare premium and MA health will then be the second insurer covering co pays etc.

What I wanted to know, if anyone has gone through this, how smooth is the transition especially regarding paying medicare premiums. It looks like it's automatic but would like to hear from anyone how it went.

Thanks.

Title says it all. After 1.5 years of applying and submitting documentation, my mom (85) finally got approved for Medicaid/Waiver Program in Pennsylvania. She is now enrolled in something called UPMC Community Healthchoices. My impression is that Medicare would be her primary coverage, and this UPMC Medicaid plan would be the secondary.

I am planning on cancelling her Highmark Medicare Advantage program. It doesn't seem necessary anymore. Does anyone know of a reason to keep it? She pays $190 per month for the Highmark plan.

Does metroplus Medicaid send EOBS to my parents since I’m under their insurance. Will the EOBS tell them what I had done in the appointment, do I have any privacy?? Please help

So they are changing the asset limit from 130k to 21k for seniors and disabled. I think that’s insane especially bc they just changed it a few years ago. Seniors have savings they have to live off of and so do disabled folks. Anyone else affected by this?

Recently I have qualified for Medicaid due to financial hardship. Prior to medicaid I was taking Mounjaro for my diabetes. When I first got on Medicaid I was given the basic plan until I picked a plan of my own. I chose Priority Health. While on the basic temporary plan my doctor called in Mounjaro with a prior authorization and it got approved no problem. Once my Priority Health went into effect on 10/1 I had to have a priority authorization called in again. They rejected it. My doctors submitted a reconsideration and still rejected. The requirements are that I need Type 2 diabetes (I have), and failed 2 preferred medications. I took metformin for a year and it never lowered my A1C (fail) and I tried Ozempic but whenever I use it I get chest pains (fail). They are claiming I needed to prove Ozempic didn’t lower my A1C. This makes no sense because I tried for a month and I kept having chest pain. For whatever reason my body handles Tirzepatide better than Semaglutide.

What confuses me is why the straight medicaid approved it with no issue but Priority Health is making it impossible.

My question is does anyone here in Michigan get Mounjaro through Medicaid and if so, what their plan is. I want to switch my plan from Priority Health and I have heard some plans are less strict and dont need the extensive lab testing that Priority Health needs. Clearly the straight Medicaid accepted it but unfortunately they dont offer the temporary plan as a full time plan. If my next plan doesn’t approve it then I will have to pay $200 per month for a Trizepatide compound that I really can’t afford right now. But using Mounjaro for the last year has got my diabetes under control, my back pain has got better and I no longer need a CPap machine so I want to stay on it.