How To Get On Medicaid Even if You Can’t Get On Medicaid

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Artwork: Zeraph Dylan Moore

Anyone can apply for Medicaid any time. You do not need to be on disability. Just contact your state Medicaid office.

The Medicaid rules vary a lot by state. In some states it is quite easy to get on Medicaid, and in other states it is quite difficult.

If you got turned down for Medicaid, or thought you would be turned down so didn’t bother applying, don’t give up hope! There a whole bunch of things you can still try:

🍁 ONE

If you got turned down for Medicaid, even though you think you meet the requirements, appeal the medicaid decision. They do make mistakes sometimes. The people who work at Medicaid do not always know all the policies, and sometimes you have to learn the policies yourself and educate them: How to Respond When You Are Told You Can’t Get Medicaid

🍁 TWO

Don’t list weird people on your application. List yourself and your minor children. List your spouse if you are not legally separated. Don’t put down other people just because you live with them!! In most cases, you do not want to list your housemate, friend, landlord, aunt or other random people who live with you. Here’s a list of who to include and who not to include. If you did list these people and got turned down…. apply again!

🍁 THREE

If you need help with bathing, eating, dressing, or personal care, you can look into applying for Medicaid Waivers which will provide a caregiver in your home. In some states, this program also comes with medical care, doctor’s visits, hospitals, and medications. Some medicaid home care programs also provide delivered meals and other services such as shopping, cooking, errands, and cleaning. These programs are designed for people with “nursing-home level need.” These programs are also called “Medicaid Waivers.”

🍁 FOUR

If you are married…. If you are not eligible for Medicaid because your spouse has too much income or savings, you are still eligible to apply for the Medicaid Waivers program listed above. In most states, they will not count your spouse’s income.Β  In many states, they will also allow your spouse to keep savings, sometimes as much as $120,000.

🍁 FIVE

If you have too much income for Medicaid, you may still be eligible for to apply for the Medicaid Waiver program listed above. It will depend on your state. In some states you can have higher income and still qualify. If they tell you that you can’t qualify, try consulting with a medicaid estate planning lawyer, or a medicaid planner who specializes in medicaid long term care planning. There are many ways that your social services department won’t tell you about.

🍁 SIX

If you are applying for disability, you can make a dire need request to Social Security. This won’t get you a doctor immediately, but it could speed up your application. After you are approved, then you will have insurance! If you need critical or life-saving medical care that you cannot afford, include this in your dire need request.

🍁 SEVEN

Some estate planning lawyers recommend that couples considering getting a “Medicaid divorce” so one person can qualify for medicaid. Note: This may work for Medicaid, but it may not work for SSI. Social Security rules are different than medicaid rules. If you continue to live together or function as a married couple, Social Security may still consider you married.

🍁 EIGHT

If you are in serious need of medical care, some people move to a different state so they can get the help they need. In some states it’s super easy to get on Medicaid, in other states it’s nearly impossible. Start by finding a state that has expanded medicaid and of course make sure you will meet the requirements before making any big moves. The rules are very different in different states. As far as I know, you can be considered a resident and apply for Medicaid the first day you arrive and set up residence somewhere. There may still be a wait time while your application is processed.

🍁 NINE

If you have high medical costs, you may be able to get on medicaid through a Medicaid Buy in and Medicaid Spend Down program in some states. If you are already on Medicare, you still may be eligible for this program.

“People aren’t aware of buy-in programs, especially for working adults while disabled. People think Medicaid is only for really poor and disabled people. One of the ADAPT protestors who was arrested in Senator Gardner’s office in Colorado is a full-time attorney and has Medicaid which provides services so she can live at home, take care of her kids and work.” – Pansy

🍁 TEN

If you applied for Medicaid years ago and got turned down, try again now. The laws have changed a lot in the last few years, and are continuing to change constantly.

🍁 ELEVEN

If you have been diagnosed with Serious Mental Illness, you may be eligible for medicaid through a mental health medicaid waiver program. You will get other cool services too! These programs are now available in Connecticut, California, and Colorado. Virginia has a similar program called GAP.Β Ohio is just starting one called Specialized Recovery Services. Other states may have them as well. Call your medicaid office and ask to speak to someone who handles medicaid waivers. You can also look up the names of different waiver programs in your state. Make sure to ask about or research exactly what kind of mental health symptoms and treatment you need to qualify. Most waiver programs have very specific guidelines and if you don’t know them, you may find it difficult or impossible to get into the program.

🍁 TWELVE

If you are on Medicare and low-income, please sign up for a Medicare Savings Program. This won’t actually give you Medicaid, but it will get Medicaid to pay for all your premiums deductibles and co-pays. Don’t get scared off by the Medicare website, which, oddly, does not include the correct information about the financial criteria. Instead, check out this actually accurate guide to Medicare Savings.

🍁 THIRTEEN

Most states have medicaid programs for parents. If you were turned down for Medicaid in the past, but now you have kids…. go try again!

🍁 FOURTEEN

Never take no for an answer over the phone or in person. People are told weird, discouraging things all the time. Research the guidelines, and if you think you qualify, apply in writing. Let them turn you down IN WRITING. I have met many people who were told they would not be eligible, then applied anyway, and got approved.

Here’s a little story to give you hope: How Sage Got Approved for Disability by Ignoring Everything He Was Told.

Here’s a great story from Pansy. She certainly did not take no for an answer: How Pansy Got on Medicaid After Being Told She Can’t Get on Medicaid.

Here’s some ideas for How to Respond When You Are Told You Can’t Get Medicaid

🍁 FIFTEEN

Social Security automatically comes with health insurance. If you think you are not eligible to apply for disability, you may be right, or you may be wrong. Every now and then I meet someone who is wrong about this, and that is a happy day. Please double check: Fifteen Ways to Qualify for Disability After You Were Told You Don’t Qualify for Disability

🍁 SIXTEEN

If you are already on disability and your disability check is under $735 per month, you may be eligible for SSI (which automatically gives you Medicaid). If you are not getting SSI, there is a reason. Maybe it is a good reason (you are rich!) or maybe it is a bad reason (you didn’t know you could apply for SSI, or your bank account has $1 too much). Check out How to Make SSI Stop or Start and Ten Common Reasons SSI Might be Denied. If you have an inheritance or too much money in the bank, you are allowed to spend it in certain ways and then qualify (for example, pay a mortgage, buy a house, or open a trust).

🍁 SEVENTEEN

If you are applying for disability, you will automatically get health insurance after you are approved. But that will be three years from now! Or will it? How to Greatly Improve Your Chances of Getting Approved Quicker

🍁 EIGHTEEN

If all else fails, you give up on Medicaid and instead try some other ways to find medical care: How to Get to the Doctor When You Can’t Get to the Doctor

🍁 NINETEEN

Look into Medicaid programs for working people with disabilities. In some states you can work just a few hours per month and still qualify. Other states require more work. Here’s How Pansy Got a $40,000 Hospital Bill Paid Through this Program.

🍁 TWENTY

Consider being independent. If you are listed as a dependent on someone’s taxes, you may be considered part of their Medicaid household. If you are not a dependent, Medicaid may consider you a separate household even if you live in the same house. Please check the regulations in your state.

Example: Suzy is an adult and lives with her parents. She is not a dependent on her parents’ taxes. Medicaid considers Suzy an independent household. Suzy follows the regulations and does not list her parent’s financial information on her Medicaid application. She attaches a note that she is living with her parents but did not include their financial information because she is not a dependent. Medicaid does not consider her parent’s income or assets when making the decision.

🍁 TWENTY ONE

If you are not yet on disability. It is possible to get turned down or to be told that you are not eligible, just because you checked the wrong box on one form!! Here’s the deal:

If your state that did NOT expand Medicaid.Β Contact Medicaid and look online to see if they have a Medicaid program for people who are aged, blind or disabled. You will have to submit medical records and prove to Medicaid that you are disabled. You can get in these programs even if you are not yet on SSI or SSDI. These programs exist in North Carolina, Florida, Wisconsin, Utah and probably a few other places. I found these programs by googling “state name medicaid aged blind disabled”.Β  Try it! Or contact your local medicaid office and ask for the medicaid, blind, aged and disabled program.

If your state that DID expand Medicaid. In your state Medicaid is easy to apply for and anyone who is low-income can get on and in most states it doesn’t even matter if you have money in the bank. But there is a catch…. If you check the wrong box you will be denied!!!Β  On the form, they will ask you if you are disabled. Since you are not yet approved for Disability, the answer is “no”. This is the legally correct answer. If you check yes, you may run into a lot of problems. Instead of just processing your application like everyone else’s, they may instead screen you for a special disability Medicaid program that is way harder to get into, or may be impossible for you to get into.

If you checked the wrong box, apply again! Check the right box this time.

 


🍁 Updated: July, 2017.

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