Medicaid Spend down

[Flopper]

This is a Medicaid Program that they claim is a new benefit. Actually it has been around for a few years but Covid came along and stopped the implementation. It may be a benefit if you are only few hundred dollars over the limit for Medicaid. For the disabled it is a nightmare.

I know someone who is totally disable and can not hold down any job. He receives SSI which is $913 a month, an additional $1100 in survivor benefits from his father who was in the service and mother who were killed in a car crash. So his total income for the month is $2013. He has been on Medicaid for years and they have paid all of medical expenses that run from $25,000 to $125,000 a year.

A few days ago he got a letter from Apple Health, (Medicare in Washington State) about a new exciting Medicaid program called spend down. The letter said he was being put on spend down and that he will have to meet a $15,123 deductible (half every 6 months) before Medicaid pays anything, not even preventive care. He called DHS to explain paying 62% of his income would be completely impossible because of the expenses due to his disability. The DHS lady expressed sympathy for his problem and explained many people having the same problem. She said, "I will tell you what I tell them. Don't pay any part of your hospital bills. You don't have any assets or income that they can touch. All they can do is ruin your credit and sell your debt to bill collectors."

After listening to this, I don't know what is worst, the bureaucrats who come up with these crazy programs or the people they hire to administer them. It is expected over the next year 12 million adults and 5 million children will lose their health insurance.

 

[The Duke]

Let the government into healthcare they said.

 

[The Duke]

$15K deductible per year, that's a lot of money.

 

[JustAnotherNut]

Yes spend down has been around for many years, and for the most part is or was used for elderly care expenses and maybe those working with little or no other insurance. It's been kind of a 'gap' type insurance. For those who make too much for full Medicaid, but not enough for private insurance


IIRC, your spend down amount is based on your total income and yes you have to pay your 'deductible' first before the state kicks in. The amounts can be outrageous for limited income.


And unfortunately she may be right as to how to deal with those bills. If you can't afford to pay them, or meet your spenddown amount, then there is little choice but to not pay them and lose your credit rating and/or file bankruptcy. The state or any creditor can't take your home or one vehicle needed for medical or employment purposes unless of course they are financed and you can't make the payments.

This 'medical bankruptcy' has been a problem for years, that Obamacare was supposed to fix, but didn't.

 

[gipper]

And yet we have billions to give a nation no real American cares about, that is terribly corrupt and full of Nazis.

We live in a failed state run by psychopaths.

 

[rampart]

This is a Medicaid Program that they claim is a new benefit. Actually it has been around for a few years but Covid came along and stopped the implementation. It may be a benefit if you are only few hundred dollars over the limit for Medicaid. For the disabled it is a nightmare.

I know someone who is totally disable and can not hold down any job. He receives SSI which is $913 a month, an additional $1100 in survivor benefits from his father who was in the service and mother who were killed in a car crash. So his total income for the month is $2013. He has been on Medicaid for years and they have paid all of medical expenses that run from $25,000 to $125,000 a year.

A few days ago he got a letter from Apple Health, (Medicare in Washington State) about a new exciting Medicaid program called spend down. The letter said he was being put on spend down and that he will have to meet a $15,123 deductible (half every 6 months) before Medicaid pays anything, not even preventive care. He called DHS to explain paying 62% of his income would be completely impossible because of the expenses due to his disability. The DHS lady expressed sympathy for his problem and explained many people having the same problem. She said, "I will tell you what I tell them. Don't pay any part of your hospital bills. You don't have any assets or income that they can touch. All they can do is ruin your credit and sell your debt to bill collectors."

After listening to this, I don't know what is worst, the bureaucrats who come up with these crazy programs or the people they hire to administer them. It is expected over the next year 12 million adults and 5 million children will lose their health insurance.

why doesn't the guy just pay his bills. he does not meet the means test. join the club. for medicaid you can not have over $2000 total in the bank and there is a limit on the blue book value of any vehicle that is low enough that if my mom had one the repairs would have been ruinous.

 

[debbiedowner]

This is a Medicaid Program that they claim is a new benefit. Actually it has been around for a few years but Covid came along and stopped the implementation. It may be a benefit if you are only few hundred dollars over the limit for Medicaid. For the disabled it is a nightmare.

I know someone who is totally disable and can not hold down any job. He receives SSI which is $913 a month, an additional $1100 in survivor benefits from his father who was in the service and mother who were killed in a car crash. So his total income for the month is $2013. He has been on Medicaid for years and they have paid all of medical expenses that run from $25,000 to $125,000 a year.

A few days ago he got a letter from Apple Health, (Medicare in Washington State) about a new exciting Medicaid program called spend down. The letter said he was being put on spend down and that he will have to meet a $15,123 deductible (half every 6 months) before Medicaid pays anything, not even preventive care. He called DHS to explain paying 62% of his income would be completely impossible because of the expenses due to his disability. The DHS lady expressed sympathy for his problem and explained many people having the same problem. She said, "I will tell you what I tell them. Don't pay any part of your hospital bills. You don't have any assets or income that they can touch. All they can do is ruin your credit and sell your debt to bill collectors."

After listening to this, I don't know what is worst, the bureaucrats who come up with these crazy programs or the people they hire to administer them. It is expected over the next year 12 million adults and 5 million children will lose their health insurance.

We have something like that here in Florida with a $1500 deductible per month. I can't remember what it is called I just say partial Medicaid.

 

[Flopper]

Yes spend down has been around for many years, and for the most part is or was used for elderly care expenses and maybe those working with little or no other insurance. It's been kind of a 'gap' type insurance. For those who make too much for full Medicaid, but not enough for private insurance


IIRC, your spend down amount is based on your total income and yes you have to pay your 'deductible' first before the state kicks in. The amounts can be outrageous for limited income.


And unfortunately she may be right as to how to deal with those bills. If you can't afford to pay them, or meet your spenddown amount, then there is little choice but to not pay them and lose your credit rating and/or file bankruptcy. The state or any creditor can't take your home or one vehicle needed for medical or employment purposes unless of course they are financed and you can't make the payments.

This 'medical bankruptcy' has been a problem for years, that Obamacare was supposed to fix, but didn't.

Example:
A disabled person received SSI from Social Security, $913/mo. His medical expenses which were paid by Medicaid were about $20,000 a year. He received SNAP, 325/mo. and with the help of family, he was able to survive.

Then in 2022, his estranged Dad dies and he begins receiving $1100/mo in survivor benefit so two things happened, he lost SNAP, and he was put on Medicaid spenddown. His spenddown amount was $15,500 a year. That means Medicaid will not pay medical expenses until he paid out $15,500 each year.

So now he has to pay $15,500 in medical expenses, plus he loses SNAP

His income in 2022 from SSI and SNAP was 1,138 a month or $13,656
His income in 2023 from SSI, Survivor Benefits less $15500 in medical expenses and less SNAP will be $11,006.

The bottom line is that he is losing $2650/yr because Social Security started paying him Survivor Benefits which kicked off the Medicaid Spenddown. He called Social Security to ask them to stop it. He was told there was no way. If he didn't cash the checks, after one year, payments would be stopped but the funds would be credited to his S.S. account and reported to the IRS as income and thus Medicaid.

To put it another he was fucked because his asshole dad that deserted the family made him the beneficiary of his Social Security survivor benefits. I guess he thought he was doing a good thing.

 

[Flopper]

We have something like that here in Florida with a $1500 deductible per month. I can't remember what it is called I just say partial Medicaid.

A disable person who gets $913 a month won't be paying $1500 to a hospital. Considering what hospitals stays cost today, if Medicaid or private insurance doesn't pay it, it won't get paid and hospitals will be raising hell. So prepare for an Obamacare 2.0.

 

[gipper]

A disable person who gets $913 a month won't be paying $1500 to a hospital. Considering what hospitals stays cost today, if Medicaid or private insurance doesn't pay it, it won't get paid and hospitals will be raising hell. So prepare for an Obamacare 2.0.

We live in a failed state run by psychopaths.

 

[debbiedowner]

A disable person who gets $913 a month won't be paying $1500 to a hospital. Considering what hospitals stays cost today, if Medicaid or private insurance doesn't pay it, it won't get paid and hospitals will be raising hell. So prepare for an Obamacare 2.0.

I remember what it's called "Medically need" the ones on it are not happy with it and yes they will stick the hospital for the $1500 and always have. Just think if on September 28th you went into hospital, $1500 deductible and stayed until Oct 2 another $1500 deductible. People have been sticking doctor's and hospitals for ages and always will.

 

[Flopper]

I remember what it's called "Medically need" the ones on it are not happy with it and yes they will stick the hospital for the $1500 and always have. Just think if on September 28th you went into hospital, $1500 deductible and stayed until Oct 2 another $1500 deductible. People have been sticking doctor's and hospitals for ages and always will.

Actually the deductible was $15000. However, whether it was 1500 or 15000, it is immaterial for people that can’t pay it.

The idea that people who lack insurance or a means of paying the bill are going to get all the care they need is not really true. The hospital is obligated to delivery emergency care to stabilize the emergency. They are not required to treat the underling causes or serious problem that exist.

 

[debbiedowner]

Actually the deductible was $15000. However, whether it was 1500 or 15000, it is immaterial for people that can’t pay it.

The idea that people who lack insurance or a means of paying the bill are going to get all the care they need is not really true. The hospital is obligated to delivery emergency care to stabilize the emergency. They are not required to treat the underling causes or serious problem that exist.

Oh, I was speaking of Florida's medically needy program the step down from full Medicaid.