Join Early Retirement Today
Reply
 
Thread Tools Search this Thread Display Modes
Anyone have experience with Ohio (or another state's) Medicaid?
Old 04-27-2015, 01:59 PM   #1
Confused about dryer sheets
 
Join Date: Apr 2015
Posts: 8
Anyone have experience with Ohio (or another state's) Medicaid?

I'm in the late planning stages of early retirement, and have been thinking about health care. I am a resident of Ohio. By virtue of my age, I will not have a pension or social security and will be living only on my savings when I retire.

By researching on healthcare.gov, I noticed that with Medicaid expansion due to the ACA, Ohio residents can qualify for Medicaid based on their income. with no other requirements (disability, children, etc). I then went to Ohio's Medicaid website and found that with annual income less than 133% of the federal poverty limit (monthly income of $1,744 for a household of 2 like mine, or $20,928, based on 2014 numbers), I should qualify. I also found an entry on the Ohio website that said an individual's asset level doesn't preclude them from qualifying since eligibility is only based on income.

This seems too good to be true.... Is there anyone else out there who is FI and on Medicaid?
__________________

__________________
FIRE by 40 is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 04-28-2015, 09:15 AM   #2
Thinks s/he gets paid by the post
 
Join Date: Feb 2014
Posts: 1,050
Actually there are two Medicaids now. The traditional, with income and resource tests. This is for the disabled, blind, and elderly. The new expanded MAGI Medicaid group for those under 65, not disabled, with an income test <138% FPL.

Where I live those on MAGI Medicaid are forced to use "Managed Care". These are run by the insurance companies on the Exchange. They have their own doctor network. The fee for service Medicaid is not even an option for this group. Luckily, all my doctors are in most of these plans.
__________________

__________________
jim584672 is offline   Reply With Quote
That's helpful
Old 04-28-2015, 01:20 PM   #3
Confused about dryer sheets
 
Join Date: Apr 2015
Posts: 8
That's helpful

Thanks, that is helpful. I do see this on the Ohio site:

"Most people who are eligible for Ohio Medicaid will be asked to enroll in a Managed Care Plan. Soon after you receive your fee-for-service Medicaid card, you will receive a letter asking you to choose a Medicaid Managed Care plan."

Now here's the next question. I believe I would be subject to "Medicaid Estate Recovery" once I pass away on the value of my estate? I am running into some people in this situation who are upset about that provision. That's fine with me though; my goal isn't to leave a huge estate to someone so I don't really care if my assets go to the state after I die. Is there something else I'm missing? It's not like they can recover my assets while myself or my spouse are alive right?

I've been doing some searching online and there are a significant number of people out there trying to stay off Medicaid, which doesn't make sense to me other than asset recovery which is not a factor to me. Am I missing something else? If my income is just barely over the Medicaid threshold, would I get free regular insurance through the federal stipends?
__________________
FIRE by 40 is offline   Reply With Quote
Old 04-28-2015, 06:21 PM   #4
Thinks s/he gets paid by the post
 
Join Date: Dec 2014
Location: Florence, AL/Helen, GA
Posts: 2,093
I was thinking the Medicaid Estate Recovery was for those in long term nursing care that have spent all their savings and have limited assets. After the state pays all of the nursing home bills, they're coming after the estate for repayment.

The problem with Medicaid in many places is the quality of the physicians and nurse practitioners that accept their miserable payments. Doctors also hate the hassle of getting any medical procedure prior approved. And they hate being questioned for ordering every little test--and often not receiving payment.

I only deal with the best of doctors, and they'll only see me as a Medicare patient if I have a good supplement insurance policy. They absolutely to see any Medicaid patient of any kind.

It seems as if the doctors that accept Medicaid are sub par and often speaking English as a second language.
__________________
Bamaman is offline   Reply With Quote
Old 04-28-2015, 07:15 PM   #5
Thinks s/he gets paid by the post
 
Join Date: Feb 2014
Posts: 1,474
Quote:
Originally Posted by Bamaman View Post
I was thinking the Medicaid Estate Recovery was for those in long term nursing care that have spent all their savings and have limited assets. After the state pays all of the nursing home bills, they're coming after the estate for repayment.

The problem with Medicaid in many places is the quality of the physicians and nurse practitioners that accept their miserable payments. Doctors also hate the hassle of getting any medical procedure prior approved. And they hate being questioned for ordering every little test--and often not receiving payment.

I only deal with the best of doctors, and they'll only see me as a Medicare patient if I have a good supplement insurance policy. They absolutely to see any Medicaid patient of any kind.

It seems as if the doctors that accept Medicaid are sub par and often speaking English as a second language.

It depends on which state you are in. In California they require that you pay back all medical expenses to Medicaid from age 55 on. My cousin is faced with a Medicaid estate recovery bill of $90K and only two months to pay it back from the estate before they charge interest. He only got about 20K in cash from the estate and is going to have problems selling the house in a rural area.

We owned a farm together and I've been bugging Medi-Cal wondering why I should sell my property to pay her bill.

My cousin and I are looking at the 1000+ claims she had. I've already found double billing that the state missed.

Avoid Medicaid like the plague. Many doctors don't accept Medicaid as well. Even if the doctors who accept(ed) it are good, and many of them are (moi), they are frequently overworked (and RE).

Besides, cap gains distributions and dividend income and maybe some Roth conversions will raise you out of that poverty line.


Sent from my iPhone using Early Retirement Forum
__________________
EastWest Gal is offline   Reply With Quote
Old 04-28-2015, 08:36 PM   #6
Thinks s/he gets paid by the post
John Galt III's Avatar
 
Join Date: Oct 2008
Posts: 1,285
Fireby40, yes, there are a few people on this site who chose to go on ACA medicaid. I was tempted to, but got scared off. I do not know if there is any difference between "regular" Medicaid and ACA medicaid as far as being liked or hated by doctors. I would guess they both have the same (low) reimbursement rates. I am in Pa. My annual income is low ($10,000) on which I would pay no taxes, I think, but I would be forced onto the feared Medicaid then, so I chose to increase my income by doing a Roth conversion for $5,xxx. I must pay approx $700 in taxes at that income level of $15,xxx, but then qualify for a conventional ACA Blue Shield plan, for which I only pay $20 a month premium, with $100 deductible and $500 max out of pocket. I was also afraid of the medicaid asset recovery program. Couldn't get a clear answer about it for Pa. If you go on a medicaid plan, let us know how it works out. Good luck.
__________________
John Galt III is offline   Reply With Quote
Old 04-29-2015, 08:21 AM   #7
Thinks s/he gets paid by the post
 
Join Date: Feb 2014
Posts: 1,050
Quote:
Originally Posted by FIRE by 40 View Post
Thanks, that is helpful. I do see this on the Ohio site:

"Most people who are eligible for Ohio Medicaid will be asked to enroll in a Managed Care Plan. Soon after you receive your fee-for-service Medicaid card, you will receive a letter asking you to choose a Medicaid Managed Care plan."

Now here's the next question. I believe I would be subject to "Medicaid Estate Recovery" once I pass away on the value of my estate? I am running into some people in this situation who are upset about that provision. That's fine with me though; my goal isn't to leave a huge estate to someone so I don't really care if my assets go to the state after I die. Is there something else I'm missing? It's not like they can recover my assets while myself or my spouse are alive right?

I've been doing some searching online and there are a significant number of people out there trying to stay off Medicaid, which doesn't make sense to me other than asset recovery which is not a factor to me. Am I missing something else? If my income is just barely over the Medicaid threshold, would I get free regular insurance through the federal stipends?
Check the doctor list in the managed care plans, also the drug list. Compare this to the ACA Exchange plans. If you need an expensive drug or specialist make sure it is covered no matter which you go with.

As far as "Medicaid Estate Recovery", it depends on your state whether the go after MAGI Medicaid. From my reading they will. I have 4.5 years before I am 55 so I can see how I like it till I'm 55. In my state avoiding Probate avoids the recovery. Just a matter of estate planning and the issue goes away.

The Managed Care plans are paid a capitation fee for each enrollee every month, no matter what care they need.

The next best alternative is a Silver Plan with cost sharing reductions. But these plans still have the potential for thousands in max out of pocket expenses and moderate premiums.
__________________
jim584672 is offline   Reply With Quote
Old 04-29-2015, 09:21 AM   #8
Moderator
MichaelB's Avatar
 
Join Date: Jan 2008
Location: Rocky Inlets
Posts: 24,491
Medicaid is a federal program that is implemented and administered by each state, so looking at the program for one state might not help when considering its use elsewhere. There have been quite a few threads on this. Here's one Pension, healthcare, Medicaid conundrum but there are many others, and it would appear a number of forum members have considered this. Try looking over other threads in the Health sub-forum for more discussions.
__________________
MichaelB is online now   Reply With Quote
Old 04-30-2015, 11:35 PM   #9
Recycles dryer sheets
 
Join Date: Mar 2014
Posts: 257
There is no way you will get better or equal care on Medicaid than you will get in an ACA or private plan. I would never do it if I had a choice.


Sent from my iPhone using Early Retirement Forum
__________________
iac1003 is offline   Reply With Quote
better care
Old 05-08-2015, 03:05 PM   #10
Confused about dryer sheets
 
Join Date: Apr 2015
Posts: 8
better care

Thanks to all for the responses.

iac1003, at this point I'm not concerned about good care. I'm 39 years old, with no health conditions. I don't even have a primary doctor, although my company pays $7,000 a year for the privilege of me having an insurance card in my wallet. I'm looking for catastrophic coverage if something awful happens. If there's an accident and they take me to an emergency room, are they going to treat me differently because it's a Medicaid card rather than an insurance card that is presented to them?

If the time comes that I'm dissatisfied with the coverage, I can pull out more money from my Roth IRA to create more taxable income in order to get out of Medicaid and onto the exchange. I'm planning to give it a try. I'll keep the group posted once it actually happens.
__________________
FIRE by 40 is offline   Reply With Quote
Old 05-08-2015, 03:14 PM   #11
Thinks s/he gets paid by the post
Dash man's Avatar
 
Join Date: Mar 2013
Location: Limerick
Posts: 1,671
Quote:
Originally Posted by FIRE by 40 View Post
Thanks to all for the responses.

iac1003, at this point I'm not concerned about good care. I'm 39 years old, with no health conditions. I don't even have a primary doctor, although my company pays $7,000 a year for the privilege of me having an insurance card in my wallet. I'm looking for catastrophic coverage if something awful happens. If there's an accident and they take me to an emergency room, are they going to treat me differently because it's a Medicaid card rather than an insurance card that is presented to them?

If the time comes that I'm dissatisfied with the coverage, I can pull out more money from my Roth IRA to create more taxable income in order to get out of Medicaid and onto the exchange. I'm planning to give it a try. I'll keep the group posted once it actually happens.

Sounds like you think you'll be able to plan when you get sick.
__________________
Dash man is online now   Reply With Quote
Old 05-08-2015, 03:21 PM   #12
Confused about dryer sheets
 
Join Date: Apr 2015
Posts: 8
No Dashman, not planning on when I will get sick.

But the odds are that as a healthy 39 year old who is not a user of health care currently, that this will continue to be the case for at least long enough for me to try out Medicaid for a year upon retirement. Isn't that a reasonable assumption?

Aren't many of us here relying on the odds that our money will last us many years, making assumptions, considering the variables that may cause success or failure? This is no different to me. I'm not saying I won't have health care, but rather that I will use what the state has provided as my catastrophic coverage. I don't spend my life worrying about if I will get sick, and therefore don't intend to use my own funds to avoid Medicaid.
__________________
FIRE by 40 is offline   Reply With Quote
Old 05-08-2015, 03:51 PM   #13
Thinks s/he gets paid by the post
Dash man's Avatar
 
Join Date: Mar 2013
Location: Limerick
Posts: 1,671
I'm not saying to spend your life worrying about being sick. I'm just saying if you can afford it, opting for a policy that provides better care can be a life saver, even at 39. My step son's dad died at 40. A friend of mine from my Air Force days who was a pararescueman, in top shape, died at 41. I could name several more that developed severe illnesses in that age group that needed expensive care. I'm just saying things happen when least expected.
__________________
Dash man is online now   Reply With Quote
Old 05-08-2015, 10:53 PM   #14
Thinks s/he gets paid by the post
 
Join Date: Dec 2014
Location: Florence, AL/Helen, GA
Posts: 2,093
Quote:
Originally Posted by FIRE by 40 View Post
Thanks to all for the responses.

iac1003, at this point I'm not concerned about good care. I'm 39 years old, with no health conditions. I don't even have a primary doctor, although my company pays $7,000 a year for the privilege of me having an insurance card in my wallet. I'm looking for catastrophic coverage if something awful happens.
My 41 year old niece was healthy when we visited her in London two years ago. She came up with uterine cancer, and we buried her exactly a year ago. She had healthcare through the U.K. health system which insisted she undergo radiation and chemo prior to having surgery. And they did a 6 month followup on her--too long.

We're convinced that had she come home to the U.S. for immediate surgery, she'd be alive today.

Those that are not under the care of a doctor, no matter their age, are playing Russian Roulette with their life. This includes yearly physicals with chest xrays, PSA test (for men) and certain testing for females yearly.
__________________
Bamaman is offline   Reply With Quote
Old 05-16-2015, 10:40 AM   #15
Thinks s/he gets paid by the post
John Galt III's Avatar
 
Join Date: Oct 2008
Posts: 1,285
Just got a letter and a robocall from my ins co telling me that I may now be eligible for even more affordable health care options through the newly expanded Medicaid program in Pa. Went to the specified website and the details of coverage are not yet available. But I am assuming it will still be the dreaded and to-be-avoided stuff.
__________________
John Galt III is offline   Reply With Quote
Old 06-02-2015, 01:19 PM   #16
Thinks s/he gets paid by the post
 
Join Date: Feb 2014
Posts: 1,050
I signed up for a Platinum plan in January since I had unemployment till May. Yesterday I reported a drop in my monthly income (now under the Medicaid level).

Today I see that I am approved for Medicaid and signed up for the UnitedHealthcare Communiy Plan which starts July 1 and my old plan will be cancelled 6/30. The site worked very well (NewYorkStateofHealth).

The plan has all my doctors. My Megacorp plan was UnitedHealthcare as well.

Will see how all this works out and report back.
__________________
jim584672 is offline   Reply With Quote
Old 06-09-2015, 05:19 PM   #17
Thinks s/he gets paid by the post
John Galt III's Avatar
 
Join Date: Oct 2008
Posts: 1,285
Quote:
Originally Posted by jim584672 View Post
I signed up for a Platinum plan in January since I had unemployment till May. Yesterday I reported a drop in my monthly income (now under the Medicaid level).

Today I see that I am approved for Medicaid and signed up for the UnitedHealthcare Communiy Plan which starts July 1 and my old plan will be cancelled 6/30. The site worked very well (NewYorkStateofHealth).

The plan has all my doctors. My Megacorp plan was UnitedHealthcare as well.

Will see how all this works out and report back.
Jim, Thanks for the update. My insurance co keeps sending me letters reminding me I might be eligible for the expanded Medicaid here in Pa. I look forward to hearing your experiences with Medicaid. JG3
__________________
John Galt III is offline   Reply With Quote
Old 01-06-2016, 05:15 PM   #18
Thinks s/he gets paid by the post
 
Join Date: Feb 2014
Posts: 1,050
Just an update.

I have been on the UHC Medicaid Managed Care plan since July 2015. Fortunately all my docs from the former Megacorp are in this plan.

I have been to 1 PCP and 3 Specialists, with no difference in care quality. No co-pays and Rx are only $1 each.

The biggest weakness is the dental benefit. VERY weak and very sparse selection of dentists. Based on a visit with one I would avoid them in the future.

Finally got my BP under control with diet and meds. Have a colonoscopy scheduled soon. Overall the plan is good. The doctor network could be better.
__________________
jim584672 is offline   Reply With Quote
Old 01-06-2016, 09:12 PM   #19
Thinks s/he gets paid by the post
John Galt III's Avatar
 
Join Date: Oct 2008
Posts: 1,285
Jim, Thanks for the update. Glad it is working out for you! What happens if they involve a provider who doesn't accept medicaid? Are you on the hook for that? I assume not, just asking. That would be one big reason for me to decide to go on Medicaid: No more worries about surprise uncovered bills.
__________________
John Galt III is offline   Reply With Quote
Old 01-06-2016, 09:33 PM   #20
Thinks s/he gets paid by the post
 
Join Date: Feb 2014
Posts: 1,050
According to the member handbook about bills...

"If You Get a Bill

UnitedHealthcare provides a full range of health care services at no cost to you. You never have to pay your PCP or any other UnitedHealthcare participating provider anything. You should not be charged for any approved services offered through UnitedHealthcare when you get them from a UnitedHealthcare Community Plan provider. If you are asked to pay for services by a UnitedHealthcare Community Plan provider, remind the office that you are covered by UnitedHealthcare and present your UnitedHealthcare Community Plan member ID card. You can also call Member Services at 1-800-493-4647 for help.

You may be asked to pay for services that are not covered by Medicaid or UnitedHealthcare. You cannot be charged for any such service unless you understood and agreed before the care was given that you would pay for it."

The max OOP is $200 a year.
__________________

__________________
jim584672 is offline   Reply With Quote
Reply

Tags
medicaid, ohio


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Twitter Experience Like ER-Forum Experience? TromboneAl Other topics 10 03-23-2015 01:17 PM
Anyone Get Approved for Subsidy with 100% to 133% FPL (non Medicaid Expansion State) John Galt III Health and Early Retirement 26 10-29-2013 07:49 PM
Anyone Have Any Personal Experience with CORUS BANK? ShokWaveRider FIRE and Money 2 05-11-2005 08:40 PM

 

 
All times are GMT -6. The time now is 10:10 AM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.