Join Early Retirement Today
Reply
 
Thread Tools Display Modes
anybody been on Medicaid?
Old 11-12-2019, 06:26 AM   #1
Full time employment: Posting here.
 
Join Date: Apr 2016
Location: warren
Posts: 935
anybody been on Medicaid?

Just retired in May, my wife is likely to follow next May. Live in Michigan which has expanded Medicaid. We will have very low income and could manage it to get below138% FPL and qualify for Medicaid for a couple of years. Is this smart?
What does Medicaid pay for?
Do many Dr.s take it?
What about surgeons etc , if God forbid we needed something done?
Would we be better to just get a max subsidy and get on the exchange with the high deductibles and high max OOP?
Thanks
garyt 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 11-12-2019, 06:50 AM   #2
Recycles dryer sheets
 
Join Date: Mar 2017
Location: Andover
Posts: 79
It's called something different in MA. And it'll matter what state your in. There are several plans under the program. Called my PCP and asked which plan he accepted. I'm pretty healthy and haven't needed anything more than an office visit and a prescription refill (statin). Works for me.

Overall, I keep my expenses low, pull most distributions from my tax-paid account, and just a bit from the tax-deferred account.
Mykle57 is offline   Reply With Quote
Old 11-12-2019, 06:50 AM   #3
Recycles dryer sheets
 
Join Date: Jan 2013
Posts: 380
I think it will vary by region. In Massachusetts my experience as a doctor was my Masshealth ( medicaid) patients had a lot of trouble finding specialists to take them. In fact my group ( internal medicine) only accepted Masshealth for our existing patients who had an insurance change.

You may not find the lowest cost exchange plan has much better access to a wide range of doctors. Or maybe you will. This again seems to be location specific. Massachusetts has a decent choice of exchange plans - maybe 7 or 8? At all the metal levels. Only three take both my pcp and my one specialist.

I would talk to your current doctor who will probably have a sense of medicaid there and then start looking for doctors that you know you would want for surgery etc and see if they are on the exchange plans.

It is a lot of work I know but this is important and too late if you get sick and have a restrictive plan
Sarah S is offline   Reply With Quote
Old 11-12-2019, 06:53 AM   #4
Administrator
MichaelB's Avatar
 
Join Date: Jan 2008
Location: Chicagoland
Posts: 40,586
Medicaid is a federal program that is managed by each state, often at the county level, so experience with Medicaid in Alabama or California may have little relevance for Michigan. Many states subcontract insurance companies to administer the program, so you might look first to see how it is managed in your area.

It’s pretty safe to say that in some areas Medicaid is a comprehensive health care option for low income beneficiaries, and in other areas it is a health care plan that suffers from budget limitations and narrow, overloaded networks.
MichaelB is offline   Reply With Quote
Old 11-12-2019, 06:58 AM   #5
Moderator
Jerry1's Avatar
 
Join Date: Nov 2014
Posts: 9,101
Doesn’t Medicaid have a total asset test? As in, you have to be really poor, not just lacking in reported income, to qualify?
__________________
Every day when I open my eyes now it feels like a Saturday - David Gray
Jerry1 is offline   Reply With Quote
Old 11-12-2019, 07:42 AM   #6
Thinks s/he gets paid by the post
 
Join Date: Aug 2010
Location: Back woods of Fennario
Posts: 1,170
Quote:
Originally Posted by Jerry1 View Post
Doesn’t Medicaid have a total asset test? As in, you have to be really poor, not just lacking in reported income, to qualify?
Single data point: In Colorado in Larimer County, there is no means testing. DS is on Medicaid this year dues to missing about a half-year of work last year due to an auto accident.

As MichaelB pointed out, it certainly varies state by state and even county by county.
__________________
"Time wounds all heels...." - Groucho Marx
LRDave is offline   Reply With Quote
Old 11-12-2019, 07:54 AM   #7
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
MRG's Avatar
 
Join Date: Apr 2013
Posts: 11,078
Quote:
Originally Posted by Jerry1 View Post
Doesn’t Medicaid have a total asset test? As in, you have to be really poor, not just lacking in reported income, to qualify?
I don't think the expanded Medicaid has an asset test.
MRG is offline   Reply With Quote
Old 11-12-2019, 08:15 AM   #8
Full time employment: Posting here.
 
Join Date: Apr 2005
Posts: 807
Yes, no asset test under ACA.

We've had a few years when we were on Medicaid but have mostly managed our MAGI to hit the subsidy sweet spot (around 23K for married filing jointly this year). As others have said, it is very state and local specific in terms of what doctors you'll have access to.

Also very much worth being aware of are individual state rules about work requirements and claw backs (ability to come after your estate to get repaid for any Medicaid benefits you took).

As examples, in small-town Colorado we had access to slightly fewer doctors under Medicaid than ACA but also had access to subsidized dental care under Medicaid that ACA doesn't offer. Meanwhile in Arizona where we are now they are always pushing for a 20 hour a week work requirement and have also asked for a 5 year cap on Medicaid benefits regardless of age. So choose your state and city carefully - and stay on top of the news as the battle to gut ACA and Medicaid is still very much alive.
kevink is offline   Reply With Quote
Old 11-12-2019, 08:25 AM   #9
Thinks s/he gets paid by the post
 
Join Date: Jan 2014
Posts: 1,174
Quote:
Originally Posted by garyt View Post
Would we be better to just get a max subsidy and get on the exchange with the high deductibles and high max OOP?
If you qualify for max premium subsidy, you also get Cost Sharing Reductions (CSR) which reduce deductibles and MOOP on Silver plans. There are 4 levels of Silver plan CSR.

Over 250% FPL: No cost sharing reductions
200%-250% FPL: Small CSR
150%-200% FPL: Medium CSR
Below 150% FPL: Largest CSR (lowest deductible/MOOP)
MBSC is offline   Reply With Quote
Old 11-12-2019, 08:28 AM   #10
Moderator
Jerry1's Avatar
 
Join Date: Nov 2014
Posts: 9,101
Okay. To OP original question. Not sure about the physicians, but I’m sure that every hospital in Michigan accepts Medicaid. Now if it’s a third party Medicaid HMO, that’s a completely different animal, but if it’s the State Medicaid program, all hospitals. So be careful what you sign up for.
__________________
Every day when I open my eyes now it feels like a Saturday - David Gray
Jerry1 is offline   Reply With Quote
Old 11-12-2019, 10:34 AM   #11
Full time employment: Posting here.
 
Join Date: Apr 2016
Location: warren
Posts: 935
Thanks for the replies. I think we'll likely just plan to get a max subsidy and get a silver plan, but man those deductibles and max OOP are high. We're pretty healthy right now,so it may not cost us a ton.
garyt is offline   Reply With Quote
Old 11-12-2019, 11:06 AM   #12
Thinks s/he gets paid by the post
gauss's Avatar
 
Join Date: Aug 2011
Posts: 3,594
Not sure if you can get an ACA subsidy or plan if your income is too low.

I believe all expansion Medicaid plans in Michigan (aka Healthy Michigan) are administered by private companies.

I would ask providers if they accept Healthy Michigan rather than Medicaid.

Gauss
gauss is offline   Reply With Quote
Old 11-13-2019, 07:20 PM   #13
Thinks s/he gets paid by the post
 
Join Date: Feb 2014
Posts: 3,054
Quote:
Originally Posted by garyt View Post
Just retired in May, my wife is likely to follow next May. Live in Michigan which has expanded Medicaid. We will have very low income and could manage it to get below138% FPL and qualify for Medicaid for a couple of years. Is this smart?
What does Medicaid pay for?
Do many Dr.s take it?
What about surgeons etc , if God forbid we needed something done?
Would we be better to just get a max subsidy and get on the exchange with the high deductibles and high max OOP?
Thanks
Most states have Medicaid Managed Care plans. They are like a Medicare Advantage plan with their own provider networks. I was on these plans in NY for the last 5 years, and no problems with specialists. Luckily they have the same doctors as my work plan used to. Max OOP per year $200, $1-$3 Rx. Dental is VERY limited, basic cleaning and fillings. Look at Medicaid Managed Care plans in your state, they will have their own web sites so you can look the networks and formularies.
jim584672 is offline   Reply With Quote
Old 11-13-2019, 07:35 PM   #14
Thinks s/he gets paid by the post
 
Join Date: Dec 2014
Location: St. Charles
Posts: 3,903
I don't know OP's finances, but there is no way in Hades I would default to Medicaid, if I could easily afford the alternates. Even if they might hurt for a few years. Yes, they can be expensive. Frankly, it needs to part of the ER plan. Everyone is perfectly healthy, until they aren't.
__________________
If your not living on the edge, you're taking up too much space.
Never slow down, never grow old!
CardsFan is offline   Reply With Quote
Old 11-14-2019, 05:54 AM   #15
Thinks s/he gets paid by the post
 
Join Date: Feb 2014
Posts: 3,054
Quote:
Originally Posted by CardsFan View Post
I don't know OP's finances, but there is no way in Hades I would default to Medicaid, if I could easily afford the alternates. Even if they might hurt for a few years. Yes, they can be expensive. Frankly, it needs to part of the ER plan. Everyone is perfectly healthy, until they aren't.
The MMC networks in my area are basically the same as the networks for the ACA metal plans, so even paying more isn't going to get you any better quality, just a bigger bill. Do you speak from personal experience or just from what you have heard others say?
jim584672 is offline   Reply With Quote
Old 11-14-2019, 06:06 AM   #16
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Dec 2014
Location: Huntsville, AL/Helen, GA
Posts: 6,002
In our state, Medicaid is essentially for pregnant low income women and children. Approximately 40% of the state's children on the plan. My daughter is chronically unemployed and she's ineligible for Medicaid since she was turned down for Social Security Disability.

Those on SSI disability are also eligible for Medicaid--usually the disabled young and those that have never worked 40 quarters. You have to jump through the same hoops as Social Security Disability, and few people are approved without horrendous injuries/illnesses.

Few of our quality physicians accept Medicaid, as the payments are ridiculously low. Those doctors accepting Medicaid are very often foreign born (for a lack of a better term.) Come to think of it, but our very best doctors (and some hospitals) won't even accept Medicaid Advantage programs.
Bamaman is offline   Reply With Quote
Old 11-14-2019, 06:17 AM   #17
Thinks s/he gets paid by the post
 
Join Date: Feb 2014
Posts: 3,054
Quote:
Originally Posted by Bamaman View Post
In our state, Medicaid is essentially for pregnant low income women and children. Approximately 40% of the state's children on the plan. My daughter is chronically unemployed and she's ineligible for Medicaid since she was turned down for Social Security Disability.

Those on SSI disability are also eligible for Medicaid--usually the disabled young and those that have never worked 40 quarters. You have to jump through the same hoops as Social Security Disability, and few people are approved without horrendous injuries/illnesses.

Few of our quality physicians accept Medicaid, as the payments are ridiculously low. Those doctors accepting Medicaid are very often foreign born (for a lack of a better term.) Come to think of it, but our very best doctors (and some hospitals) won't even accept Medicaid Advantage programs.
Non Medicaid expansion states make it impossible for able bodied childless adults from even qualifying, they are categorically denied.
jim584672 is offline   Reply With Quote
Old 11-14-2019, 11:13 AM   #18
Thinks s/he gets paid by the post
swakyaby's Avatar
 
Join Date: Feb 2011
Location: central California
Posts: 1,134
Our local hospital, part of a larger chain of hospitals covering a wide area of Northern California, has opted out of accepting Medicaid patients for non-emergency care. The consequence of that financial decision is that any emergency care cannot be denied and will not be reimbursed to the hospital by the state. Apparently, the bean-counters at the hospital looked at Medicaid payments and decided reimbursements were too low to bother. The only other hospital in our town is Kaiser Permanente, but I’m not sure what their policy is regarding Medicaid. It would seem to me that obtaining care could be more limiting and require more travel, depending on your location.
swakyaby is offline   Reply With Quote
Old 11-14-2019, 11:45 AM   #19
Thinks s/he gets paid by the post
 
Join Date: Feb 2014
Posts: 3,054
Quote:
Originally Posted by swakyaby View Post
Our local hospital, part of a larger chain of hospitals covering a wide area of Northern California, has opted out of accepting Medicaid patients for non-emergency care. The consequence of that financial decision is that any emergency care cannot be denied and will not be reimbursed to the hospital by the state. Apparently, the bean-counters at the hospital looked at Medicaid payments and decided reimbursements were too low to bother. The only other hospital in our town is Kaiser Permanente, but I’m not sure what their policy is regarding Medicaid. It would seem to me that obtaining care could be more limiting and require more travel, depending on your location.
I don't think emergency care can ever be denied under the Emergency Medical Treatment & Labor Act (EMTALA) of 1986. As long as the hospital is Medicare participating.

"Section 1867 of the Social Security Act imposes specific obligations on Medicare-participating hospitals that offer emergency services to provide a medical screening examination (MSE) when a request is made for examination or treatment for an emergency medical condition (EMC), including active labor, regardless of an individual's ability to pay. Hospitals are then required to provide stabilizing treatment for patients with EMCs. If a hospital is unable to stabilize a patient within its capability, or if the patient requests, an appropriate transfer should be implemented."
jim584672 is offline   Reply With Quote
Old 11-14-2019, 12:44 PM   #20
Thinks s/he gets paid by the post
swakyaby's Avatar
 
Join Date: Feb 2011
Location: central California
Posts: 1,134
Like I said, emergency care is not denied. But the hospital cannot received any payment from the state for emergency care provided, due to opting out of Medicaid.
swakyaby is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools
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
Anybody been to Margarita Island chinaco Travel Information 39 10-21-2008 02:02 PM

» Quick Links

 
All times are GMT -6. The time now is 06:44 PM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2024, vBulletin Solutions, Inc.