Decent income but put on Medicaid!

vafoodie said:
Why would people refuse Medicare?
Click to expand...

Medicare is the age 65 and older federal govt health insurance.

This thread is about Medicaid, the state health insurance program for low income people. People are concerned that Medicaid patients are not given the same priority in treatment as others with other types of health insurance.
 
Morgan22 said:
Medicare is the age 65 and older federal govt health insurance.

This thread is about Medicaid, the state health insurance program for low income people. People are concerned that Medicaid patients are not given the same priority in treatment as others with other types of health insurance.
Click to expand...

Right, but in the the post I quoted, the poster writes, "If you qualify for and refuse Medicare..." Maybe a typo.
 
I have never heard of such a thing as "being selected" for it. If your income was low for one month and you reported it then you may be put in it. It is true due to the pandemic no one loses Medicaid right now.

You can always cancel it voluntarily if it really bothers you.
 
The "selected" was their words and due to the pandemic, they said. No low income months reported. They said normally our income would put us over, but due to covid....... . Seems like good healthcare access in mass for medical (although we are going private for dentist -a root canal is needed and although 100% covered, the dentists are limited). It does make me wonder how much other stuff like this goes on.
 
Last edited:
I was supposed to leave Medicaid and they locked me in due to the pandemic, which is fine by me. I never had a problem with it (NY).
 
Morgan22 said:
Being on MassHealth (Massachusetts Medicaid) is actually not a bad thing. I have a parent, and some acquaintances, that are on it and they have received excellent care. There is no discrimination that I have heard of or witnessed in Massachusetts for Medicaid patients. My parent has always been treated well and gone to top hospitals in the Boston area when needed. They have never had problems receiving referrals either for treatments/ surgeries. The doctors do not seem to know, or care, that someone is on Medicaid.
Click to expand...

The issue isn't really if the OP would get good care or not...it is if the state would look to clawback because of the income/assets.
 
Last edited:
ExFlyBoy5 said:
The issue isn't really if the OP would get good care or not...it is if the state would look to clawback because of the income/assets.
Click to expand...

jim584672 said:
https://www.mass.gov/doc/masshealth-estate-recovery-policy-update-0/download
https://www.mass.gov/doc/estate-recovery-frequently-asked-questions-0/download

Looks like Mass would try to recover the monthly capitation fees from the Estate for the 55 or older MAGI (expansion) group. There are exceptions and it gets complex.

NY does not recover from the MAGI group, only for institutionalized care.
Click to expand...
So, Massachusetts has a clawback policy. Safe to say it should be a consideration here.

Another factor to consider is most Medicaid providers are local. That means when away from home - even perhaps a short distance - coverage may be limited to emergency care.

This situation is very unusual. Medicaid rules are clear and the OP is not eligible. Personally, I would be unwilling to base my health care insurance on what is clearly a misunderstanding or error.
 
It might be a quirk in the system. When you sign up for ACA in mass they put you on medicaid (masshealth) initally until they get your docs and verify your income (we still had COBRA during this period). But If the law prohibits losing Medicaid during covid then maybe you get to stay on it until covid is over? Just a thought.

I am going to call them again to make sure what is going on.......
 
Last edited:
Well I called MassHealth again, and explained the situation. They kept saying if they have gone through the process and have determined that you get it then you get it. I said you seriously do not have a problem that we are reporting >$120K income and are getting free healthcare when normally it is $21K limit, you don't think something is wrong? She just said if they approved you then you get it, and it will be re-assessed in 12 months. I told her to make another note in our casefile that I have questioned this and that our income is too high! WTF!!!! We will get travel insurance when travel but I guess we get a platinum-plus level plan for free for now!
 
BobTomas said:
Well I called MassHealth again, and explained the situation. They kept saying if they have gone through the process and have determined that you get it then you get it. I said you seriously do not have a problem that we are reporting >$120K income and are getting free healthcare when normally it is $21K limit, you don't think something is wrong? She just said if they approved you then you get it, and it will be re-assessed in 12 months. I told her to make another note in our casefile that I have questioned this and that our income is too high! WTF!!!! We will get travel insurance when travel but I guess we get a platinum-plus level plan for free for now!
Click to expand...
As long as you have it documented I wouldn't worry about it. They will probably ding your Estate for the 5-6 hundred a month (guessing) capitation fee for the plan.
 
Morgan22 said:
Ah, got it. I thought there was a concern about receiving proper care.
Click to expand...

I did have some concerns initially but not now after seeing what is available. Not worried about clawback - either pay while I am alive or when I'm dead....I'll take the latter and enjoy my treasure now:)
I wouldn't ever want to deprive someone who really needed help, but don't feel that is the case here.
 
Do you have ACA healthcare navigators or brokers in Mass? That would be your best bet to get this done correctly.

In NH I had to keep our income low to get full subsidies for a silver plan so I could get off COBRA. I didn’t have to supply anything that I recall as we just retired and past income was not applicable. I got frustrated trying to apply on my own and through my amazing research skills I found a broker who used to be a health care navigator in NH before the positions were eliminated in the state. Our income actually ended up below what I predicted and I probably should have been on Medicaid but was only on the ACA plan a year and a half and now on Medicare. So too late now!
 
If your state has its own web site, or you signed up un healthcare.gov, you’ll probably read about qualifying.

In NY, you might have seen able to get some subsidy, but it’s all about household taxable income (not assets).

I believe when I tried out the NY site, I would not be able to sign up if my household income was low enough to qualify for Medicaid.

Your state may be different.
 
Mass MBTA unionized personell were all hired in & after the 70s with a unionized BCBS clause for life* in their pensions. 100% BCBS position if retired unencumbered.

An odd 5 yrs ago everyone, even members retired 10/15yrs ago were switched from BCBS &(switched*switched) to the same states state medicaid program.
Along with FED Medicare after FRA.
AFAIK. Please LMK if im mistaken, Im not to sharp.

You challenge it in court for a decade or so, because you have the right atty & resources right? :blush:.

OP/Medicaid has now become a base health metric. Afaik.

Good luck & Best wishes.
 
Last edited:
I haven't heard that one before. I know a few people who expected to be kicked off Medicaid that haven't been due to the lack of government workers. Others were continued at the same 2019 level for the same reason.
 
disneysteve said:
That sounds really odd, and I'd be pretty pissed if it happened to me. Medicaid is NOT good coverage. Many doctors don't accept it. Access to care can be extremely challenging. If you earn over 100K, you should be able to get yourself regular non-Medicaid coverage.
Click to expand...



I don’t know how true that is and to what extent. I know someone on expanded Medicare and they get excellent medical care. Dental might be a bit tricky. Maybe it varies by state. The trick seems to be getting a doctor from a practice within a hospital.
 
Last edited:
a60dan said:
If your state has its own web site, or you signed up un healthcare.gov, you’ll probably read about qualifying.

In NY, you might have seen able to get some subsidy, but it’s all about household taxable income (not assets).

I believe when I tried out the NY site, I would not be able to sign up if my household income was low enough to qualify for Medicaid.

Your state may be different.
Click to expand...
NYSOH is set up you to seamlessly for ACA QHPs, Essential Plan, and Medicaid.
 
Thanks for all the discussion guys. Mass has been on ACA type healthcare for many years before Obamacare, due to Romney, and is quite well setup.

I think opinions on medicaid are probably tainted by politics or location....so it is difficult to get a true picture. Massachusetts is not a state that is hell-bent on destroying universal healthcare!

I get the same doctors and same hospitals as I would if I was paying the $2k/month premium. The best doctors at Dana Farber - one of the best cancer places in the USA take it,..but thankfully I dont need it!

So I am happy while it lasts.....but will let you know if I have any issues with treatments.
 
Last edited:
IMO opinions on Medicaid here are entirely driven by lack of provider access (from what they've heard or from family/friend experience), nothing more. And that's because 99% or more folks here don't qualify and don't care otherwise.

I really don't understand how you ended up on Medicaid either, but it's a quirk of some MA law/reg I guess.
 
Last edited:
You must log in or register to reply here.

Similar threads

S
Please check my understanding of ACA subsidies.
Replies
6
Views
555
SecondAttempt
S
M
Transitioning to Retirement - Healthcare Hurdles
2 3
Replies
67
Views
6K
Koolau
Koolau
D
Marriage Tax Penalty on Social Security wish I knew earlier
Replies
6
Views
1K
Dave J
D
C
Do any of you cut it really close in easy retirement?
2 3 4
Replies
87
Views
8K
Koolau
Koolau
D
A couple ACA and HSA Questions
Replies
4
Views
901
cathy63
C

Latest posts

Back
Top Bottom