anyone had to pay medicaid back??

amother

Thu, Apr 03 2014, 4:03 pm

My income fluctuates and I've always recertified for family health plus during a "lower" month. We got a letter saying we've been overincome and received benefits we weren't eligible for.
HELP!
anyone gone through this and/or know a lawyer to help?? thanks!

(ps this works out to a LOT of money...)

SplitPea

Thu, Apr 03 2014, 6:27 pm

Family health plus or Medicaid?

Family health plus you pay on a sliding scale so you would own what you should have been paying in a "good" month.

Are they asking you to pay for services rendered or asking you to pay what the premiums would have been if you had told your income In good month?

amother

Thu, Apr 03 2014, 6:28 pm

family health plus. and it's not on a sliding scale, like child heallth plus.
and they want for services rendered, equaling $72,000
surprisingly, insurance was not canceled (yet)

amother

Thu, Apr 03 2014, 6:31 pm

ps we are not wealthy people who were trying to swindle the government!
I didn't realize you had to report fluctuations in income. we're only over by a few thousand a year
we live simply

smmsm

Thu, Apr 03 2014, 6:51 pm

From what I understand, family health plus works by your yearly imcome if you don't make the same amount each month. So check if your taxes at the end of the year can prove that yearly you make within their limits. Good luck!!!!

smmsm

Thu, Apr 03 2014, 7:18 pm

Was this past year the first time you made more than the limit? How far back are they billing you from? Maybe on those months you made less you can get away with the bills for that month

amother

Thu, Apr 03 2014, 9:01 pm

Quote:

I didn't realize you had to report fluctuations in income. we're only over by a few thousand a year

You don't have to report fluctuations in income. You do have to have an annual income below a certain number, and it's your responsibility to make sure you fall within the requirements.

Quote:

Maybe on those months you made less you can get away with the bills for that month

No, it's based on annual income.

I'm sorry about your situation, OP, and I wish I had a good lawyer to recommend. I hope other posters will have good recommendations.

I also hope that this is (unfortunately) a cautionary tale to others.

amother

Thu, Apr 03 2014, 9:18 pm

I'm confused. How would they know that your income increased mid-year? The renewal is only once a year and documentation is provided from previous year. How can they know that your current year income is too high to qualify (possibly for next year...)?

amother

Thu, Apr 03 2014, 9:37 pm

they see as per previous tax returns/w2's that my yearly income is too high
and it's not that my income changed, but it fluctuates monthly. I get paid by the hour, so months with yomim tovim I have low pay checks, summers are low, etc.

amother

Thu, Apr 03 2014, 10:23 pm

what if you recertify and get approved and then you start working? can you just wait until the next recertification not to recertify again? someone told us this would be ok

amother

Sat, Apr 05 2014, 11:40 pm

anyone know a lawyer who could help us (and not charge an arm & a leg)?
medicaid is willing to work with us, but a lawyer may help further.... And I'd rather not take someone just from his own website online without referrals...

smmsm

Sun, Apr 06 2014, 12:01 am

I do not have a lawyer, though I want to wish you lots of luck in the whole process. Please let us know when theres good news. Hatzlacha!

chatz

Sun, Apr 06 2014, 1:34 am

before spending on a lawyer, you can try the UJO or a similar organization who know the system and rules very well and will advocate for you if they can.
UJO 718-643-9700

umlikeyeah

Sun, Apr 06 2014, 1:53 am

try contacting a councilman or state senator like greenfeld. also met council.

amother

Sun, Apr 06 2014, 10:42 pm

Thanks. COJO doesn't know what to do, I will try UJO.
Do you know MEt's number?

amother

Thu, Apr 10 2014, 5:01 pm

Thanks! UJO has a "benefits lawyer" who may or may not be able to help us, but can't meet with us until end of month. Meanwhile, we will have to meet the medicaid woman before and then I guess we'll see if she can help us further :\

amother

Thu, Apr 24 2014, 2:30 pm

Now I am nervous too- I got medicaid in summer when I was not working and neither was DH. I started working in mid year and I make over the limit for medicaid- I tried calling them to inform them but no one ever picks up! I continued using it for medication- I figured I could do that until I need to recertify. I jusy got recertification and am not planning on filling it out- I assumed my medicaid would automatically emd. But now I am terrified I will be fined! And I do not have any money to pay for a fine. I never sent in any fraudulent information but is it very bad I continued to use it?