Information and experience on Medicaid with a Spenddown

doodlesmom

Thu, Oct 23 2014, 10:54 am

I am not eligible for Medicaid or family health plus,but was notified that I can get Medicaid with a Spenddown- or Medicaid with a surplus. Which would make sense for me to do for the meanwhile until I figure things out.

I was wondering if anyone has experience with it, and how I go about applying, since they wrote that I need to go to my Local dept of Social services, and am not sure what that means, also if I need an appt/ or can I just walk in.

Another question, once I get the medicaid is it the one only accepted in clinics and hospitals?

Anything you know will help.
Thanks!

Ashrei

Thu, Oct 23 2014, 11:02 am

I'm sorry I can't contribute, but I'm curious what "Medicaid with spenddown or surplus" even is?

(Regarding where you can use Medicaid though, I can at least tell you that it depends on if you will have an HMO such as Affinity or such, or if you will have 'straight up medicaid' without an HMO. then you just call the doctors like with any insurance, tell them what kind of medicaid you have, some take, some not. Unfortunately, as you can predict, less of the excellent doctors accept medicaid and often ppl wind up at clinics to see those particular doctors. but on the other hand, doctors who have experience with special needs per se will most definitely be set up for varieties of medicaid bc they understand their customer base will most definitely have it.)

doodlesmom

Thu, Oct 23 2014, 11:24 am

Quoting their site:
"The Medicaid Excess Income program is sometimes referred to as the "Spenddown program" or the "Surplus Income program". Here we will be referring to it as the Excess Income program.

If your monthly income is over the Medicaid level, you may still be able to get help with your medical bills. The amount your income is over the Medicaid level is called excess income. It is like a deductible. If you are eligible for Medicaid except for having excess income and you can show that you have medical bills equal to your excess income in a particular month, Medicaid will pay your additional medical bills beyond that for the rest of that month. This includes outpatient care, doctor and dental visits, lab tests, prescription drugs, and long-term care in the community such as home care and assisted living. There are special rules for hospital stays which is explained further below."

Basically if you are $500 a month over the limit for medicaid if your medical bills are above $500 for that month then medicaid will pay the rest.

It is not ideal, but for this year for sure (which is only 2 months) if I apply for other insurance and have a deductible plus the cost of the insurance monthy it will cost me way more and the program will help if CH"V something terrible or major happens in this time.

Ashrei

Thu, Oct 23 2014, 11:29 am

That's so interesting, thank you. Could I have the link?

My son has a medicaid card so I was going to give you the number on the back, but it actually says: "For answers to Medicaid eligibility questions contact your local Department of Social Services," so maybe it's best just to find that number to get the answers. (In addition to seeing what our experienced and savvy peers on Imamother could tell you, hope you get more replies.)

thanks

Fri, Oct 24 2014, 12:33 am

"You must be under age 21, age 65 or older, certified blind or certified disabled, pregnant or a parent of a child under age 21. This allows you to become eligible for Medicaid even though your monthly income is too high."

If this fits you, contact the Lifetime Care Foundation run by Ohel.