medicaid

denise

New member
My husband and I were just told that we are losing our medicaid because we have started making too much money. We have about $1000 us dollars in meds a month in addition to dr visists. My husband's best freind is a lawyer and says that we can go to court and the judge will probably let us keep our benefits. I was wondering if anyone has ever appealed and kept gov't benefits and what advise you have.

I hate to waste our time and money but we are overwhelmed with the cost.
thanks
 

JazzysMom

New member
What state do you live in? In New York there is a spenddown (deductable) that you can meet each month. This just means you have to spend a certain amount out of your own pocket to lower your eligibility & then all other services after that are paid for for that month. If you are definitely too high in income it wouldnt make sense to seek it, but definitely look into it more.
 

anonymous

New member
Denise, I've gone to court (appeals court) WITHOUT a lawyer and won three different cases concerning government benefits-1 being medicaid, 2 being food stamp benefits. I RECOMMEND you go to court WITHOUT a lawyer. If they take away your benefits, they send you paperowrk explaining why and if you disagree with the decision, you can APPEAL. I encourage you to APPEAL. If you go and the administrative law judge still rules against you, you can appeal that and I would recommend you get a lawyer at that point. Is this best friend going to help you for free? If so, that is the only condition under which I would recommend a lawyer initially. It's a very informal hearing with a ALJ, very informal.

Let me know if you'd like some pointers.

Julie (wife to Mark 24 w/CF)
 

denise

New member
OUr friend is going with us for free to the hearing.
We are in SC and I cant find any other state plan.
I am glad you were able to get your benefits----it gives me great hope<img src="i/expressions/face-icon-small-smile.gif" border="0">
 

denise

New member
I would love any pointers you have. I am getting letters from two of the doctors we see. Is there any other documentation you think I should bring?
Thanks
 

anonymous

New member
Denise, as the last poster noted- take ALL documentation of medical expenses. If it seems excessive, it might be just what you need to win the case. It's great you are bringing in letters from the doctors, that is always helpful. Here's a list of what I brought for our food stamp hearing:

1.List of medical expenses since the beginning of the year-I put them on an excel spread sheet separated by month, and totaled by month-very easy for people to view. Make sure to include all information on copays, insurance premiums, out of pocket expenses for non-covered but necessary benefits...
2. ALL MEDICAL relate reciepts or pharmacy print outs as well as any doctor fee print outs-I made copies of the reciepts at work so nobody needed to make copies of mine and "loose them".
3. Some print outs on Cystic Fibrosis, expenses unique to CF such as extra food expenses, pediasure/boost/excel shakes, and anything else you can think of to justify expenses

I also throughly researched the FS program on the website. So in your case, I recommend you visit the SC health and human services website and review the medical elgibility and criteria. Do they allow for medical deductions to meet "income limits"?; do they have a list of conditions they will cover subject to a "spend down"? I have found that almost all government benefits have a loophole, being that you can find a way to make it work for you.

If you have any more questions, let me know.

Julie (wife to Mark 24 w/CF)
 
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