Possibly losing Medicaid... how to proceed?

August 24, 2018 11:58 PM

I am in a big deal of trouble if I lose my medicaid since I am barely working and am on a number of meds (for depression, anxiety, etc.) that I can't pay for. I am not sure why I may be losing it but I will list some possible reasons inside. I will be going to the office to state my case next Monday - how should I prepare? I cannot lose this benefit at this time or it will really hurt me and my family.

I am living in Ohio.

The reason that was given for my losing the Medicaid was "did not provide the information you were asked for in the renewal form or you did not return the renewal form." I did submit everything properly (I think) so this does not compute for me.

Something that worries me, though, is that I didn't know about the $2000 asset limit until I was denied (looked it up after). The reasons stated above did not mention this as being a factor in my denial, but I did have a little over $5000 in my bank account, which apparently disqualifies me?? But it was not my money - it is effectively my parent's since I am living with them and pay them for room and board... we just didn't complete the money transfer yet.


There was a box I checked which gave the IRS permission to look at my tax records - I don't recall anything mentioning bank accounts specifically, but who knows - I may have misread it, am not sure. This thought terrifies me.

(I did transfer it a few days ago but it is too late if that was the reason it was denied. But again, excess money was not listed as the reason for the denial.)

Since I will be going to their office on Monday, what do you think I should do to prepare? Do you think my denial (despite the reasons stated above) could have something to do with the $2000 asset limit, and should I even bring it up? For anyone with any experience in matters like this - is there anything else I should know about this situation before I head in? I'm not going to be getting very good sleep for the next couple of days, that's for sure :(

Thank you all very much in advance.

posted by anonymous to Work & Money (7 answers total)

There is a $2,000 asset limit for most versions of Medicaid, though not for all.

The following will sound harsh, but it needs to be.

Your application no doubt asked about assets, and if you did not list this account that would by itself give the state agency a reasonable basis to suspect Medicaid fraud in the application.

If you did not keep a copy of your application, by now you probably realize you should have.

You did not say where the $5,000 came from. If it was your savings, then you were disqualified as soon as you accumulated more than $2,000. That could be viewed as fraud in receiving past benefits over what may be a long time.

What you intended to do with the money you accumulated is not relevant. This is apparently not a situation where your account held someone else's money, for whatever reason. Saying that it "effectively" belongs to your parents because you intended to pay it to them in a legitimate transaction appears to be a dodge.

You are writing on Saturday at 3 am, asking what you can do before Monday. Not much. You need to consult with a lawyer or another professional who knows the Medicaid program. You may want to delay the meeting until you can do so.
posted by megatherium at 3:17 AM on August 25, 2018

Ohio is a Affordable Care Act (ACA) medicaid expansion state. Asset limits were eliminated for most non-nursing home medicaid recipients in the 31 states that took the medicaid expansion, replaced by an income test (133 percent of the poverty line). There is a bunch of crappy stuff happening with work requirements in Ohio and other expansion states with republican administrations in the Trump era, but I haven't seen anything about asset tests being added back in the mix.
posted by rockindata at 5:15 AM on August 25, 2018

This seems like a pretty solid summary of the current medicaid situation in Ohio.
posted by rockindata at 5:20 AM on August 25, 2018 [1 favorite]

At least in IL (all states are different) that letter is pretty generic for exactly what but says, your missing a document . Could be
that they lost it, could be that you didn't turn it in. Bring everything you think you need to the appointment in case they lost your application. If you were denied for other reasons it would explicitly say so. If your ACA medicaid and not SSI medicaid (called traditional medicaid) the asset limit isn't the same.
posted by AlexiaSky at 5:51 AM on August 25, 2018

Mr. dinofuzz here. I'm a Medicaid case manager in Ohio, but NYCM. Unless you are over 65, on Medicare, or have long term care (nursing home, waiver services, or some sort of in-home assistance) then the asset/resource limit doesn't apply. So that most likely doesn't apply to you (let me know if it does and I can help - I do long term care and aged, blind, disabled Medicaid too). If you were due for a renewal and were denied for not turning verifications in (even if you did!) you have 90 days from the denial date (which should be on the letter) to provide the verifications requested. So if it hasn't been 90 days from the closure date, just bring your verifications in again and have them reassess your case.

If it has been longer than 90 days, provide verification that you submitted the documents when you go in on Monday. Could be fax confirmation, receipts, email confirmations, etc. They should be able to determine your eligibility then. As long as you are under $1350 gross a month (for a single adult, if you aren't married or have children, and your parents don't claim you on taxes) you should still qualify.

Good luck! Hope you get everything sorted out. Try not to panic! I know health insurance can be stressful, but this is definitely fixable!
posted by dinofuzz at 6:43 AM on August 25, 2018 [10 favorites]

There are community resources that may be available to help you, including free or low-cost legal assistance. For example, Ohio Legal Services may be able to offer you advice and/or advocacy for Medicaid issues, and you can find your local office on their website. They may also be able to make referrals to other resources, such as Disability Rights Ohio.
posted by Little Dawn at 8:26 AM on August 25, 2018

Do want dinofuzz says but also re-read your denial letter. When I worked in benefits eligibility, we would send out an initial renewal letter saying "please return X by Y date" even if the drop dead date for the renewal was 15 days later on Z date. When Y date came, we would send the denial letter, with the denial date of Z. What I am saying here is that even though we actually wanted your items back by Y, your case won't close until Z. It's pretty unusual for benefits to terminate in the middle of the month, your benefits probably won't end until the end of the month on 8/31, so don't panic, re-read your notice, you may have more time to sort this than you think.
posted by Gyre,Gimble,Wabe, Esq. at 12:08 PM on August 25, 2018