some people just can't catch a break!

Discussion in 'The Watercooler' started by muttmeister, Dec 7, 2010.

  1. muttmeister

    muttmeister Well-Known Member

    My younger difficult child is a doofus - is in trouble a lot and usually deserves it.

    HOWEVER, this time I think he is getting @#$%^ed. Some of you will remember that last spring he and wife (she was driving) had a terrible car wreck. She broke her right arm and left leg and was in the hospital and rehab for quite awhile.

    At the time they had the accident, they were on Medicaid. During the time she was in the hospital, they missed a deadline for submitting some paperwork so they lost food stamps, medicaid, etc. They are only now finally getting the food stamps started again. I'm sure it is mostly due to their negligence in getting things done on time. Still.... Anyway, they were told several times that the medical bills would be covered. Yesterday they found out that Medicaid is not going to pay their (over $200,000) bill. At the time they qualified difficult child was working full time. Admittedly, it was a crappy job but at least he was working. Now he is unemployed. daughter in law works part time as a waitress for $3.85 / hour plus tips. But now they don't qualify?

    Anyway, I told him to see my lawyer; they will have to file for bankruptcy. THey have no other bills, just the medical stuff. Their credit rating is low or nonexistent so it won't make that any worse than it already is. It just will be one more thing for me to pay (lawyer, filing fee, etc.)

    What a bunch of doo-doo!
  2. Hound dog

    Hound dog Nana's are Beautiful

    Um gonna ask a really stupid question. Why isn't car insurance, either theirs or the other drivers, paying for the medical bills? Odds are this is why medicaid footing the bill for the accident. They're expecting an insurance co to pay for that.

    As for qualifying now............hmmm sounds a bit off to me. If they had it before while he was working, and he is now unemployed, they should still qualify for it. I doubt she's making enough as a waitress to throw them up out of the income bracket.

    If per chance those bills are from a county hospital........odds are if they go in and fill out paperwork the county will foot all or about 90 percent of those bills. It's what county hospitals do for low income families.
  3. muttmeister

    muttmeister Well-Known Member

    Car insurance won't pay the medical bills. They only had liability and it was a one car accident. And, no, not a county hospital. None around here.
    I did tell difficult child that when he talks to my lawyer he should ask about some kind of appeal process about the medicaid because they have less money now than they did then so I can't understand why they don't qualify.
  4. susiestar

    susiestar Roll With It

    The one BIG reason that they would not qualify now would be if they lied or falsified ANY info on an application or benefit review form. In our state if you lie once on the form you lose the benefits for many years. I am not sure if this is an issue or not - and they certainly don't verify anything on their own, but it would be the one thing I could see that would make them not get benefits. Also, not having insurance and having a low paying job is not necessarily grounds for getting medicaid. I know that when husband was in grad school and I NEEDED the hysterectomy to help save my life we did NOT qualify even though we were WELL below the poverty guidelines. They told me I could have the surgery and file for medicaid AFTER it was done and MAYBE they would pay for it. Of course I knew that they would NOT backdate a request for medicaid because NO govt dept does that! It was what they told people here to get them to stop calling them.

    I hope this gets figured out. There is most certainly an appeal process - the letter that denied coverage should have info to file the appeal in it. Often it is on the back of the letter as part of the efforts to use less paper.
  5. svengandhi

    svengandhi Well-Known Member

    Does your state not have no fault mandatory medical payments on insurance policies for cars? I have only liability as well (my NEW car is a '97) but there is medical coverage up to 50K included even in a one car (each car covers its own passengers and driver) with the option to buy more, very cheaply. I have a 300K liability policy (own my own home and have a decent job) with medication coverage up to that amount. Only problem might be (assuming your state has this) is timing. Here, you have to file within 30 days of the accident.
  6. muttmeister

    muttmeister Well-Known Member

    Mope, no such thing here. I think the car insurance paid $500 for medical.
  7. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Mutt...were they covered by medicaid when she had the accident? How long after the accident did medicaid stop?

    I am pretty sure timing is probably pretty much shot at this point to be honest.

    If she was covered by medicaid at the time of the accident, it would pay up to and including the day she became ineligible for medicaid for whatever reason that was...even if it was because someone missed a review appointment. When THAT denial letter came, that was the time to go back in and appeal and get the medicaid restarted.

    In reality, I have very rarely seen anyone...especially a family, denied medicaid for fraud. They may get fined or yelled at but its really a rarity. Medicaid fraud is normally gone after for doctors. But that is just my experience. If we found someone who was getting medicaid illegally, we just stopped the case. If they reapplied, we just made sure they were eligible the next time. No biggie.

    Im betting more that they simply didnt go in on time to do the applications while she was in the hospital and rehab. Then those huge bills built up. Now, they should be eligible at least for the kids...not sure about the adults. The income limits change drastically with the ages of the kids. I cant tell you without looking at your states guidelines exactly what those are and at what ages each step is. There are so many different types of medicaid. The ones that would effect your son are Medicaid for Infants and Children or Medicaid for Families. MIC or MAF. I get MAD. Medicaid for the Disabled. There are ones that just pay for Part D and ones that pay for Part B and those that pay for other things...its like a At one time I knew every single program that social services had inside and out. Time is fraying my memory a bit. I used to know all the income
  8. Star*

    Star* call 911

    The laws in this country protect the crooks.......I'm sure of that - PASSES THE TOILET PAPER FOR THE DOO DOO.