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General Parenting
Medicaid ..spend down questions???
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<blockquote data-quote="OTE" data-source="post: 18671"><p>Found some things that may help from Tx website. First one if from the state website medicaid section under FAQ.</p><p></p><p>"I was told I make too much money for regular coverage, but that my child might qualify for spend down. What does that mean?</p><p></p><p>Spend down is another name for the Medically Needy Program. You can be reimbursed for unpaid medical bills if, by paying them, your income would be low enough to qualify you for Medicaid coverage. For example, a family of four with an income of $1,000 a month would be covered if their medical expenses were at least $692 a month. Doctor visits, prescriptions, past medical bills, and medical insurance charges are covered. If you have other insurance it must pay first. Only the amount that it doesn't pay may be counted. This program is for children and pregnant women only."</p><p></p><p>Here's the list of people who qualify for Medicaid in Tx. So each line represents a different category of people who qualify. You don't fall into the regular Medicaid (line 1)presumably because your income is over those limits. Your son doesn't qualify for line 2 because he's not on SSI (again presumably because your income is too high). But if you look down the list you'll see a lot of other categories and one is called Medically Needy. Your son is falling under that category. And under that category, which is for children only, your son can have other medical insurance. This is similar to my situation in which my middle son and I qualify in category 1 and my youngest and oldest are in category 2. In my state that means that we have different kinds of Medicaid with different rules. eg my middle and I are on a managed care plan, an HMO. My SSI kids are not. So if you, your husband or another child want to qualify you would have to look at the rules of each line to figure out which line you might fall under. Also note that the title of this is Medicaid waivers. So that only the first couple of lines are regular medicaid and every other line is a separate Medicaid waiver plan.</p><p></p><p>So what they were trying to say is that it IS medicaid, but it's a different kind of medicaid, a different category or whatever word they want to use.</p></blockquote><p></p>
[QUOTE="OTE, post: 18671"] Found some things that may help from Tx website. First one if from the state website medicaid section under FAQ. "I was told I make too much money for regular coverage, but that my child might qualify for spend down. What does that mean? Spend down is another name for the Medically Needy Program. You can be reimbursed for unpaid medical bills if, by paying them, your income would be low enough to qualify you for Medicaid coverage. For example, a family of four with an income of $1,000 a month would be covered if their medical expenses were at least $692 a month. Doctor visits, prescriptions, past medical bills, and medical insurance charges are covered. If you have other insurance it must pay first. Only the amount that it doesn't pay may be counted. This program is for children and pregnant women only." Here's the list of people who qualify for Medicaid in Tx. So each line represents a different category of people who qualify. You don't fall into the regular Medicaid (line 1)presumably because your income is over those limits. Your son doesn't qualify for line 2 because he's not on SSI (again presumably because your income is too high). But if you look down the list you'll see a lot of other categories and one is called Medically Needy. Your son is falling under that category. And under that category, which is for children only, your son can have other medical insurance. This is similar to my situation in which my middle son and I qualify in category 1 and my youngest and oldest are in category 2. In my state that means that we have different kinds of Medicaid with different rules. eg my middle and I are on a managed care plan, an HMO. My SSI kids are not. So if you, your husband or another child want to qualify you would have to look at the rules of each line to figure out which line you might fall under. Also note that the title of this is Medicaid waivers. So that only the first couple of lines are regular medicaid and every other line is a separate Medicaid waiver plan. So what they were trying to say is that it IS medicaid, but it's a different kind of medicaid, a different category or whatever word they want to use. [/QUOTE]
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