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General Parenting
Medicaid ..spend down questions???
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<blockquote data-quote="OTE" data-source="post: 18681"><p>I was talking about the Medicaid case mgr. Medicaid is only going to pay what they deem necessary. So if they decide the in home isn't necessary you have to go back to the clinic and ask them to argue with Medicaid for you. First step would be to simply submit the plan from the clinic that you are happy with. If the clinic is a big, public one chances are you won't have any fights because they work with medicaid already and know what medicaid will pay. They've done the same kind of plan at the clinic 100 times and know medicaid will approve it. If your clinic doesn't know medicaid rules it could be more difficult. But right now I'd work on getting the $89 thing fixed so medicaid will approve you. Forget what I said about charities and so forth, this is a full ride on medicaid, go for it! Call the worker again and ask how you pay the $89. Ask if you send her a check every month, if you pay $89 to a provider yourself and send her the receipt. If it gets complex ask her if there's a way to make it simpler. Go back to the stuff I said about reducing your income by $89/mo. Earning that $89 per month is sure a lot less than the deductibles and co-pays you pay now that medicaid will start picking up plus all the additional services. Also, that $89 is going to change every month if your paycheck fluctuates eg overtime, every yr when inflation changes, etc. That's why I find it easier to just earn under the limit and save myself the hassle.</p></blockquote><p></p>
[QUOTE="OTE, post: 18681"] I was talking about the Medicaid case mgr. Medicaid is only going to pay what they deem necessary. So if they decide the in home isn't necessary you have to go back to the clinic and ask them to argue with Medicaid for you. First step would be to simply submit the plan from the clinic that you are happy with. If the clinic is a big, public one chances are you won't have any fights because they work with medicaid already and know what medicaid will pay. They've done the same kind of plan at the clinic 100 times and know medicaid will approve it. If your clinic doesn't know medicaid rules it could be more difficult. But right now I'd work on getting the $89 thing fixed so medicaid will approve you. Forget what I said about charities and so forth, this is a full ride on medicaid, go for it! Call the worker again and ask how you pay the $89. Ask if you send her a check every month, if you pay $89 to a provider yourself and send her the receipt. If it gets complex ask her if there's a way to make it simpler. Go back to the stuff I said about reducing your income by $89/mo. Earning that $89 per month is sure a lot less than the deductibles and co-pays you pay now that medicaid will start picking up plus all the additional services. Also, that $89 is going to change every month if your paycheck fluctuates eg overtime, every yr when inflation changes, etc. That's why I find it easier to just earn under the limit and save myself the hassle. [/QUOTE]
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