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Too Good To Be True


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i found out today that because i'm going to be collecting SSD and not SSI anymore (due to them finishing my case), that i'll have to achieve a "spend-down" amount monthly to qualify for medicaid in that month (i think it is in that month). i haven't been told what my amount will be yet, but this sucks!

it sucks because i want my scripts filled. the mental health center i go to is free, and they'll keep giving me samples for as long as is necessary, but of course with medicaid i can get my meds in regular bottles from the pharmacy, which is a lot better obviously. it goes month to month, so i may make my amount i none month and not the next.

which begs the question- if i go to the pdoc and my visit is $100 but medicaid only pays $50, does only $50 count towards this "spend-down", or does the full $100?

that also makes me ask- do i already, if the center were to charge me (and they can), rack up enough in medical bills to pay this amount, once i know what it is?

and if not, would changing doctors, like maybe going back to my other pdoc and a new tdoc help me make the amount?

the system sucks!

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I don't have any specific answer to spend down procedures.

However, after working 5years in the prosthetic office I did pick up on a couple items related to medicaid.

First, hawk your income and savings to the dollar so you don't lose elegibility temporarily. We had one elderly couple who were sweet old folks but dumb as rocks. One period they had $2 over the limit (I couldn't make this up) and had to go without coverage for a while!

Second, many people on medicaid keep some portion of their finances in cash, avoiding running them thru a bank account where it can be traced, and accidently bite them if a mistake is made, etc. This is why you see so many people buying money orders at convenience stores. They keep cash at home, or in money orders payable to themselves, and pay most bills in cash or with money orders.

The hell of it is, the system wants to be sure that people are truly needy, and makes you spend down, but if anything goes wrong in life, you don't have any assets to take care of yourself. Catch-22.

Good luck.


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