Help with Medicaid, Moving, and Ugh

[mommytobees]

So, I have a question and I'm hoping someone here might have some knowledge and/or experience.

 

In the divorce, my XH was ordered to cover the kids' health insurance. No biggie, he is active duty military so it's cheap. Right now, he is being an (insert bad word). I suspect he is planning on dropping my DS17 (18 this month) from the health insurance after he graduates. He will graduate late, a 3rd senior semester, because of his hospitalizations last semester. He was dx'ed with MS in October. So, he has lots of $$ medical stuff to deal with.

 

I am a full-time student and we live off alimony ($1500 a month) and child support. I know we (he as an adult and myself) qualify for Medicaid (I self pay for my health insurance, though am considering going onto Medicaid as well) based on income. But, can he go on Medicaid if there is a parent with health insurance that _can_ cover him? Will Medicaid cover DS if his NCP father refuses to cover him?

 

Second question, how do you move to a different state when on Medicaid? How does the coverage work?

 

Who do I even talk to about getting the information? I've been told, if I go into the whatever-the-local-office-is-called and ask this, they then have the ability to refuse him coverage.

 

Thanks,

Kris

[cjzimmer1]

I've called our local office and asked lots of hypothetical questions and they have been really good about helping me figure out what to do.  One time they have even "forced" a test through the system because there was no other way to determine the answer and then when back and updated it to current information.  It was really helpful to have the actual numbers for our decision making.  In our state (and maybe this is everyone) children can stay on medicaid all they way through 18 (so don't get kicked off until 19).  If your ex takes your son off his insurance than I think it would work to have you apply and DS would still be considered your dependent.  Next year he would have to open his own case.  At least that's how it works here.  My kids are actually double insurance through DH's work and medicaid.  Medicaid just covers our high deductible which is a huge blessing.  I would really call and just start asking questions, you won't know how your state opperates until you talk to them.

 

Oh I think when you move you have to reapply in the new state after you have established residency.

Edited April 5, 2016 by cjzimmer1

[Ottakee]

Not sure but have you called the health department to see about special coverage due to the MS?

[Crimson Wife]

If he applies for Social Security and gets deemed "disabled" by the government, he may be able to qualify for Medicaid as a "wraparound" to the employer-sponsored healthcare. My SN child is on Medi-Cal secondary to our family's insurance and it picks up the deductible and co-pays for her.

 

In terms of Tricare, I believe there is a way to submit the court order directly to the benefits office and maintain your son's coverage. It's like the same thing as having child support or alimony come out of his paycheck automatically. Back when my DH was an Army officer, he had to deal with some of his soldiers acting like deadbeat dads so if you need to, threatening to go to your ex's CO for assistance might make him straighten up & fly right.

[sbgrace]

 I am pretty sure losing primary coverage is considered a qualifying event to be added to medicaid at any time if a person qualifies for medicaid otherwise. If your ex legally can and does take him off his plan and your son qualifies for medicaid, this should be a qualifying event.

 

Your local office should certainly be able to answer that question for you officially. His dad is going to drop him--can he then get medicaid, assuming he is eligible due to income or disability.

 

You may be able to apply now and receive medicaid, with the ex's insurance as primary until it's dropped, given he will lose it at x age. That may vary by state and situation though. My son received medicaid as secondary to private insurance due to disability. In our state, that doesn't pay anything at all unless he loses his primary insurance. But losing that primary insurance, even voluntarily, bumps medicaid to primary payer.

 

Medicaid is administered by states. I believe you have to reapply when you move, but I'm not positive. They should be able to answer that for you as well.

[ThisIsTheDay]

So, I have a question and I'm hoping someone here might have some knowledge and/or experience.

 

In the divorce, my XH was ordered to cover the kids' health insurance. No biggie, he is active duty military so it's cheap. Right now, he is being an (insert bad word). I suspect he is planning on dropping my DS17 (18 this month) from the health insurance after he graduates. He will graduate late, a 3rd senior semester, because of his hospitalizations last semester. He was dx'ed with MS in October. So, he has lots of $$ medical stuff to deal with.

 

I am a full-time student and we live off alimony ($1500 a month) and child support. I know we (he as an adult and myself) qualify for Medicaid (I self pay for my health insurance, though am considering going onto Medicaid as well) based on income. But, can he go on Medicaid if there is a parent with health insurance that _can_ cover him? Will Medicaid cover DS if his NCP father refuses to cover him?

 

Second question, how do you move to a different state when on Medicaid? How does the coverage work?

 

Who do I even talk to about getting the information? I've been told, if I go into the whatever-the-local-office-is-called and ask this, they then have the ability to refuse him coverage.

 

Thanks,

Kris

 

Once you have moved to a different state, notify your old state office that you have moved and apply for MC in the new state.  My state's cutoff was the 16th of the month--if you were cut off before the 16th, your coverage would end on the last day of the month. If you were cut off after the 16th, your coverage would end on the last day of the following month (up to six weeks or so later).  You need to be sure that your old coverage is cancelled, and when you apply at your new location, just tell them that your old MC will be end effective on whatever the date is.

 

In my state, based on what you've described, your ds would not be eligible for full coverage MC once he turns 19. He has not been determined to be disabled; he is not a parent/caretaker of a child under 18.  His income does not matter.  My state does not have expanded MC, and I don't know how this would affect anything differently.

 

You can try to get answers from your local office.  Our state workers are required to tell people to apply, and coverage would then be determined.  They are not allowed to guess or make any sort of suggestions, because they often do not have enough information about a client's situation to provide accurate answers.  Local (and probably state) social services websites in my state have minimum qualifications on the program web pages, and you can apply online from there.  I believe you can also apply for Medicaid over the phone, but that may only be for certain programs.  Contrary to what you were told, you will not be denied just because you called to ask for information.  That can only be determined after you actually file an application.

 

It would not matter if his father were mandated to have coverage; if your son is eligible and does not have that coverage, he would qualify.  If he does have that other coverage, then any MC coverage would kick in as a secondary insurance.  Also, if his father drops the coverage, your son would need to provide an End of Benefits letter, referred to as an EOB, to prove that he is no longer covered under that insurance.  This can be tricky with insurance through the military, unless your ex-husband cooperates and requests the letter be provided.  In the meantime, any bills may not be covered until the information is received, at which time MC would back pay for any eligible coverage.

 

Because of your ds's illness, I would encourage you now to be researching and applying for any prescription assistance for whatever major MS drug your son may be taking.  There are different companies that you can find by googling, and you can also try going through the drug manufacturer to see what they may offer.  Most, if not all, is income based, so your chances of getting help is very good.

[mommytobees]

Not sure but have you called the health department to see about special coverage due to the MS?

 

Not in this state. AZ stinks.

Kris

[mommytobees]

If he applies for Social Security and gets deemed "disabled" by the government, he may be able to qualify for Medicaid as a "wraparound" to the employer-sponsored healthcare. My SN child is on Medi-Cal secondary to our family's insurance and it picks up the deductible and co-pays for her.

 

In terms of Tricare, I believe there is a way to submit the court order directly to the benefits office and maintain your son's coverage. It's like the same thing as having child support or alimony come out of his paycheck automatically. Back when my DH was an Army officer, he had to deal with some of his soldiers acting like deadbeat dads so if you need to, threatening to go to your ex's CO for assistance might make him straighten up & fly right.

 

Sadly, there is nothing I can do about the health insurance if XH removes him. The state isn't going to do anything after he turns 18 & graduates or turns 19yo.

 

Thank you though,

Kris