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  • Medicaid and driving

    I've been on Medicaid for 2 yrs now, since I came home from the hospital. I have an assigned case manager who visit very month. She came by last time and told me that they will cut my benefit because I am now driving. Since I'm driving I'm independent and no longer need to be on the program. The program im on is NJ medicaid global option. The program provide a home help aid for 15 hrs/wk. they cut down the hr to 10/wk now. I explains to her that I am looking to go back to work but still need Medicaid for my monthly supplies until I can find a job and start working. I am fine if they decide to cut the home help aid but she told me they will take me off the whole Medicaid program. How am I supposed to pay fr catherters w/o Medicaid? She didn't seem to care.
    Have any of you ever had to deal with something similar? Any advice or suggestion?
    Thanks,
    Tin
    T3 Complete
    to my alarm: "quiet b*tch! I know what I have to do every two hr. Argggggg!!!!"

    sigpic

  • #2
    They can't just cut you off medicaid because you're more independent... Thats ridiculous. Its not like you lost your disability.

    Call up and ask to speak with your case workers supervisor, make sure you take detailed notes of the conversation and the name of everyone you speak with. Hopefully you can get things cleared up this simply. But if not, make sure to take notes and names of all interactions and keep copies of ALL paperwork you receive (anything that you need to fill out and send back, make a copy just before sending it back). If you believe any coverage was dropped unfairly, appeal. If nothing else this should get your case looked at more closely and get more complete explanations of whats going on.

    Now, losing your coverage because you get a job and are making above x amount of money is another thing entirely and nothing can be done about that. So if you start working and don't have enough money for catheters, don't have health insurance yet, your options are limited. Do you have medicare as well or just medicaid? I don't know as much about medicare but I have been told they have a program to help you return to work where you get a trial to return to work so if something goes wrong you don't lose your benefits. Does your state offer any additional insurance programs for the underinsured? Some states offer programs that are between medicaid and regular insurance to help those making too much money for medicaid acquire insurance. Unfortunately if this is your issue you're at the point where I see the most problem with the current system but have no idea how to fix it. How is a person supposed to jump from poverty and medicaid to a job with enough money or medical insurance that you don't end up back in poverty on medicaid from paying your medical costs (or give up without even making it that far because why bother.)
    Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

    I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

    Comment


    • #3
      Medicaid isn't tied to driving, it's tied to income and disability. If you get a letter reducing your benefits, appeal. They can't change your benefit without a written notice. If you're earning over the Medicaid standard ($698/mo here in Oregon), you can be reduced or denied. As long as Social Security says you're disabled, you're Medicaid eligible.

      Comment


      • #4
        Maybe Anban can help you with this. I found the website of the program.

        http://www.state.nj.us/health/senior/go.shtml

        http://www.state.nj.us/health/senior...ochure_eng.pdf

        Here is the guidebook:

        http://www.state.nj.us/health/forms/go-1.pdf

        It seems this program is tied to services you need and you must NEED them to qualify. There is a list in the guide. It also heavily depends on your functional assessment or would appear to.

        I hope this helps.

        Perhaps you will be eligible for a different program?
        T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

        My goal in life is to be as good of a person my dog already thinks I am. ~Author Unknown

        Comment


        • #5
          Originally posted by ~Lin View Post
          They can't just cut you off medicaid because you're more independent... Thats ridiculous. Its not like you lost your disability.

          Call up and ask to speak with your case workers supervisor, make sure you take detailed notes of the conversation and the name of everyone you speak with. Hopefully you can get things cleared up this simply. But if not, make sure to take notes and names of all interactions and keep copies of ALL paperwork you receive (anything that you need to fill out and send back, make a copy just before sending it back). If you believe any coverage was dropped unfairly, appeal. If nothing else this should get your case looked at more closely and get more complete explanations of whats going on.

          Now, losing your coverage because you get a job and are making above x amount of money is another thing entirely and nothing can be done about that. So if you start working and don't have enough money for catheters, don't have health insurance yet, your options are limited. Do you have medicare as well or just medicaid? I don't know as much about medicare but I have been told they have a program to help you return to work where you get a trial to return to work so if something goes wrong you don't lose your benefits. Does your state offer any additional insurance programs for the underinsured? Some states offer programs that are between medicaid and regular insurance to help those making too much money for medicaid acquire insurance. Unfortunately if this is your issue you're at the point where I see the most problem with the current system but have no idea how to fix it. How is a person supposed to jump from poverty and medicaid to a job with enough money or medical insurance that you don't end up back in poverty on medicaid from paying your medical costs (or give up without even making it that far because why bother.)
          It's called ticket to work, the program that helps you get back to work. you can do a 'trial' work period of up to nine months and still receive your disability payments and medicare at the same time. but after said nine months of working those benefits go away and you're on your own.

          Comment


          • #6
            Thanks anyone for your input. It's not like I want to stay on the program forever. I've asked Dvr to help. Dvr is paying for me to take a course next month. After that they will help with job hunting. But this lady doesn't understand that getting back to work is not as easy as 1 2 3. She's coming by next week. I'll see what she has to say.
            T3 Complete
            to my alarm: "quiet b*tch! I know what I have to do every two hr. Argggggg!!!!"

            sigpic

            Comment


            • #7
              If she isn't able to understand the situation or making sense, like I said get a hold of her supervisor. That would be the first step! I hope this conversation goes much better for you. But if it doesn't, you aren't alone and this sort of thing happens really frequently unfortunately. Just be proactive in managing your case so that if a mistake is made it can be cleared up quickly.

              This past fall my local medicaid office made a simple paperwork mistake during yearly review. I made sure to do my part to fix it asap with re-faxing them the paperwork (like I said, make copies of EVERYTHING) and then followed up by phone repeatedly. I spoke to 3 separate people who had told me everything was fine once I faxed the paperwork and my medicaid would not be affected. However on the first of the month I couldn't fill my prescriptions, and nearly had to reschedule some Drs appointments. I IMMEDIATELY went up the chain of command very high (I've also kept names and contact info for the local regional supervisors since I've run into so many problems personally) and it only took them 3 days to get my medicaid reinstated. The first person I spoke to on the phone simply told me "well the others you spoke to were obviously wrong, weren't they" in response to the problem and told me I'd just have to wait until the state evaluated my case to reinstate.

              I've had LOADS of problems that I never had before I moved to Indianapolis, I think being in such a big city with so many people on these benefits makes it more difficult for them to keep everything straight. But I've also seen an abnormal amount of mistakes happen in some small towns, like for a friend of mine. When her caseworker found out her boyfriend had moved in with her she lost her food stamps, they dropped her down to $16 dollars and her caseworker said there was nothing she could do about it that with them living together they had to have financials combined. This made no sense, he moved in as a roommate and they've never shared any financials. In fact for him to move in they had separate leases drawn up with the landlord to pay their halves of rent separately! There are great employees that know what they're doing and will either keep your case running smoothly or fix the mistakes others make in a timely basis, and there are employees that have no idea what they're doing and simply don't care about the importance of their job. I'm hoping your current issue is just a mis communication one and once you guys sit down again you can work this out.

              Working with DVR should be a lot of help with returning to work, I've started working with them too and am hoping to return to school or part time work in the future.
              Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

              I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

              Comment


              • #8
                The case worker just called and cancelled the visit due to personal emergency. I'll update when she decides to stop by.
                Thanks again,
                Tin
                T3 Complete
                to my alarm: "quiet b*tch! I know what I have to do every two hr. Argggggg!!!!"

                sigpic

                Comment


                • #9
                  Everyone has given good info. The fact that your driving has nothing to do with your benefits. I can only urge you to not wait on the ill advised lady-- I would call me region office or 800 # to get further clarification and to have notes made in your file. In any case from my experience benefits change at the beginning or end of a month and with Medicaid you get something in the mail from the state agencies that manage it such as DCF, etc. in Florida people can also manage their benefits online..... Stay ahead of the game so you have no interruptions. And congrats on DVR-- they can be a great resource for many things
                  Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

                  Comment


                  • #10
                    I don't know if I am right. But what I understand of obamacare. Anyone who don't make enough to purchase insurance will get thrown into medicaid. So if that is true next year you can tell that case worker to shove it. I can't wait to see the flood to medicaid. Obama's will save us all! ha ha ha!

                    Comment


                    • #11
                      edicaid is not Medicaid is not Medicaid....

                      Originally posted by TheRainman View Post
                      I don't know if I am right. But what I understand of obamacare. Anyone who don't make enough to purchase insurance will get thrown into medicaid. So if that is true next year you can tell that case worker to shove it. I can't wait to see the flood to medicaid. Obama's will save us all! ha ha ha!
                      Medicaid has federal rules administered by CMS, but states have great latitude within those federal rules to design and operate their Medicaid programs. A functional needs assessment is a standard protocol used to ensure services aren't provided to people who don't need them, your case worker is likely assuming you are now driving because of a change in your functional ability. Are you on a waiver, or just the NJ Medicaid state plan? Waiver rules tend to be very different than state plan rules, as are the services provided under waivers and the state plan. I would start by trying to explain why your long term service and support needs have not changed, driving has enhanced your independence but has not altered your functional needs. If your services are cut, you have the right to appeal, if the appeal is not found in your favor you can appeal that decision as well, usually to an Administrative Law Judge. Try not to get angry, but don't just accept a bad decision. The 3 most important words to remember when dealing with any gov't service agency: APPEAL, APPEAL, APPEAL!
                      http://about.me/joshuawinkler

                      Comment


                      • #12
                        Thanks all for your inputs. The case worker from medicaid stopped by yesterday and to my surprise she didn't mention anything about cutting me. I mentioned that I will start class the following day. She wished me luck and hoped I will find a good job so I could get off the program. I was like "wow is she ok today?". Anyways, my goal is to get back I to the work force and get off the program. However, I can't afford to be off the program until I am permanently working with health insurance.
                        One more question. If I go back to work I know they will discontinue my ssdi which is fair. Let just say 3 or 4 years down the road my body decided to give up would I be able to re-apply for ssdi? Or once I go back to work they no longer considered I'm disabled?
                        Thanks,
                        Tin
                        T3 Complete
                        to my alarm: "quiet b*tch! I know what I have to do every two hr. Argggggg!!!!"

                        sigpic

                        Comment


                        • #13
                          Originally posted by tinng321 View Post
                          Thanks all for your inputs. The case worker from medicaid stopped by yesterday and to my surprise she didn't mention anything about cutting me. I mentioned that I will start class the following day. She wished me luck and hoped I will find a good job so I could get off the program. I was like "wow is she ok today?". Anyways, my goal is to get back I to the work force and get off the program. However, I can't afford to be off the program until I am permanently working with health insurance.
                          One more question. If I go back to work I know they will discontinue my ssdi which is fair. Let just say 3 or 4 years down the road my body decided to give up would I be able to re-apply for ssdi? Or once I go back to work they no longer considered I'm disabled?
                          Thanks,
                          Tin
                          The way I understand obamacare your not going to need to worry about that. I believe anyone not making a certain amount of income gets thrown into medicaid.

                          Comment


                          • #14
                            If your condition changes so you're unable to work again theres no reason (e.g. only allowed to use ssdi once) that would not allow you to receive benefits again. Peoples condition changes, they can decline unexpectedly or improve unexpectedly. You can go back on benefits if you need them again. And I'd look in to the trial to work program.
                            Board Member of Assistance Dog Advocacy Project working in Education. Feel free to ask me any service dog questions!

                            I am not paralyzed. I have a genetic connective tissue disorder with neuro complications and a movement disorder.

                            Comment


                            • #15
                              Originally posted by TheRainman View Post
                              The way I understand obamacare your not going to need to worry about that. I believe anyone not making a certain amount of income gets thrown into medicaid.
                              The Medicaid coverage under the Affordable Care Act is not required to be as robust as that provided under current eligibility categories.

                              As for getting back on SSDI, you can easily during your Trial Work Period, semi easily during the 5 year Expedited Reinstatement period, after that you would need to re-apply and prove disability.

                              http://www.ssa.gov/redbook/eng/ssdi-...s-supports.htm
                              http://about.me/joshuawinkler

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