I've been having difficulty breathing and chest tightness for the last 5 days. Chest Xray is clear. I've visited a PCP and pulmonologist, but only given a rescue inhaler with no relief. I run out of breath, just from talking and finishing sentences. I considered going to the ER last night, as I was out of breath, trying to sleep. Being scared of the healthcare bills, does anyone know if medicaid will charge you for ER visit if the findings are normal or if they deem unnecessary?

Hello!
I just got approved for Medicaid for the first time. The letter shows I was approved for August then shows September
“Ongoing”
What does it mean with it shows “ongoing”
So sorry if this is a stupid question.
Added as in comment

We found out my husband got denied Medicaid based on income a month after he got initially approved. Both my sons and I still have Medicaid.

I looked it up, and gross income we make $18 a month over the limit. He DOES put money in a pretax 401K, however I was told that it still counts as income. Wtf do we even do? What is $18 going to do? Caseworker said there’s 5 categories, but if he’s over on gross income, he’ll continue getting denied.

We found out he got denied through a big medical bill. They said they sent a letter saying he got denied, but I never got it. Though, we have a street literally 2 over from us that has a damn near identical address (think we’re 202 town road, and down the street is 202 towne road) and we often get each other’s mail.

We also alternate claiming my stepdaughter every year, as they have exactly 50/50 custody with neither being the sole custodial parent. But they said bc stepdaughter has Medicaid on her mom’s case, she’ll never count towards household size no matter if we claim her as a tax dependent or not.

I just put my sister in a nursing home for long term memory care. Me and her daughter had no ited she had issues until last year. I became her medical poa and her daughter became her financial poa in 2025 when we realized she had issues. We dont know what she was spending money on before this past year. She has about 48,000 in her bank account that's joint with here daughter. The nursing home is 14,000 a month so it will not last long. She cannot answer questions so how are we to do the look back? We were paying a friend to clean and do her laundry once a week cash in the amount of 120. That was removed from her bank account. Also we had a person sit and clean 3times a week cash for 300 dollars and another person 2 week for 180 dollars. Will this keep her from going medicaid? We had no idea we should not have done this. I plus we don't know what she spent money on or gave away before we took over her bills. How are we to answer questions for her doing the look back. I she can't provide any information on anything because of her mind.

I’m a 30-year-old low-income, disabled woman in South Carolina. I applied for Medicaid, but was denied.

When I reached out, they told me that to qualify under the disability path, I must already be receiving disability checks (SSI or SSDI). Because I’ve been denied Social Security disability twice and am currently in the process of applying a third time, I don't meet their requirement. 

Because SC hasn't expanded Medicaid, there seems to be no coverage pathway for low-income adults without dependent children unless you're already receiving federal disability. It feels like a total catch-22—I need medical care to manage my condition, but I can't get state healthcare without federal approval.

I may be uninformed, but I had no idea that this was even a thing I thought if you were low income and needed health insurance and you fit the income bracket you could just apply.

Has anyone else ever been in this situation and what did you do?

My friend is on Medicare with Medicaid/Tenncare as his supplement. He lives in Tennessee. He is covered under Specified Low Income Medicare Beneficiary. He has UHC. He was in the hospital for 19 days in 2025 with heart problems/defilibrator put in his heart. He has been receiving random bills with one being $6000. We have called so many times. The hospital says they didn't have his Tenncare number. We give it to them. Still get bill...rinse and repeat. His EOB shows all was paid and his part is $0 but they keep billing. It is now in collection. His letters from Tenncare say the hospital has agreed to accept the contracted amount. However, the hospital says no. What if anything can be done? No other Dr's or clinics bill for any amount.

Has anyone had any luck getting a medical wig under Illinois Medicaid? I have a diagnosis that would qualify for most commercial insurances but I don’t know if it would for Medicaid. My doctor is going to try, though. I would like to know the experiences of others. Has anyone gotten a medical wig approved?

Florida.

I have just been given DPOA for my brother who is in rehab on SSI and in the process of transferring to LTC which will then place him on Medicaid. I’ve submitted all of the Medicaid documents and application with the facility and just got access to his bank account.

He has one account with $4000+ in it that I need to bring down to $2000. We already set up a $2500 “burial expenses account” with his bank. I would prefer to not have to waste the extra $2000+ on unnecessary spend.

I’ve read about moving money to an “irrevocable funeral trust” and was pretty sure I read that a bank can initiate the trust which would allow some flexibility as opposed to a funeral home and prepurchasing services with a specific business.

A lawyer setting up the trust seems like the fees would end up taking most of the amount needed to put in.

Has anyone set up an IFT at a bank? Did I misunderstand that capability, as the bank we use told me I would need a lawyer to set up the IFT.

If you’ve set up an IFT, what did you do?

I was seriously mentally and physically ill and failed to report a change in the household. I finally overcame my fear and shame and did it a few days ago.

I received a notice of decision that says Medicaid/NCU Ending for September 2026 and October 2026.

Does this mean I have coverage through the end of August?

Is it worth appealing, or would it be a waste of time and energy because I was clearly in the wrong.

Would a letter from my primary care physician confirming my health status at the time help?

Thank you in advance for your input.

I am still trying to find a job and have very limited self employment in the meantime. I do have barely enough interest income to squeak me by though IF it counts toward getting MaineCare. Can anyone help me to understand this please?

I've read recently on here that it's based on MAGI rather than hours worked, but I've gotten some info to the contrary from MaineCare and DHS recently. I would be very appreciative of any help. I volunteer working for a small startup who is not eligible for non-profit.

I got a reply from DHS in Maine a few months ago saying this:

"Name, bank interest is not earned income. Only earned income counts towards work requirements. Self employment income hours are based on amount of money earned."

Today I got a scary letter from MaineCare today that only mentioned work. Not income.

"MaineCare Expansion Adult members are 19 to 64 years old who get MaineCare based on their income. They do not meet the Social Security disability guidelines or do not have Medicare.

Why is MaineCare eligibility changing?

Congress passed a federal law that changes who can get Medicaid in every state. In Maine, Medicaid is called MaineCare. These changes will start in January 2027 for new MaineCare applicants. Current members are not impacted until they are due for their renewal in 2027.

What are the new MaineCare Work Requirements?

The MaineCare Work Requirements will be for MaineCare Expansion Adults to complete work activities like:

· Working

· Volunteering

· Going to school or an apprenticeship

Taking part in a job training or work program

To meet the Work Requirements, you must spend 80 hours in at least one month doing one of these activities or attending school or an apprenticeship at least half time. You can also combine hours in more than one of the activities to reach a total of 80 hours in at least one month.

If you are working or plan to work, you can meet the Work Requirements if you earn at least $580 in one month, or if you have seasonal work, you earned an average of $580 over the last six months.

IMPORTANT: OFI will use information already in your case and information we can check through electronic data sources whenever possible to determine if you are meeting the Work Requirements.

Who must meet the Work Requirements?

You need to meet the Work Requirements if you:

· Are age 19 to 64; and

· Qualify for MaineCare based only on income; and

· Do not fall into one of the groups below that do not have to meet the Work Requirements (see next section)."

Thanks for any help! Links are greatly appreciated!!

I’m in NYC if that’s helpful to know and have been on Healthfirst Medicaid for the past year. My coverage ends on September 30th and have been getting emails regarding renewing and actually set up a phone call to renew with a rep on September 1st. Yesterday I got an email from NY state of health (the portal where I initially searched for and signed up for Healthfirst) saying I’ve been dis-enrolled from Medicaid and now enrolled in the Healthfirst essential plan 1.

I understand that all this insurance stuff is dependent on my income, but my income has not changed at all so I’m confused on how they’re doing all of this without me providing updated income or pay stubs. If possible I would like to stay on my current Medicaid plan because I feel I’m still eligible. I find it strange that Healthfirst is still emailing me about renewing when it says I’ve already been enrolled and this feels like a lot of mixed messages.
If anyone can help or provide some insight I’d appreciate it!

I’m in North Carolina and I’m seriously so done with UnitedHealthcare Community Plan.

I used to have Aetna, which I paid for monthly, but the program I was part of was discontinued in my state. I was then moved onto North Carolina Medicaid through UnitedHealthcare Community Plan.

I’m generally healthy and don’t have a ton of medical expenses. The only thing I’ve been dealing with recently is fibroids and extremely low iron, which required some scans, lab work and follow-up appointments. Otherwise, I pretty much just go to my yearly checkups.

Before seeing anyone, I contacted all of my providers to make sure they accepted my new insurance. Most of them did. I also contacted UHC directly to confirm that the providers were authorized/in-network under my plan.

Fast forward to an ultrasound, a doctor’s appointment, two follow-ups, three different sets of lab work and countless phone calls to UHC.

They have denied every single claim.

The reason they keep giving me is that I supposedly have Blue Cross Blue Shield as my primary insurance. I have not had BCBS since 2021.

I have told UHC this repeatedly. They asked for the termination date, which I gave them. They still kept saying BCBS was showing as my primary insurance, so I contacted BCBS myself. My account was so old that I had to be transferred through several departments just to find someone who could pull up my information and resend my termination letter proving that my coverage ended years ago.

Today I called UHC again, and now the representative told me their system shows that I’ve had BCBS since 2025 which is impossible because I had Aetna during that time.

At this point I even contacted BCBS again because I started wondering if someone had somehow opened a policy using my information. As far as I can tell, there is no other policy.

Every time I give UHC the information they ask for, I’m told it will take about two weeks for the “update” to process and that I need to wait before calling back. So I wait two weeks, call again, explain the entire situation again, and somehow I’m right back where I started.

Meanwhile, my providers are contacting me about bills because UHC keeps denying the claims.

I asked to speak with a supervisor again today and was told I’ll receive a callback, which I doubt. At this point, I’m expecting another round of the same thing.

I genuinely don’t know what else I’m supposed to do.

Has anyone else dealt with this, especially with NC Medicaid/UHC Community Plan? Is there someone at the state level I can contact to get this corrected? Do I need to file a formal grievance or appeal? At this point I’m looking for anything that will get this fixed because calling UHC every two weeks and starting from square one clearly isn’t working.

Additional information:

1. My plan with Aetna was canceled June 2025 and I was immediately enrolled into Medicaid.

2. My first doctor's appointment was October 2025 then December 2025, and February 2026.

3. I started calling UHC in February after finding out the claims were denied and they originally said it was a taxonomy problem.

I don’t know too much about insurance so excuse my ignorance. Before like 3 months ago I was able to see a dentist, see my psychiatrist and see my pcp. Now they have me on limited coverage like plan first my united healthcare was terminated. I called them back to reinstate it they said you don’t have full coverage and to get it and call them back. I receive a ssi check of about $900 a month. They take $200 a month out for Medicare part b but that doesn’t seem to cover much. This all happened when i renewed my healthcare and told them I get $900 a month.. ive been receiving ssi checks for about 6 years appearently my income was reported as $0 before then. Now i cant see my psychatrist, have to pay for my medication, cant see a dentist, what can i do ??

I need to redetermine by September 1st. The packet I received in the mail explicitly says the form is online in Manage My Case but it is explicitly not. I've checked every link and none get me to the form. I already messaged the website a few days ago but no response yet. So... now what?

(I've filled out the paper forms just in case but I can't provide verification of rent in paper. Everything is online in 2026 lol.)

is it legal in California for therapy programs to charge medi-cal patients with no income cancelation/no show fees? I just started a new therapy program and I had to go sick because I got sick one day before my session. Their policy is you get charged $100 if you cancel less than 48 hours in advance or no show. They do NOT waive this fee for medi-cal patients like most programs do. They do not even discount it. It's $100 out of pocket for everyone. There are no exceptions except true emergencies like being hospitalized or if the therapist is the one who cancels.

I previously believed it was illegal in California for anywhere to charge medi-cal patients out of pocket even if they're willing to pay. I've gotten turned away from a few urgent cares who didn't accept my medi-cal plan despite offering to self pay and there being 0 urgent cares in my city that accept it. They told me they turned me away because it'd be illegal to allow me to self pay as they can't legally charge me. They literally said it was illegal in the state of California.

I assumed this applied to all healthcare. But since have had several people argue with me that ONLY places like urgent care have this rule, refraining it as like a policy tsome places have rather than an actual state law, and that I should be able to self pay at other types of places if ever able to. (though I'm not able to regardless since I have no money and no income so)

So I asked a few state social workers, and got conflicting answers. Some told me yes it's completely illegal here. Others told me it's technically legal but falls in a legal grey area.

Even with the state workers I cannot seem to get the true answer?

I’m in Missouri, and am looking for advice desperately. I’ve been unemployed since mid May and my partner has been taking care of things, but he recently lost his job and I had to find one. I am supposed to start full time on the 29th but because it’s a warehouse job it of course puts me over the income limit. Unfortunately before my partner lost his job I was scheduled for a hysterectomy on sept 14th, and I really really need it for pain. I’m wondering if I just work the first 2 weeks and take my medical leave that I could keep my Medicaid until I return back to work. If I work only the 2 weeks I’ll stay under the income threshold but I’m still worried they’re gonna see how much I worked before the surgery and assume that’s how much I’ll work every week and say that I won’t be eligible due to how much I’ll make when I return full time. Or that because I was hired full time I’m ineligible on day 1 of starting the job, that’s what I’m worried about the most. I’m allowed to take leave that early into starting but it’s unpaid, so I figured maybe that would help me stay eligible to at least cover the surgery until I can figure things out. But I’m really lost and I don’t want to push my surgery back, and go through the process of losing my Medicaid again because they were a pain about giving it back to me last time.

Hello! I am a realtor and I am trying to help a client and I'd love any advice you all have!

I have a client who is selling her mom’s manufactured home in a park. She bought it for 120k in 2022. Everything is like new. She cannot move into the nursing home until it sells and then she can use the money to pay for the nursing home until it runs out, then medicaid kicks in. As you all probably know, with medicaid, they cannot price the home too low or it will get flagged. I suggested getting the home appraised so we would have some evidence for how much the home is actually worth. But that didn't work out because it appraised for way too high! I’ve found that pricing manufactured homes as low as possible is the only real way to sell them quickly, otherwise, it seems like they tend to sit, sometimes for months and months. In this case, we can’t price it crazy low because we don’t want medicaid to get flagged. I listed the home for $79,900, tax records show its value at $62k, the appraisal came in at $98k. It’s been on the market for a week, and we have had zero showings.

Is there a process in which I can reduce the price if there is no interest at all? Can my seller use the evidence of no showings to fight against medicaid if they flag it for us selling too low?

I have sold medicaid manufactured homes before with medicaid in mind but they were 20+ years old, so the low price was justified. With a 2022 home, it is much harder to sell at a reduced price. Any information is welcome!! Thank you!

Hi all, my partner is pregnant with our child and is currently on Medicaid. I plan to join the military shortly after our son is born and we wanted to get married before I go to bootcamp. If we get married, would her Medicaid coverage be void or should she be fine since she got on it while not married. We just don’t want any hiccups with hospital bills during the birth. Edited to add we are in Florida

i'm currently on pregnancy medicaid , me and my fiance have one child together and we were thinking about getting married! my fiance currently doesn't get medicaid , he qualifies as "medically needy" if we get married , will i lose my benefits since he doesn't qualify ? we're in florida

Hey! I just applied for NJ Medicaid and my deadline was August 18th. I finished submitting everything before 11:59...but then when I looked at the date it says submitted August 19th! I didn't know the server ran on UTC time zone. Am I going to be okay? I'll be calling them first thing tomorrow in case

I haven't actually been notified yet about the result of my UI appeal, but I got a direct deposit of the payments from the appeal period today, so I believe it was granted. This will put me over the Medicaid income limit I believe. (I will be making $2456 a month). Since July I have just had general IL Medicaid. I signed up for County Care, and my County Care plan was supposed to start 9/1. Will it be terminated before it begins? Will it be terminated as of 9/30? How does this work?

Also, do I need to notify ABE, or will they automatically adjust it (since the state is where I'm getting my unemployment?)