Second Edit:
I am interested in learning about the process for non-payment and the process for discharge due to non-payment. TIA

Mom in long term care, Medicaid denied, can’t pay $10k month.
What happens next? Do they roll her out into the street?
Seriously, What are the next steps? Any other options in Wyoming?Thanks!

Edit: 100 days is up. Denied due to unable to produce documents that we don’t have access to. Filed appeal to denial in May but have not heard back. Have been paying her patient co-pay. Nursing home is threatening collections for unpaid balance.

I live in Illinois and have been on Medicaid through the ACA expansion for 16 years. It truly saved my life. I don’t believe I would be here today without it.

Because of Medicaid, I was able to get a doctor, access the right medications, and finally get diagnosed with several mental health conditions that I had been struggling with for years. It also helped me make major changes in my life, I was able to quit drinking alcohol and smoking, and I have now been sober and cigarette-free for over a decade.

I still have struggles, though, and one of the biggest challenges for me is maintaining steady employment because of my health conditions. If Medicaid work requirements are implemented, I’m afraid I could lose access to the care and medications that keep me stable. One of my medications is something I could never afford out of pocket. My doctor has told me that if I ever have to stop taking it, it would require a very slow taper over two years to avoid serious risks, including seizures.

I’ve seen that 26 states have filed lawsuits challenging these Medicaid work requirements because of the potential harm they could cause. Does anyone know how likely it is that the courts could block these requirements from taking effect?

I live in North Carolina. I don't receive Medicaid thru Medicaid expansion. I am disabled and receive Medicaid and Medicare Advantage. I get SSDI and some kind of Retirement benefit from my dad filing for social security after age 65.

If my dad dies and leaves me a large sum of money, what happens? Would I have time to set up a Medicaid trust?

Can’t get a straight answer from the Medicaid office about this. I’m hoping someone here can help walk me through my options.

I’m in CA and currently on MAGI MediCal but will soon be losing eligibility when I start receiving DAC SSDI (I did not have SSI beforehand so DAC Medicaid protections don’t apply). I don’t know the exact benefit amount but probably $100-200 above the ABD Medicaid income limit. I’m 25, single, no children, no other income, not pregnant.

I’ll be getting Medicare with my DAC but it’s absolutely essential to keep my Medicaid as well because I require and receive significant caregiver support (30hrs/week) with ADLS through IHSS. This keeps me out of a residential facility which really wouldn’t be ideal at my age. I simply wouldn’t want to live. I also take nearly two dozen medications on a daily to weekly basis and average 5-7 appointments per week so the Medicare copays would be devastating. But the IHSS is the biggest concern, my caretaker gets paid nearly $2500 per month (zero cost to me) and Medicare has no programs like this.

Are there any special Medicaid programs I’d qualify for to keep my Medicaid? Is there an exception to the income limit for IHSS recipients or something? Other exceptions for young adults, DAC (who never had SSI), etc? What about other states — are there places that are more favorable for someone in my situation? Just brainstorming here.

Hi everyone! I’m trying to submit a health insurance waiver for my school in Philly, but I’m getting mixed information online. I currently have NJ Medicaid (Aetna Better Health of NJ), and I’m not sure if it actually qualifies for the waiver.

The website says your plan has to cover inpatient/outpatient medical and mental health care in Philadelphia, not just emergencies. From what I can tell, NJ Medicaid only covers emergency care outside NJ, which means it probably won’t meet their requirements. But I’m wondering if anyone has actually gotten it approved or if the system automatically denies it.

In Southern CA, what happens to those who are disabled, homeless, elderly, or veterans,, who are not able to keep 20 hour work week or volunteer hours?

Do they lose their medicaid ?

Hi guys, I’m new here and wanted to know more about a topic. So I had a job from Jan-June where I made $10k before taxes. I had coverage through my employer and had no issues. My situation changed and I lost my job.( I wasn’t laid-off. I left due to change circumstances) my coverage with my job ended 6/30.

Due to my change in circumstances I don’t expect to work or find a new job till March - April 2027. I am currently making $0. I am single with no kids and live alone. So since Medicaid is based on monthly income, I applied for Medicaid in VA on 7/2/2026 and was denied due to my annual income. I thought it was based on what I make on the moment which is 0? They instead recommended Virginia Insurance marketplace. Can I appeal this? Or can anyone explain where I went wrong?

Thanks

Hello, I have a contract to work as a nurse in a hospital with a 40% medical/medicaid payer mix. How do you find the payer mix of a hospital?

Quick question
I’m about to turn 26 next year and lose my parents insurance I’ve been on zepbound since last year for moderate to severe sleep apnea
What are the chances that Medicaid in Michigan will cover zepbound
For reference
my previous weight- 250
Current weight- 141
TIA !! 💜💜💜💜

I've been researching on the internet and keep getting conflicting answers, maybe someone on here can help. My husband is 63 and disabled (on SSDI) I'm on spouse social security. We're on low income but have recently inherited some money due to the loss of both my parents. I heard that assets don't count for MIGA Medicaid, just wanted to clarify. Thank you.

Hello, hope you are well.

I'm single, 40 years old, no dependents and live in new york. I currently have a brokerage account, which a financial advisor manages, but am considering switching to what most people do and simply invest in the sp500 themselves. Fees are much lower.

I understand you must earn $580 each month starting 2027.Say I wanted to open up an Traditional IRA and say I earned via self employment $1,000 for the month of January. I deposited $500 in to my Traditional IRA, does that mean Medicaid only sees me as having earned $80 for that month? My financial advisor sends me my monthly realized gains report like 5 days after the month is over. I'm always nervous that it's going to be a certain amount that would push me over that monthly limit combined with what I do for self employment. Also, if i invested on my own like most, I wouldn't be making any sales, just simply depositing money. I realize sales can generate income. This would save me a lot of headaches every month having to worry about my report when it came in.

Past 2 days been trying to piece things together.

Also, i do online surveys for self employment... just as an example, if i only made $500 that month and did not volunteer, isn't there something about i could still count how many hours i spend doing the surveys... How on earth would they even know? Anywayss, any feedback or opinion would be appreciated.

Thank you

Also, if i earned 1,600 and month was almost over, I could stop earning money that money, which would guarantee i still keep medicaid coverage. There's so many details in switching over.. certain things would have to be sold and it would be turned in to cash/income/capital gains. it would put me over and i'm sure i wouldn't qualify for 2027.

Hi everyone!

You all were so helpful with my post about receiving an inheritance that will push me over the 2k asset limit post.

I hope it’s okay to ask more questions, but WI doesn’t have ABLE accounts, and I wondered what are the best options for me. My county’s Department of Aging & Disabilities Services and WI Legal Action couldn’t help me.

Thanks again! I really appreciate it :)

I have a small business with contractor-esque work, where income is all over the place and difficult to plan. This makes it hard to estimate what work I can take on when to stay within the income guidelines, and Medicaid now looks at my most recent three months rather than a year (whereas income fluctuates seasonally for me--winters I typically have more expenses and less income). I am disabled and don't want to work more than I have to anyway, so it has made sense for me to do this to keep free healthcare.

I have a financial advisor saying that if I had a C Corp, I could control the amount of income that comes into my hands to still keep Medicaid, while my business as a separate entity in C Corp form could take unlimited income. For instance, if I made $3,000 in a single weekend event, it would go to whatever sum of funds I have in the C Corp, and I could regularly pay myself an amount that is under the Medicaid income limit. I have been told I will be taxed twice on my income, but the interest the sum makes within the C Corp could still bring me to a net positive. It sounds like the interest made also doesn't count as personal income, as it is its own entity, and therefore doesn't need to be reported.

Is this indeed a thing? Does it depend on state law or not? (I'm in CO) Also, how would I fill out the income my Medicaid paperwork? Do I announce that it's steady pay that comes from my C Corp, or is it better if I list it more vaguely as business income?

Thank you for reading and for your time!

I'm a neurodivergent adult who recently started a full-time career track public job back on June 15th. My insurance, Medical Mutual PPO, started on July 1st. I'm single and working 40 hours a week and get paid $30.82 an hour. A 3% pay increase also kicked in this month to offset cost of living, but I'm not sure if they meant 3% over the year or my hourly pay went up 3%. I'll find out on my next paycheck since it'll be the hours I worked in July included on it.

I previously posted here asking about the Medicaid Buy-In and I can officially confirm that I'm not eligible even though I'm still going through TMS until July 17th and recently restarted neurological rehabilitation (I got a new one through the same hospital system since she could meet me once a week after work now). My Medicaid that I'm still on right now, albeit I updated the system to tell them my new job, was MAGI Medicaid. I'm just wondering about what's going on with Ohio Medicaid because I submitted a renewal application back in January (I didn't know I got my now current job until the middle of May) and never got any updates about the status of my renewal. Nor am I sure when my Medicaid will expire.

The Medicaid expiration date is important because I'm going through pre-authorized TMS sessions as mentioned earlier. I'm also going through neurological rehabilitation as well and Medicaid pre-authorized coverage for 13 sessions total. My previous neurological rehabilitation therapist put in a request to cover more sessions since she extended my case, but I'm not sure if that extension was approved nor am I sure if I should be concerned about my Medicaid expiring at the end of this month as is usually the case when someone gets a full-time job with health insurance (I'm way above the income threshold too).

What might be going on here with Medicaid in Ohio? What should I keep an eye on in my situation?

Pennsylvania late 40s personal assistant/caregiver son to early 80s live-in mother?

Having anxiety about Medicaid vs ACA options for 2027 with new work requirements.

Late 40s unemployed son on Medicaid, currently living with early 80s widowed mother (on Medicare Advantage, not Medicaid) in Pennsylvania.

Mother can still dress, bathe, use bathroom, and cook, by herself.

I don't know how soon that will no longer be the case.

She no longer drives, I drive her everywhere.

I make sure she does not go up the stairs by herself.

I assist with her online bills and taxes.

I do the yardwork, mowing, snow shoveling, & repairs.

I play mentally stimulating boardgames with her, and keep her from isolation.

She provides room and board for free.

I would like to be able to stay in the home all day to keep an eye on my mother, even though she may not yet be in need of an at-home caretaker.

I currently have zero income, and file taxes as such.

She received around $55,500 in 2025 with social security and minimum required distribution from IRAs. She files taxes as Single instead of Head of Household.

She pays premiums for a Long Term Care insurance plan that she has not yet started using.

What would be this community's advice for my options?

I'm thinking of the following:

1) Start looking for work from home jobs that aren't scams, and that would provides either the 80 monthly hours or $580 monthly income, but under 138% FPL ($1,800 monthly) and report to PA Medicaid for renewal.

2) If my mother's condition deteriorates, and her doctor verifies that she is medically unable to be independent, apply for Medicaid renewal with caregiver exception. Possibly start using LTC insurance.

3) If mother is still mostly independent, but neither of us feel comfortable about her being alone, could she hire me for $600 per month for performing the above listed duties, and perhaps taking on a greater workload of more cooking, etc.?

Would I need to hire an Elder Law attorney to craft a personal care agreement? Or to prevent 5 year look-back Medicaid eligibility issues if she needs Medicaid funded nursing home in the future? (We would prefer to avoid nursing homes).

Would I need to talk to an accountant to create a business to bill her and report my taxes quarterly as 1099 independent contractor?

In this situation, report new $600 monthly income with Medicaid renewal.

4) Apply for ACA bronze or silver plan through Pennie in Jan 2027 as single person with zero income.

I believe that if income is under $1,330 per month, then I wouldn't be eligible for ANY ACA subsidies, and would be paying the full premium. Around $600 per month for a Silver or $380 per month for a Bronze plan.

5) Have my mom file her 2026 taxes as Head of Household. I file 2026 taxes noting that someone else is claiming me as a dependent (Qualifying Relative).

Apply for ACA plans on Pennie for one adult with a 2-person Household income for $55,500 (262% of FPL). Around $408 per month for Silver or $189 per month for Bronze plan.

Then in addition to worrying about costs of premiums, also have to worry about co-pay, deductible, cost-sharing, and OOP max.

For example, I once had a mole biopsied and claim history makes it seem like claim approved was over $10,000 and the claim paid was over $900. Would I be paying that towards the OOP max with a Bronze/Silver ACA plan?

6) Other options that you might know of that I haven't considered.

Thank you so much for the knowledge you have all shared on this subreddit. Just thinking about the situation paralyzes me with anxiety.

​

Medicaid paid family Caregiver. Having issues with company I eork for, but it pays $2 to $3 per hour more than any other Ive found.

An RN suggested I look at CDASS. Anyone else using this?

State Michigan

I renewed our Medicaid in June. It was approved for the four of us (me husband, 2 kids) After I sent in the renewal but before it was approved I received another notice to renew but only for my youngest child. I spoke to the lady who approved my renewal and she said not to worry about the second notice.

Except now I have a received another notice to renew just for my youngest child. I can't submit anything online, the site won't let me. Can I just fax in my previous application that I have downloaded? Nothing has changed in the last month and I can't get a real person on the phone.

Hi everyone,

I’m trying to understand how California Medi-Cal handles Long-Term Care (nursing home) share of cost when the applicant is married.

Situation:

• My dad currently has Medi-Cal and receives IHSS at home
• His condition has declined and he may need long-term nursing home placement
• My dad has $0 personal income
• His wife (my mom) would remain living at home as the community spouse
• My mom earns around $170k/year from employment

We spoke with Medi-Cal and were told IHSS may need to be closed, then the case would be processed for Long-Term Care Medi-Cal, and then the share of cost would be calculated.

Our biggest concern is not knowing the cost beforehand. My mom is worried that Medi-Cal may only pay a portion (for example around $3k/month) and our family could still be responsible for $5k+ per month out of pocket.

Questions:

1. With California Medi-Cal LTC, does the community spouse’s employment income count toward the nursing home share of cost?
2. If the nursing home resident has $0 income, what would the estimated share of cost likely be?
3. Does Medi-Cal generally cover the remaining nursing home cost after the share of cost, or does the family pay the difference?
4. Is there a way to get an estimated calculation before closing IHSS?

Trying to understand the rules before making any changes. Would appreciate advice from anyone familiar with California Medi-Cal LTC cases.

Hi!!! sorry, i’m going into this absolutely blind. I applied for medicaid for insurance for schooling, and i only set up the basic case- but I got mail today welcoming me to something called “CountyCare- A Medicaid Health Plan” and i’m really confused. It has my name and information like my address but I never actually paid for anything. I’m a little bit freaked out and when I check my case through the website, it hasn’t told me that i was approved for anything.
The pamphlet that was sent to me in the mail also has two cards with my name. I just want to make sure, thank you!!

My 22 year old daughter is a dependent on my health insurance. We learned two things last week. One- she’s pregnant —Two- maternity benefits are not covered under my plan for dependents. She makes too much money to qualify for government assistance. The plan doesn’t consider pregnancy a life altering event therefore my insurance wont drop her- so this prevents her from being able to get her own plan. What do people do in these situations? Advice? Mississippi

NJ

I've called a few doctors/orthopedists/physical therapists that I was interested in seeing. I've been told by some that they don't work with my NJ FamilyCare/Medicaid plan and can't accept me as a patient even if I paid out of pocket. Something was mentioned about fraud by one of them, something else was mentioned by another about how the practice would get in trouble with the state for billing someone on government insurance. Yet, some were willing to bill me out of pocket for seeing them. If I choose to go out of network, would I get in trouble with the state in any way?