| Subject | Date Asked |
|
| Medicaid HMO cut letter | 9/22/2008 |
Q: I work for a longterm care facility, I have recently been asked by a Medicaid HMO company to have a ...
A: Ms. Stevens, I do not typically answer these questions. Its my opinion, in this and other areas ...
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| Medicaid From Another State | 9/21/2008 |
Q: My mother is currently on Medicaid through the state of Florida. I live in Massachusetts and ...
A: Allison, someone is Massachusetts is going to be better off answering this question. Vaguely, you ...
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| inheritance and medicaid/food stamps | 9/20/2008 |
Q: food stamps ($140.) and medical insurance through Medicaid/Medicare. This is all NY state. I am ...
A: Lynn, I am a bit confused, with your income, you should not be on Medicaid. The inheritance will ...
|
| Medicare coverage for refugee and permanent resident | 9/17/2008 |
Q: Do a person on refugee or permanent resident, qualify for medicare once he or she is over 65 years? ...
A: RJ, to be eligible for Medicare you must be 65 or older, or have been disabled for more than 2 years ...
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| Mom in nursing home | 9/17/2008 |
Q: My Mother has been on Medicaid for a year now and just recently went into the nursing home. Her ...
A: Marlene, this is the magic question right now for millions. This is how it works: When you go into ...
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| AZ hospital will not accept OK medicaid | 9/11/2008 |
Q: I was on vacation in Arizona with my sons. One of them, who is on Oklahoma Medicaid (SoonerCare), ...
A: Heather, try submitting the bill yourself with OK Medicaid. I don't know that the Physicians are ...
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| medicaid for a dependent parent | 9/7/2008 |
Q: I live in Florida, as does my elderly mother. She has virtually no assets and her monthly income is ...
A: Christine, no, your income is not counted, however, you must be very careful in handling her money. ...
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| use of trusts to protect assets | 9/6/2008 |
Q: My parents live in a condo I own. They have about $100,000 in the bank in CD's. I rely on their ...
A: Ms. Saini, the options right now aren't great but its better to check as early as possible. I ...
|
| 19 year old w/out insurance | 9/5/2008 |
Q: Our insurance company dropped her when she turned 19. She doesn't make much money and really needs ...
A: Cara, I can't help you with other insurance companies, you'll just have to find out what's available ...
|
| medicaid/medicare | 9/3/2008 |
Q: My mother is moving from Indiana to an ALF in FL that has Medicaid waiver. We have applied for ...
A: Nancy, once she is on Medicaid, her check will first give her a $ 30 per month needs allowance, then ...
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| 29 yr old denied hysterectomy by Medicaid | 8/30/2008 |
Q: My good friend is 29 yrs old and has a cyst on one ovary, an enlarged ovary, and multiple tumors in ...
A: Michael, she needs to appeal Medicaid's decision. Enlist your doctor's help with this process. ...
|
| medicaid/medicare | 8/29/2008 |
Q: My mother is moving from Indiana to an ALF in FL that has Medicaid waiver. We have applied for ...
A: Nancy, the Medicaid waiver is for at home or in lieu of nursing home care, not for medical care. So ...
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| can I still be covered by Medicaid | 8/29/2008 |
Q: I would need some advice, I just received a high medical bill from the hospital that I had to use ...
A: Ms. Mehrens, I would check with the social worker at the hospital, who will be very well versed in ...
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| mom need to get on medicaid | 8/25/2008 |
Q: my mom had to be placed in a nursing home. It was first short-term stay but she needs to stay over ...
A: Katrina, once your mother is on nursing home Medicaid, she is entitled to $ 30.00 per month (maybe ...
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| tubiligation | 8/23/2008 |
Q: my neice has had 5 children, she is 31 does medicaid pay for a tubiligation.we live in texas
A: Kathy, Medicaid is a state specific program. Most medicaid programs will cover tubal ligation, and ...
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| Medicaid vs. HMO | 8/19/2008 |
Q: Kelim, My wife and I will soon be moving back to the US and I would like to compare the care ...
A: Mr. Rossi: Each system will have its good points and its bad points. The good points for Medicaid ...
|
| MECAID AND WEIGHT LOSS | 8/10/2008 |
Q: I HAVE A PROBLEM WITH MY WEIGHT WHICH IS LEADING TO MANY OTHER SERIOUS PROBLEMS WILL MEDICAID PAY ...
A: Julie, I believe that Medicaid will pay for medicine, treatment, therapy and surgery if "medically ...
|
| Dropping an HMO | 8/7/2008 |
Q: My mother has insurance with Texas Health Springs (HMO)and is very unhappy due to lack of coverage ...
A: Letty, your mother should not make any changes without going through a SHIP counselor, available ...
|
| getting inheritance on medicaid while in a nurisng home | 8/5/2008 |
Q: mom is in nurisng home on medicaid and she just recieved 50g inheritance form aunt. what happens ...
A: Pam, she has to come off Medicaid. She should spend some money on a prepaid funeral if she can. ...
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| Medicare Pre-Approval for outpatient procedure | 8/5/2008 |
Q: I am in North Carolina. My Cardiologist recommended a sleep study following a diagnosis of frequent ...
A: Tom, Medicare is nationwide. I am not sure that you need preapproval from medicare (not sure they ...
|
| NJ medicaid | 8/4/2008 |
Q: My mother is currently on Medicaid. She has alzheimer. We have been informed that she will be ...
A: Cathy, each state's Medicaid office has different rules so it is important to get in touch with a ...
|
| Medicare while working. | 8/2/2008 |
Q: I will turn 65 on Sept 7th and have already applied for plan A & B Medicare and have my card. I am ...
A: Mr. Hansen, it depends. You have a complex set of circumstances that should be set out in front of ...
|
| Manged Medicaid | 8/1/2008 |
Q: My mother has Medicare and a manged medicaid plan. Which one is considered the primary and ...
A: Robert, it depends. Typically Medicaid is the payor of last resort. There are a number of plans ...
|
| Medicare Can they lien your home | 7/21/2008 |
Q: I have gotten info about how Medicaid can put a lien on your home in a probate situation. Can ...
A: Judy, typically, Medicaid can put a lien on a home if the recipient was in a nursing home and ...
|
| medicaid | 7/21/2008 |
Q: how do i find out if medicaid has paid an 1999 doctor bill? some has been paid by insurance ...
A: Clara, you can contact your Medicaid office to determine if it has been paid. I do not know what ...
|
| Medicaid provider recoupment | 7/19/2008 |
Q: I am appealing a recoupment for fees paid over the course of 21 months following a policy change by ...
A: Keith, I cannot find a copy of this document online. However, there is an ombudsman who can help ...
|
| Medical scooter | 7/19/2008 |
Q: My grandmother is having a hard time getting around and I want to help her to get a hoveround or ...
A: Chris, it appears that if she needs it to get around her home, and cannot manually operate a ...
|
| humana and medicaid | 7/18/2008 |
Q: My mom has Medicare and Humana for prescriptions and is an Alzheimer patient. She ran out of money ...
A: Nancy, its important for you to see someone who can help you as soon as possible. I recommend first ...
|
| Medicaid as co-insurance to pay Medicare copay | 7/18/2008 |
Q: Orthopedics provider received payment from Medicare B and billed me for copay. I also covered by ...
A: Mira, it doesn't sound right to me. First, if the provider took your Medicaid card prior to ...
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| Will I automatically be approved for MediCAID if I was approved for SSDI... PLEASE HELP!!! | 7/16/2008 |
Q: I was just recently approved for SSDI. I have severe Crohn's disease and not able to work. They ...
A: Leslie, you don't qualify for Medicaid. You have to have income of less than $ 657 per month to ...
|
| Can someone on medcaid obtain a secondary insurace | 7/14/2008 |
Q: Son recently obtained medicaid. He has a severe mental ilness that may require him to be in a non ...
A: Sandy, I cannot answer state specific questions. I can say that generally, you can't have ...
|
| Perscriptions Charge | 7/13/2008 |
Q: I have Blue Cross Senior Secure. I have Emphysema,and COPD. We have been fined with getting my ...
A: Mr. Storto, You need to contact your local SHIP counselor, who will assist you for free. If you ...
|
| Cleft pallet | 7/11/2008 |
Q: i was told that if a cleft pallet is a birth defect medicaid is required to pay the costs of ...
A: Larry, Medicaid is health insurance for very low income people. If you get Medicaid, it will cover ...
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| Kentucky Medicaid for children | 7/9/2008 |
Q: My 8 year old daughter is permanently totally disabled and has Medicaid benefits for therapy, ...
A: Tracy, it certainly will affect her. Her portion should be placed into a special needs trust, which ...
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| approval for breast reduction | 7/9/2008 |
Q: I am 5'2" and weigh 235. My bra size is 46 DDD. My weight is due to a medication I take due to an ...
A: Liz, I have answered the breast reduction question previously in various questions. As far as I can ...
|
| SHARE OF COST | 6/27/2008 |
Q: MY SHARE OF COST IS $1693.00 WHAT IS SHARE OF COST CAN YOU PLEASE EXPLAIN HOW THIS WORKS. I HAVE ...
A: The share of cost is what you have to pay before Medicaid will pay the rest. In this case, your ...
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| medicare | 6/27/2008 |
Q: when medicare is secondary is the provider required to submit a claim to medicare to cover the cost ...
A: James, the provider has to submit it for reimbursement. If not, then you can submit it yourself but ...
|
| Medicare repayment?? | 6/25/2008 |
Q: My mother is in the hospital since Friday the 13th. She is terminally ill with cancer. She had ...
A: Mike, no, but what you may need to worry about is Medicaid, should she need nursing home care. What ...
|
| old bill | 6/24/2008 |
Q: Kyla, I had an ER visit in January of 2007. Come to find out last month, there was a bill from an ER ...
A: Leah, Medicaid should also pay the doctor. I would contact them, contact the facility and notify ...
|
| Medicaid | 6/23/2008 |
Q: State: Nebraska My father has been in the nursing home for the past 3 years. We are in the process ...
A: Lisa, I have no idea what Medicaid will allow your mother to keep in Nebraska, as each state is ...
|
| Nevada Medicade | 6/23/2008 |
Q: My husband is medicade approved in long care nursing facility in Florida. We want to move to ...
A: Tina, you will have to contact Medicaid in NV to coordinate. It will not "carry over" but you would ...
|
| Medicare - age discrimination | 6/20/2008 |
Q: I am a young person (47) on SSDI and Medicare. A Medicare doctor who accepts assignment was ...
A: Kelly, I know this is frustrating. In this instance, what Medicare did not find is something that ...
|
| Florida Medicaid | 6/20/2008 |
Q: My husband was a Pilot for a major airline in the USA and has been laid off without further notice ...
A: Misty, I doubt you and your husband will qualify for Medicaid but your kids likely will. The fact ...
|
| medicaid | 6/17/2008 |
Q: I AM A NC RESIDENT AND MY BABY BORN IN FL AFTER EMERGENCY, WHERE DO I NEED TO APPLY FOR MEDICAID, NC ...
A: Elinot, sounds like you should apply for Medicaid in North Carolina for care following the baby's ...
|
| medicaid and tubal ligation reversal | 6/17/2008 |
Q: I had a tubal ligation in 1997, ever since then sex has been painful and my periods have either not ...
A: Ms. Ramos, I cannot find support anywhere for this proposition. I would check with your doctor's ...
|
| medicaid reimbursement | 6/13/2008 |
Q: my mother has passed away, 2yrs. ago. at the time she was receiving medicaid. She owned a mobile ...
A: Nancy, you really need to consult a local lawyer familiar with both probate law in your area and ...
|
| Accident and medicaid | 5/15/2008 |
Q: I had an accident last year and at the time I was covered by Medicaid(MISSOURI). I am going to ...
A: Yes, you have to pay Medicaid before anyone, including your attorney. Medicaid will typically ...
|
| Mom died in hospital w/no insurance, is estate liable? | 5/7/2008 |
Q: My Mom was admitted into a state hospital and passed away there a week later. They are in the ...
A: Traci, as she received money from a reverse mortgage, its possible she won't have any equity in her ...
|
| Florida Medicaid Reimbursement | 5/3/2008 |
Q: I am on disability (since 2002) an receive Medicaid benefits. I was involved in an auto accident ...
A: Jeanne, Medicaid is entitled to their money. Your lawyer should be able to negotiate with Medicaid ...
|
| Medicaid Insurance | 5/2/2008 |
Q: I know a 24 year old male who has recently been diagnosed with stage 4 Lymphoma. Unfortunately, this ...
A: Susan, your friend should contact North Carolina's Medicaid. I would honestly ask him to get with ...
|
| medicaid billing | 5/2/2008 |
Q: I JUST MOVED MY DIABETIC BROTHER FROM MS. TO MD. IT TOOK ME SEVERAL MONTHS TO GET MEDICAID COVERAGE ...
A: Ron, this is the website for Maryland's Medicaid program: ...
|
| medicare coverage cancer | 4/30/2008 |
Q: If I would get cancer or other life threatening disease, would Medicare cover the costs of ...
A: Ken, Yes, Medicare covers 80% of charges after a deductible ($132) is met for the year, however, ...
|
| Outstanding Billing Issue | 4/29/2008 |
Q: I have EOBs for two separate services from Secure Horizons Direct.They state Total charges was ...
A: Barbara, if they take you to collections, you can of course contest it and have it removed from your ...
|
| Medicaid Coverage during accident? | 4/28/2008 |
Q: My mother is enrolled in medicaid (health not auto) and recieves benefits due to her disability. I'm ...
A: Stellios, I suspect your mother probably is on Medicare and Medicaid. I think you're asking me if ...
|
| child w/ disability | 4/27/2008 |
Q: My husband is self employeed. We got personal ins. but daughter who is 3 denied due to down ...
A: Karen, your story is heartbreaking, and, unfortuntately, not uncommon. Depending on your state, you ...
|
| Medicaid and weight loss surgery | 4/26/2008 |
Q: I live in Michigan and have Priority Health Medicaid. I'm wondering if my insurance covers the ...
A: Mindy, Priority's certificate of coverage is here: ...
|
| Medicaid/Primary insurance copays | 4/23/2008 |
Q: My daughter has Medicaid (Texas) and group health insurance through my husband's employer. Are we ...
A: Diana, after reviewing the 1180 page provider manual under Texas Medicaid, I can find no reference ...
|
| 6 month documented wgt. loss by physician | 4/21/2008 |
Q: I recently began going through the preparation process for lap-band surgery in Jacksonville. They ...
A: Jennifer, it looks like Medicaid requires 6 months of physician supervised documented weight loss ...
|
| medicaid question | 4/18/2008 |
Q: i have bcbs ppo of illinois i was told i had an exclusion don't know what that really means but i ...
A: Gina, it sounds like your Medicare is a BCBS PPO, which has an exclusion for the gastric bypass. If ...
|
| medicaid spenddowns& medicare | 4/16/2008 |
Q: my mom is in a nursing home now from a fall at home that broke her hip & arm DEC. 29th 2007. have ...
A: Janet, Every state has a different lingo: spenddown means different things depending upon the ...
|
| Medicaid/Medicare Disability and an auto settlemen | 4/15/2008 |
Q: For three years I have been on Social Security Disability making about 700. a month. I have been ...
A: Cheryl, This is a state specific inquiry and you should have had an attorney who handled this for ...
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| Medicaid Eligibility | 4/14/2008 |
Q: Sir: I have a few questions that I need to find an answer to concerning the Medicaid ...
A: Tammy: 1. Yes, she should qualify with no problem. 2. Once she is in a nursing home, the staff ...
|
| ga medicaid | 4/12/2008 |
Q: how to verify my medicaid eligibility online
A: Rosalyn, I'm not sure that you can. Here is the website for Georgia Medicaid, which instructs you ...
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| medicaid and inheritance | 4/11/2008 |
Q: Brother and I inherited mom's estate 50/50. Brother in nursing home on Medicaid after spending down ...
A: Peggy, there is a special needs trust you can explore, which would permit the inheritance to be used ...
|
| Medicare/Medicaid | 4/10/2008 |
Q: I represent a gentleman who was injured in a motor vehicle accident. He was not at fault. He has ...
A: Larry, the hospital must bill the insurance, and the insurance will be subject to subrogation from ...
|
| Medicare, Louisiana Medicaid and Private Insurance | 4/9/2008 |
Q: I was wondering if you had a Private Insurance as primary and Medicare as secondary if you could ...
A: Medicare is not secondary insurance, its primary. The private insurance would be secondary. Some ...
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| medicaid/SSI money to a nursing home | 4/8/2008 |
Q: My Dad currently resides in a nursing home in Florida. He has Florida Medicaid and also receives a ...
A: Dave, yes, the nursing home is entitled to your father's income, except for $30.00 per month which ...
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| medicaid (special needs trusts) | 4/6/2008 |
Q: is it possible to set up a special needs trust for someone who has been on medicaid for 7yrs and ...
A: Jack, not that I know of. In order for a special needs trust to be set up in this circumstance, and ...
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| bank account and lookback period | 4/5/2008 |
Q: My father and I have had a joint savings account for past 20 years. Also had a survivorship deed for ...
A: Veronica, I can only speak in generalities about the new vs. the old law as I do not practice in ...
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| medicare | 4/4/2008 |
Q: If someone who is married to a US citizen and has lived and worked in the US for over 25 years loses ...
A: Lynn, in order to qualify for Medicare, you must either be a U.S. citizen or legal alien. See ...
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| Health insurance when you retire to a foreign country | 3/31/2008 |
Q: A colleague of mine--a professor--plans to retire to her birthplace of Jordon. If she stayed in the ...
A: Steve, Here's the link to this years Medicare & You handbook which spells out what is covered and ...
|
| Medicare, SSDI and Social Security Retirement Income | 3/30/2008 |
Q: My mother asked me for help, and I've tried, but I am totally lost. Please help. Here is the ...
A: Sonja, 1. No,not in her situation. 2. Yes, her income might go up or it might go down, depending ...
|
| Medicaid | 3/26/2008 |
Q: Does the part of Medicaid called Wellcare pay for lap band or weight loss surgery?
A: Maria, Wellcare apparently covers at least eight states under Medicaid and each policy will be ...
|
| inheritance | 3/26/2008 |
Q: I am currently on SSD, Medicare and Medicaid. I have one child who is 5 years old and is also ...
A: No. What you should do is look into putting the money into a special needs trust for yourself and, ...
|
| tubal reversals | 3/25/2008 |
Q: im on amerigroup medicaid and want help finding out how the state can pay for sterilization reversal ...
A: Tarcha, I still can't get a straight answer: Texas Medicaid has a specific exclusion (see: ...
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| selling a house and medicaid | 3/25/2008 |
Q: My mother in law is in assisted living. She made a beneficiary deed 14 years ago. If her house was ...
A: Doris, I'm not sure what a "beneficiary" deed is. If its a deed where she gave up her interest, ...
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| tubal reversals | 3/24/2008 |
Q: im on amerigroup medicaid and want help finding out how the state can pay for sterilization reversal ...
A: Tarcha, I don't know what state you live in, so I can't answer this specifically, but I did find ...
|
| medicaid | 3/19/2008 |
Q: I have been on Medicaid in Colorado since Feb of 2007 for my pregnancy. My baby was born July 25, ...
A: I would contact the ombudsman. I'm just not sure, without a very indepth study of Colorado's ...
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| medicaid | 3/10/2008 |
Q: Does medicaid pay for any type of baritric surgeries? Because in some instances it may depend on ...
A: Lavettia, I think I may have danced around this in other questions, and this certainly has been a ...
|
| Gastric Bypass Surgury | 3/8/2008 |
Q: I am on SSI with medicaid insurance. I feel that if I was to get the surgury and loose the weight, ...
A: Rosalee, Like many state's medicaid system...it depends. They can pay for it, and that's a good ...
|
| medicare/medicaid part D | 3/6/2008 |
Q: My mother is a diabetic and is on medicare/medicaid part D. Does she have to pay for her diabetic ...
A: It appears that her Part B will cover the supplies such as test strips and lancets. For those who ...
|
| 59 year old Mom and Medicare eligibility | 3/3/2008 |
Q: My Mom has multiple sclerosis and has been in a nursing home for 5 years. She had a stroke almost 3 ...
A: Generally speaking, Medicaid won't accept you unless you have signed up for any resources to which ...
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| Gastric Bypass Surgury | 3/3/2008 |
Q: I am on SSI with medicaid insurance. I feel that if I was to get the surgury and loose the weight, ...
A: Rosalee, this is a state specific question as Medicaid will vary from state to state. That being ...
|
| mole removal. | 3/1/2008 |
Q: I am 15 years old and i currently have medicaid. I have a mole on the left side of my nose right in ...
A: Brittany, you cannot get Medicaid to pay for "self-esteem issues", period. You might have some luck ...
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| electrodes for a tens unit | 2/26/2008 |
Q: I have a back problem, and the tens unit appears to be helping. Will Medicare pay for additional ...
A: Tom, If Medicare is paying for the purchase of the unit, my initial research leads me to believe ...
|
| health insurance | 2/25/2008 |
Q: I am a family of 6. My husband is the only one working at this time he brings home 1330 a month. Our ...
A: Shellie, unfortunately, you (and me) are one of many millions all the politicians have been talking ...
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| weight loss | 2/25/2008 |
Q: Could you please tell me if arkansas medicaid will pay for a live in weight loss facility? If not, ...
A: These are a list of services that Arkansas Medicaid says it must cover: ...
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| No Insurance Coverage; other options? | 2/23/2008 |
Q: My friend has a 75% slip on L4. She is currently employed and has insurance, but her insurance will ...
A: First, make sure that it really is a preexisting condition. Under HIPAA, "the only preexisting ...
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| MEDICARE REQUIREMENTS FOR LAP-BAND SURGERY | 2/22/2008 |
Q: I ATTEND A SEMINAR FOR LAP-BAND SURGERY BACK IN NOVEMBER OF 2006 AT A HOSPITAL HERE IN VA. IT WAS ...
A: It sounds like Medicare will still cover some procedures, this is from their website: Effective for ...
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| medicare enrollment | 2/21/2008 |
Q: I turned 65 last August based on advise from my medical carrier. They said that I would still be ...
A: This answer requires a state-specific answer. The State Health INsurance Program, or SHIP, provides ...
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| Medicare/Medicaid eligibility | 2/20/2008 |
Q: I am being medically retired from the military and my VA benefits will probably only cover certain ...
A: I ran across an excellent article that may give you a good option, and some important questions to ...
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| ER services on Medicaid | 2/9/2008 |
Q: I am visiting LA, California and my daughter is sick for 3 days. I want to take her to ER but I am ...
A: I found this on ...
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| Getting Employer based Health Plan after Medicaid | 2/8/2008 |
Q: I'm a 26 year old with Cystic Fibrosis (CF). My situation is a bit complex and I hope that you might ...
A: John, its taken a while to find some answers to your excellent question that, I'm sure, affect many ...
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| Medicare | 2/7/2008 |
Q: I am a retired DoD employee and have a FEHBP BC/BS Health insurance plan and will turn 65 this year. ...
A: Mr. Jones, This site appears to answer many of your specific questions: ...
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| Medicare Medicaid billing in home care | 2/7/2008 |
Q: I am trying to educate some nurses in our office who are used to "the way other agencies do it" and ...
A: Carol, This sounds like dual eligible situations. There is a fairly good overview of this at ...
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