Medicaid Abuse

[mousey]

If they live in NY there is no way they can collect Medicaid and not take the insurance offered through the employer. Medicaid is not a primary payer unless there is no other insurance. If they find out that you are not eligible and have collected, you must pay it back.
I don't work for the government, but being in the medical profession I know there are very strict guidelines. The biggest abuse in NY is families that live together but fail to get married just so they can continue collecting benefits.

 

[MemoryMakers2669]

If they live in NY there is no way they can collect Medicaid and not take the insurance offered through the employer. Medicaid is not a primary payer unless there is no other insurance. If they find out that you are not eligible and have collected, you must pay it back.
I don't work for the government, but being in the medical profession I know there are very strict guidelines. The biggest abuse in NY is families that live together but fail to get married just so they can continue collecting benefits.

Well they live in NY!!! I don't know what the salary limits are for a family of 4. I don't know if they take living expenses into consideration or not (they have NONE). He is working for a major company, making fairly decent money (4 times what I saw on a chart for Medicaid in fact...but I might have been looking at the wrong chart for all I know).

I am not assuming anything, he has told me everything specifically in fact....wage, cost of company plan, etc.

I know with my DH's company, that you can only enroll in the health insurance plan at time of job start and then once per year during open enrollment. Hopefully these dummies don't try to get away with this, to end up having to go without because of an open enrollment type thing like that.

 

[LMC]

Well we pay over $1000 per month for our family coverage and we were turned down for medicaid for my disabled child and we make about 53,000 (after taxes) for a family of 5. I was (am) dismayed. We didn't want the SSI only the medicaid to help cover some of the medical expenses as a secondary insurance. Just our co-pays for DS are enough to break the bank!

 

[Mermaid02]

I think busybodies are one of the world's problems, too.
The income guidelines for Medicaid are fairly high. What you think of as a good salary may still fall within the guidelines.

Having private insurance doesn't disqualify families from receiving Medicaid, either. If they still meet the requirements then Medicaid becomes the secondary insurance.

How do you know the details of the insurance plan offered? Perhaps it was too much for them to afford?

A "great salary" (which is relative) doesn't always go far when you are paying over $1000 per month for private insurance.


I think it's pretty harsh to judge this family without knowing all of the details of their situation.

So you think we should all just turn a blind eye and let the abusers pick our pockets?
I'm actually surprised that being ex military the family doesn't have Martin's Point.

 

[DisneyBamaFan]

You know, you get paid by the government for turning in people like this - but you have to be willing to testify if necessary...

 

[Myothername]

I have a real hard time with people cheating the government. My husband's family lives in an area of our state that seems to offer disability as a career choice. No kidding. He has one family member who got on disability for TMJ!!! Oh sure I know it can be painful but believe me it never slowed her down talking or eating. Now she has diabetis but that is not a reason to be on disability in my book. I know plenty of people much worse off who are working including a coworker's husband who is paralyzed from the chest down. He owns his own law firm. He never considered getting on disability. Others in that family include people now on the public dole for knee injuries, back injuries, arthritis, etc. I have seen these people. These "injuries" and "illnesses" never slow them down from shopping, vacations, working in the yard, etc. They all brag about how much they are getting each month. There has to be a racket in this small town. They all go to the same doctors who have a vested interest in keeping these people on disability so they will keep coming back and referring their friends and family.

 

[RitaE]

Originally Posted by Holly View Post
I think busybodies are one of the world's problems, too.
The income guidelines for Medicaid are fairly high. What you think of as a good salary may still fall within the guidelines.

around $18,000 for a family of 4 according to the chart I looked at. I don't think many would qualify that as fairly high. Most of the states do have specialized programs to cover uninsured children and pregnant women where the income requirements are much more lenient. That might be what you are referring to.

Anyway, all he has to do is report his income and if they still qualify, then they still qualify and there is no problem. No need to leave it unreported.

 

[scrapquitler]

Who pays $1000 a month for private insurance. My sister only pays $3000 a year and she has many pre-exisiting conditions.

Many (or maybe MOST) people who are self employed do. My husband and I pay over $1200 a month for private insurance for our family of 4.
If you have employer based health insurance, what you pay for it is usually a very small percentage of the true price of that coverage, your employer pays the rest. If you are self employed, it all comes out of your own pocket.