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Topic: SSI, medicaid   
03-09-2006 02:21 PM
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kfurnival  
New Member

Location: Baltimore, MD
Registered: Mar 2006
Posts: 10
Last visit: 03-23-2006

I've been reading a few posts on here which make me wonder if we'll be eligable for SSI or medicaid.
My husband is in the military now but will be getting out in may2007 and we'll return to Texas. We'll definately be below the poverty line for a while as far as income, but we have savings. Currently we've got 10-15k in various accounts and when we sell our house we should have somewhere near 40-50k. We've saved this over several years of being very frugal so we'll have it when we need it and don't plan to touch it until then...will we now not get SSI or medicaid eligability due to it? Does anyone know the limits or how this works?

Also I'd like to know how medicaid works. Is it like regular health insurance? Do we have to go to certain clinics only? Are there co-pays? What all is covered(or not covered)?


Kristi
mom to Sophia(1/19/04) and soon Skyler(4/25/06 DS?)

03-09-2006 03:03 PM
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Hannah's mom  
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Location: Adironadack Mountains, Upstate NY
Registered: Jul 2001
Posts: 927
Last visit: 03-24-2006

I am not sure how it works from state to state but it is my understanding that you can not have savings or assets you can sell for income over a certain amount.I believe it is somewhere betweem $3-5 thousand. If you get SSI you automatically get medicaid. If you loose the SSI you loose medicaid.You can however apply for a medicaid wiaver.This is really a good thing to have, you can not loose it. It does pay your copays.It does however take a long time to get-we waited two and a half years to be approved.If you have a service coordinator they should be able to point you in the right direction and help you with the paperwork.It can't hurt to ask. You never know if there might be something you will qualify for.
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Heather- Mom to Hannah(7)DS and Logan (3)
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03-09-2006 03:11 PM
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LovelyKennedy  
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Location: Niagara Falls, NY
Registered: May 2004
Posts: 964
Last visit: 03-24-2006

Apply and see what happens. We do not qualify for SSI however we do have medicaid through the waiver program here in NYS. It only took us 2 months to be approved, even with a glitch in the paperwork made by our case worker. We can go to any DR. And Medicaid picks up all of Kennedy's co-pays or what insurance does not over. It was very helpful after her heart surgery. Also they paid 3 months retro on previous medical bills. Let us know what happens!!
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Beth Mom to Cameron 2/26/2000, Kendall 6/25/2002 and My Lovely Kennedy 9/10/2003(DS)















03-09-2006 03:15 PM
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Grady's Mommy  
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Location: Ohio
Registered: Jul 2004
Posts: 813
Last visit: 03-24-2006

We've never applied for SSI. We've just always been told we wouldn't qualify, so we didn't bother.

However, Grady does have Medicaid. We applied and had no problem getting accepted. Our income level was very low because DH was in school and I was staying home. We were living off of our savings. It seems they did not take savings or investements into account when determining eligibility. If they would have, there's no way we would have qualified. So, I'm not sure if Grady qualified purely on his disability (don't know if that's even a possibility) or if they don't look at savings etc. or what. But we've been approved and reapproved after one year. The only thing they requested from us were pay stubs.

It works like regular insurance. We've never had to go anywhere special and we haven't paid a cent for anything for him since he's had it (except his synthroid which Medicaid decided to stop covering). We have primary insurance, medicaid, and BCMH (a state insurance program) in that order.

Since DH got a new job though, I have to call them and give them updated paystubs. Since he's working full time now, I think there is a good possibility we'll lose medicaid.
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~Kathy
Grady (DS 5/26/04)
Baby #2 due 9/23/06

03-09-2006 03:51 PM
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iluvmacy  
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Location: Northern MN
Registered: Jan 2006
Posts: 61
Last visit: 03-23-2006

you definitely won't qualify with that much money in the bank. If you really really need it I would suggest when you apply to take that money out of the bank and put it in a safety deposit box so the govt. won't know you have it. It may be worth it to get the insurance.
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Macy-5/11/05

03-09-2006 08:00 PM
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Grady's Mommy  
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Location: Ohio
Registered: Jul 2004
Posts: 813
Last visit: 03-24-2006

It really must differ state to state or even SSI vs. Medicaid. Because like I said, they could not have taken our savings & investment accounts into consideration or else I'm 100% positive we wouldn't have qualified. They didn't ask about it on the application and I assume if it was standard they would have just looked it up by our SS#'s.
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~Kathy
Grady (DS 5/26/04)
Baby #2 due 9/23/06

03-09-2006 08:12 PM
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DanielsMommy  
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Location: Rhode Island
Registered: Sep 2005
Posts: 1403
Last visit: 03-24-2006

The way it works in RI is SSI is based on OUR income...therefore we didn't qualify. The only other option was the Katie Beckett Waiver which is based on the childs health and the childs income (which is zero). I had to submit tons of medical stuff (he had heart surgery). I was told his approval was based on his heart...not having Ds. Either way, we were approved for the waiver. It is a supplemtary insurance to our primary and covers all copay and out of pocket expenses.

There is on extra benefit in RI (I don't know if every state does this or not), if you qualify for the Katie Beckett Waiver...you AUTOMATICALLY qualify for WIC REGARDLESS of your family income. So, I get WIC for Daniel which pays for formula, juice and cereal. Also, they cover any sibling who is under 5 until the child who receives the waiver turns 1. So...I also get WIC for Elayna...cheese, eggs etc. I was SHOCKED we got this. But...we got it fair and square with the Waiver. They never asked anything about our personal income....it was based on Daniels.
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Lisa
Mommy to Elayna 10-1-02 and Daniel Ds 6-7-05
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03-09-2006 08:16 PM
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DanielsMommy  
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Location: Rhode Island
Registered: Sep 2005
Posts: 1403
Last visit: 03-24-2006

One other thing I wanted to mention...I was told NEVER to have money in the childs name while they are on the waiver. If the childs income exceeds $4000 I believe...they would become ineligable.

I have a college fund for my daughter....but Daniel has his college fund in bonds...which are under mine or my husbands SSN.


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Lisa
Mommy to Elayna 10-1-02 and Daniel Ds 6-7-05
Always have hope....Without rain, there can be no rainbows.






03-09-2006 08:44 PM
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always_chaos  
Senior Member

Location: Detroit Metro, MI
Registered: Dec 2005
Posts: 479
Last visit: 03-24-2006

The diagnosis of Down Syndrome is a presumptive condition for SSI, meaning that if someone has it and they meet the income criteria they qualify automatically. The amount of payment is based on a the families monthly income. It is a bit of a hassle taking in all the proof of monthly income each month by the 5th but it is worth it if you qualify. If you qualify for SSI you automatically get Medicaid.In some states your child may qualify for Medicaid even if you do not qualify for SSI-it just depends on the state.

Each state, and some counties have their own additional programs or services you can qualify for financial assistance or medical assistance. These programs are usually managed by the Department of Human Services in that state, county mental health agencies, or private agencies. Many state funded programs have waiting lists and in some states the child's disability or level of development must be moderately or profoundly behind. This can cause a problem because determining that a child is officially delayed enough prior to age three can be difficult. This is because the standards they measure children against can be broad.Most early intevention programs have a book or list of potential services you may qualify for and providing you with this information is required under the guidelines of Early Intervention.

I guess that what I am trying to say is that while you may not qualify for SSI with the resources you have, there may be other programs or services you can utilize for help.

Here is the newest information from SSA about resources data listed as 2006.

WHAT ARE RESOURCES

To get SSI benefits, your countable resources must not be worth more than $2,000 for an individual or $3,000 for a couple. We call this the resource limit. Countable resources are the things you own that count toward the resource limit. Many things you own do not count. What things do not count toward the resource limit? The following things generally do not count toward the resource limit, no matter how much they are worth:the house you live in; your car, if it is used for transportation for you or a member of your household; life insurance policies you own with a face value of $1,500 or less per person;burial plots or spaces for you or your immediate family; a burial fund of up to $1,500 each for you and your spouse's burial expenses;household goods and personal effects; property you or your spouse use in a trade or business, or on your job if you work for someone else.

What are resources?

Resources are cash and things you own and can turn into cash. Examples of resourcesresources are bank accounts, vehicles, property, stocks and bonds.

Why are resources important in the SSI Program?

To get SSI benefits, your countable resourcesresources must not be worth more than $2,000 for an individual or $3,000 for a married couple. We call this the resource limit.

ABOUT TRANSFERRING RESOURCES

What does it mean to transfer resources?

Transferring a resource is giving away or selling a resource. For example, giving away cash to another person is a transfer of resources.

What happens to my SSI benefits if I transfer a resource?

If you, your spouse, or a co–owner give away a resource or sell it for less than it is worth, you may be ineligible for SSI benefits for up to 36 months. How long you are ineligible for benefits depends on the value of the resource you transferred.

What happens if I sell a resource?

If you sell a resource for what it is worth, the 36–month ineligibility period does not apply. But, the money you receive from the sale may make you ineligible if it puts you over the $2,000 resource limit for an individual or $3,000 for a couple.

What happens if I put my resources into a trust?

In some cases, we consider putting resources into a trust as a transfer of resources that makes you ineligible for SSI benefits. In other cases, we count the trust itself as a resource. Moreover, the value of the trust could put you over the resource limit.

How does transferring a resource affect Medicaid coverage?

Medicaid may not pay for certain health care costs if you or your spouse give away a resource or sell it for less than it is worth. If you have any questions about how transferring a resource affects Medicaid coverage, please contact the welfare or social services agency that handles Medicaid in your area. They can answer your questions about how transferring resourcesresources affects Medicaid.


http://www.ssa.gov/notices/supplemental-security-income/links-to-spotlights.htm#links

Here is a link to about another program:

State Children's Health Insurance Program
The State Children’s Health Insurance Program enables states to provide health insurance to children from working families with incomes too high to qualify for Medicaid, but too low to afford private health insurance. The program provides coverage for prescription drugs, vision, hearing and mental health services and is available in all 50 states and the District of Columbia. Your state Medicaid agency can provide more information about this program, or you can get more information at http://www.cms.gov/schip on the Internet or by calling 1-877-543-7669.



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03-09-2006 09:20 PM
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kellyrimmer  
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Location: Atwood, TN
Registered: Feb 2006
Posts: 184
Last visit: 03-23-2006

You cant have more then 4 thousand here. There real funny over it. We dont get SSI but get Medicaid so try anyway cuz the medicaid is worth it.
Kelly

03-09-2006 09:22 PM
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kellyrimmer  
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Location: Atwood, TN
Registered: Feb 2006
Posts: 184
Last visit: 03-23-2006

Oh there are other programs you can apply for as well. I am e-mailing you over them. one is through United Way and Alexis was approved last week its not based on income.
Kelly

03-09-2006 11:18 PM
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ElijahsMom  
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Location: Waverly, Ohio
Registered: Nov 2005
Posts: 130
Last visit: 03-23-2006

Elijah gets SSI, Medicaid, WIC, BCMH, and Early Intervention...they told me in Ohio that he qualifies for all of them except SSI because he has DS...he qualifies for SSI just because we are poor (I never thought that I would be happy to be poor!) I would never be able to afford all of his medical bills if he didn't qualify.
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Mommy to Elijah 2/1/06

03-09-2006 11:42 PM
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Jenna  
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Location: Texas
Registered: Feb 2006
Posts: 587
Last visit: 03-24-2006

Howdy! I'm somewhat in the same boat. I'm here in Texas and my DH is getting out of the AF in less than 2 months. He hasn't received a job offer yet so I called today to see if we qualified and they said NO based on our current income. They did say that the day he gets out to call and they will approve it for while he is job hunting. But you should call, because I think with that much money in the bank they won't approve you.

If you want more Texas information, feel free to PM me.

BTW - Where in Texas will y'all be returning to?
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Proud mamma to these beauts!!!




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03-10-2006 12:19 AM
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mariachi  
Member

Location: Corpus Christi, Texas
Registered: Dec 2005
Posts: 65
Last visit: 03-23-2006

I have medicaid on Natalie, but not SSI. For SSI and medicaid you can not have that much money in the bank so I would move it if I were you. SSI on a family of 3 including child you have to make no more that 3129.00 a month and that is gross. Once you get SSI you will automatically get Medicaid. It works just like regular insurance you can choose your doctor. The only reason we were able to get medicaid is becuase we went under some program that the social worker at the hospital hooked us up with. We were able to claim her medical bills and that helped us alot, but I have a feeling that next year we'll lose it. It was worth it this year cuz Natalie just had her heart surgery. What part of Texas are you moving to? I live in Corpus Christi (a small city by the beach). I can give you the 1-800 number for the SSI office here in Texas. You can call over the phone and set up a phone appointment without ever having to set foot in the office. Trust me it gets really packed in there! Just pm me and I can get that for you.
elisa
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03-12-2006 01:39 PM
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kfurnival  
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Location: Baltimore, MD
Registered: Mar 2006
Posts: 10
Last visit: 03-23-2006

Thank you all for your info and advice. I guess nows the time to be generous with our money...

We'll be moving to Nacogdoches, TX, my hometown.

03-12-2006 02:52 PM
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ElijahsMom  
Senior Member

Location: Waverly, Ohio
Registered: Nov 2005
Posts: 130
Last visit: 03-23-2006

Yeah you aint kidding...it's really sad that we can't "save" for our kids...it's odd that its better to spend than save when it comes to money (for them, anyways!) I guess you could always have a lockbox or something at home...as long as it isn't in the bank?
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Elisha:
Mommy to Elijah 2/1/06

03-12-2006 03:12 PM
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Grady's Mommy  
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Location: Ohio
Registered: Jul 2004
Posts: 813
Last visit: 03-24-2006

Elisha - I wondered that about Ohio/Medicaid. I wondered if he qualified purely on DS and not our income. I've never recieved a definitive answer. But we did/do have to report out income and any changes to it. So I assumed it was still based on our income. I have to call and update them about DH's new job, so I think I'm going to ask.
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~Kathy
Grady (DS 5/26/04)
Baby #2 due 9/23/06

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