How Do I Qualify for Medicaid

[Ob3135]

My workers compensation claim was made in the State of: Alaska

Do you guys know if they consider weekly comp benefits as income when considering Medicaid.? I'm losing my Medical Insurance and am trying to figure out what I'm going to do. I'm afraid if they do consider it income I wont be able to use it because I'm getting the Maximum Benefit... It would put me over what a person can make and still get health coverage

[BvIA]

All you can do is make the request/application.
Medicade is asset based, the state handles Medicade...no one here can give you a definitive answer to your eligibility.

[SteelMagnolia]

OB3135 I agree with BvIA, as all states have different criteria for Medicaid all you can do is apply for the benefits. I would be surprised IF you are approved as Medicaid is asset based in all states that I am aware of. Given that you are at Max TTD for your WC claim my gut tells me you most likely will be denied based on too much income.

However, many states also have a medical spend down and IF you have serious other medical conditions that cost a great deal of money to pay for, that WC is NOT responsible for, then they "might" take into consideration your other medical expenses and IF that is so then there may be a loop hole for you to get Medicaid that way. Don't count on it though as most states consider anything over a few hundred dollars a month as too much income. AND many do NOT allow the spend down to help you qualify for Medicaid. Again all you can do is submit the application and hope for the best. Just don't get your hopes up too high as from what you have posted you most likely will not qualify.

You may also want to do some research for programs that serves the lower income population with reduced fee for medical services. County health departments and other community services may be available in your area.

Also if you have other serious medical conditions that might qualify you for SSDI, Social Security Disability Insurance, then you would be wise to submit an application for those benefits now. It takes from several months to sometimes years to get an approval for SSDI and SSDI is NOT income based. If approved for SSDI then 24 months after The SSA says you are disabled by their rules then you become eligible for Medicare, beginning on the 25TH month. Again NOT income based. If your condition or combination of conditions are expected to last for at least 12 months or result in your demise/death, then the sooner you get that application submitted the sooner you will get an answer as to whether you qualify for those benefits or not. Also IF you get an approval for SSDI benefits then during that 24 month waiting period of Medicare to kick in you might be eligible for Medicaid based on being disabled by SSA rules.

SSI/Supplemental Security Income is paid when a disabled person is considered disabled by The SSA but not yet eligible for Medicare, OR when an applicant does NOT have enough earned credits to receive SSDI benefits. SSI IS income & asset based so IF your income precludes you from state Medicaid then it is more than likely also going to disqualify you for SSI and the Medicaid that comes with it.

Again ALL you can do is submit your application, timely respond to any denials with requests for reconsiderations, appeals, and request to be heard by an ALJ/Administrative Law Judge, when/IF your application is denied. There are very few applications approved with the initial application BTW, if memory serves me it is under 20%. Meaning around less than 80% are denied until they usually reach the ALJ level of appeals. AND there is NO guarantee that an ALJ will reverse a denial.

About the only good thing about the extremely LONG wait is once/IF an approval is obtained then you are paid back pay for ALL months from when The SSA agrees your date of disability starts and when you finally reach an approval. SSDI pays in addition to WC benefits for up to 80% of your AWW/Average Weekly Wage, at the time of your injury.

See more here:

http://www.ssa.gov/

And here is a link to help you with the application process:

http://www.disabilitysecrets.com/

Arrow down to the lower left side of the page for list of topics.

Good luck to you and hope you get some sort of help soon.