How does the Medically Needy Program ...

How does the Medically Needy Program Work

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John Morgan

Fort Lauderdale, FL

#1 Sep 15, 2008
The following is the example they give...

"If your cost of share is $800 and you go to the hospital on May 10th and receive a bill for $1000, you have met the 'share of cost' and are Medicaid eligible from May 10th thru May 31st. If the bill from May 10th is a Medicaid covered service received from a Medicaid provider, Medicaid will pay the bill."

Are they saying that Medicaid will pay the entire $1000 bill...or are they saying Medicaid will pay the difference only between the bill of $1000 and your share of cost $800. It sounds like they are saying they pay all of the bill but then why do they say 'Your Share of Cost'?

Thank You
Medicaid Area Office

Tallahassee, FL

#2 Oct 2, 2008
Medicaid will pay the bill because "share of cost"(SOC)is not a deductable in the traditional sense. Another example would be if you went to the emergency room on Monday and got a $500 bill and again on Tuesday for another $500, you would have met the SOC on Tuesday and that bill would be paid, the first $500 would not be paid. Once you meet the SOC, Medicaid opens from that date until the end of the month. After that, you must again meet the monthly SOC.
Maria G

Fort Lauderdale, FL

#3 Oct 9, 2008
Does Medicaid with SOC cover vision or dental? My son's eyesight is horrible and he desparately needs new glasses.
Mike

United States

#4 Dec 4, 2008
Medically needy DOES NOT WORK. My Wife has it and needs to see a doctor desperately. we do not have the money to afford to go to a doctor and her share of cost is only $5.00. Yet not one doctor in the orange or Seminole county will take this insurance. Is is about as good as having NO INSURANCE. The medicaid system here is a FAILURE.

I have called MANY offices that accept medicaid and they all say "We don't take it because we have no guarentee we will get paid". They even laughed at me and told me that no one will take it. Only if perhaps you were going to a doctor for a long time and got switched to it, but no doctor is going to see you as a new patient if you have Share of Cost. Even the emergency room after being informed of Share of cost told us that it really isn't insurance and no one will take it.

-This system need a fix BIG TIME!!
Kathleen

Tampa, FL

#5 Jan 11, 2009
i feel you on that.....becuaes you are right
Mike wrote:
Medically needy DOES NOT WORK. My Wife has it and needs to see a doctor desperately. we do not have the money to afford to go to a doctor and her share of cost is only $5.00. Yet not one doctor in the orange or Seminole county will take this insurance. Is is about as good as having NO INSURANCE. The medicaid system here is a FAILURE.
I have called MANY offices that accept medicaid and they all say "We don't take it because we have no guarentee we will get paid". They even laughed at me and told me that no one will take it. Only if perhaps you were going to a doctor for a long time and got switched to it, but no doctor is going to see you as a new patient if you have Share of Cost. Even the emergency room after being informed of Share of cost told us that it really isn't insurance and no one will take it.
-This system need a fix BIG TIME!!
CHANEL

Saint Petersburg, FL

#6 Jan 14, 2009
That's not true. I for providers in the Seminole and Orange county area that do accept Medicaid. You can't ask them if they accept Share of Cost. You have to aske them if they accept Medicaid.Maybe you need to research a little more, because I know for a fact that there are many providers there that accept it.
Mike wrote:
Medically needy DOES NOT WORK. My Wife has it and needs to see a doctor desperately. we do not have the money to afford to go to a doctor and her share of cost is only $5.00. Yet not one doctor in the orange or Seminole county will take this insurance. Is is about as good as having NO INSURANCE. The medicaid system here is a FAILURE.
I have called MANY offices that accept medicaid and they all say "We don't take it because we have no guarentee we will get paid". They even laughed at me and told me that no one will take it. Only if perhaps you were going to a doctor for a long time and got switched to it, but no doctor is going to see you as a new patient if you have Share of Cost. Even the emergency room after being informed of Share of cost told us that it really isn't insurance and no one will take it.
-This system need a fix BIG TIME!!
Evelyn

Fort Myers, FL

#7 Feb 3, 2009
I agree totally! I am having the same exact problem and it seems no one will help!
Mike wrote:
Medically needy DOES NOT WORK. My Wife has it and needs to see a doctor desperately. we do not have the money to afford to go to a doctor and her share of cost is only $5.00. Yet not one doctor in the orange or Seminole county will take this insurance. Is is about as good as having NO INSURANCE. The medicaid system here is a FAILURE.
I have called MANY offices that accept medicaid and they all say "We don't take it because we have no guarentee we will get paid". They even laughed at me and told me that no one will take it. Only if perhaps you were going to a doctor for a long time and got switched to it, but no doctor is going to see you as a new patient if you have Share of Cost. Even the emergency room after being informed of Share of cost told us that it really isn't insurance and no one will take it.
-This system need a fix BIG TIME!!
Evelyn

Fort Myers, FL

#8 Feb 3, 2009
yeah well if that is true I'm in Lee County Cape Coral to be exact and I have called over 50 offices and they all tell me the same!
CHANEL wrote:
That's not true. I for providers in the Seminole and Orange county area that do accept Medicaid. You can't ask them if they accept Share of Cost. You have to aske them if they accept Medicaid.Maybe you need to research a little more, because I know for a fact that there are many providers there that accept it.<quoted text>
arthur

Orlando, FL

#9 Feb 4, 2009
Why is it so hard to get help paying medical bills when you were born in this country.Seems to me that those coming across the borders get all the help they need And that is billions of the poor taxpapers in this country foot the bill yet they have hard time getting help wake up america and be heard
arthur

Orlando, FL

#10 Feb 16, 2009
were in this state of FL can you go were they accept medicare as payment and dont send you a bill for the other 20@
DANIEL

Jacksonville, FL

#11 Feb 24, 2009
The Medically Needy Program does work. But it helps to be knowledgable about it. DO NOT rely on the medical providers to know the program.

If you SOC is only $5.00. The doctors office just needs to fax the bills to the medicaid billing office. Call you local DCF office and get the fax #. Make sure the doctors office puts your DCF Case # on the bill for better tracking. Once DCF receives the bill in excess of $5.00, that will open Medicaid from the time of your doctor appt. until the end of the month.

Again, do some research about the program call your local DCF office or www.dcf.state.fl.us/ess and get the knowledge.
hayvi

Miami, FL

#12 Mar 3, 2009
well, i have a share of cost of 310 and i've been to the hospital but i've faxed the bill to the medicaid billing office and they dont pay the bills. i have an unpaid bill for over a year
Lisset

United States

#13 Apr 8, 2009
My daughter just got approved for a Share of Cost & she has florida kidcare CMS. The CMS office is giving me a hard time over the number of nursing hours she has received through Medicaid (in the past). CMS wants to cut her hours, yet Medicaid had approved 22 hours for the next six months. We were denied Medicaid in March, but we were just told that we now have a share of cost. Shoule I drop Florida Kidcare. They don't seem to want to approve services she had in the past.
Jenny

Tampa, FL

#14 Apr 14, 2009
Ok so I have this medically needy program I just had a procedure done that my doctor ordered and had complications and had to go back to the hospital my bills are way more than my share of cost, great so thats taken care of, my question is the doctor who ordered the test doesnt accept medicaid and only accepts medicaid with an HMO, so now how do I go about getting my test results?
Barbara

Clarksville, FL

#15 Apr 22, 2009
IT DOES NOT WORK and even the employees from the medicaid office have admitted that it is worthless. No one takes medically needy anymore, I have been in great need of medical attention and will suffer because I have no insurance. Health Departments, Forget it! Think I should move to Canada or France...lol..good luck all!
Paul

Owensboro, KY

#16 May 7, 2009
I use to have a share of cost of $90> My job cut my hours and now my SOC was dropped to $0. WTF! Wouldn't that be the same as regular Medicaid? Also, I've been a Type 1 Diabetic for 29 years now. Will medically needy share of cost cover insulin pumps? Any info on this would be greatly appreciated.
Lisset

United States

#17 May 8, 2009
Look like you need to call your DCF social worker.
Lisset

United States

#18 May 8, 2009
Looks like you need to call your DCF social worker.
Noureen

Tampa, FL

#19 May 11, 2009
I just approved for medically needy with share of cost of $950. This is insane. This is more then having insurance. Insurance co-pays are 25-50 dollars. Last time i had insurance i was paying $164 and was covered the entire month. Medicaid is crappy. So does this mean that if i go to the doctor and the bill comes out to $800 i have to pay out of pocket?
Amy

Pompano Beach, FL

#20 May 14, 2009
Yes, unfortunately u do.... it sucks big time!

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