How does the Medically Needy Program ...
Dee

United States

#21 May 27, 2009
I just got approved for Medically needy with share cost of $3500. Does that means that anything below this amount I am responsable for?
Esther

Terra Ceia, FL

#22 May 31, 2009
I've been at the same job for 8 years with my son on full medicade for those 8 years and another one on for 4 years and now they say i make too much? 9.75 and hour is too much??? my share of cost is 1261.... and thats what i make a month... how am i to foot a bill up to that??? so i keep reapplying and even applied for florida kid care and faxed the information they need to them twice and I get nothing back, and in the meantime while they loose my imformation my sons tooth is growing out the side of his gums. there were points in the application process where they were asking for my sons' imcome and denied me because i couldn't give them proof of his income. Where do they get this information from? I'm more than ticked with the system. It was better before when you had to wait in line and go to interviews , at least they had more time to get it right.

Since: Jul 07

Plainview, NY

#23 Jun 17, 2009
Share of Cost will only work if your medical bills exceed your share of cost and you are sure to use a doctor or hospital who accepts medicaid. If your SOC if $1000, and you get an auto accident that requires surgery and a hospital day, (again be sure they accept medicaid), your bill will surely be over $1,000. To me it takes a major medical emergency to benifit. But the alternative is paying the entire amount of the bill which could be thousands of dollars. Tough luck if your bill is only $999.00. You will have to pay it.
Yvette

Hollywood, FL

#24 Jun 18, 2009
Anyone know how long it takes them to open medically needy? I faxed my medication list from Walgreens today and it is almost double of what my SOC is so I know I am ok there....just want to know how long I have to stay in pain for before they open the damn thing so I can fill my RX's. I am guessing that since it is over my SOC I don't pay anything?!?!
tee

AOL

#25 Jul 15, 2009
yes i know how ya all feel about this share of cost crap, they always say u can go to a medicade doc but when they run ur gold card, it comes unactive, its crazy seriouly, its like if u dont have a good job or the money in ur hard, its oh heck with u or who ever thats on share of cost, its a suck behind program, i wish there was someone who i can write bout this and then everyone else needs to write about the program and mabye they will not use it no more, but not sur where to start to do so. and then u do have medicade open where the heck where a doc will see u for the lil bit of time u have medicade cus the next month u go right back to ur share of cost again, its soooooo darn crazy, but all i have to say is when u fax ur bill make sure u write the date u faxed it, cus i was getin statements for months utnil it was about to go to collection then i called medcide for the billions of times and they lik oh we are sorry i see where u faxed and faxed ur bills i say yea i did fax like i am suppose to and the bill not gettn paid, its just str8 stupid program geesh. its either have money or just stop workn and then u will b on medicade
jessica

Muskegon, MI

#26 Jul 28, 2009
I agree totally! I am having the same exact problem
Emma - Broward

Miami, FL

#27 Aug 7, 2009
Hi all,

I'm reading your comments but I'm still confused about how this "share of cost" works.

My daughter has Medicaid, and starting Sept 1, she'll be under share of cost program. She has special needs and has PT, OT, and ST 2/week. So we'll definitely meet the share of cost. My question is... the provider bills once a month for therapies. Who do they send the bill to? To me? or to Medicaid?

Also, if you need to see a specialist... do you need a referral? Authorization?

As you know, Medicaid "phone personnel" is not so friendly and I got hung up several times.

Thanks,
Carlee

United States

#28 Aug 10, 2009
tee wrote:
yes i know how ya all feel about this share of cost crap, they always say u can go to a medicade doc but when they run ur gold card, it comes unactive, its crazy seriouly, its like if u dont have a good job or the money in ur hard, its oh heck with u or who ever thats on share of cost, its a suck behind program, i wish there was someone who i can write bout this and then everyone else needs to write about the program and mabye they will not use it no more, but not sur where to start to do so. and then u do have medicade open where the heck where a doc will see u for the lil bit of time u have medicade cus the next month u go right back to ur share of cost again, its soooooo darn crazy, but all i have to say is when u fax ur bill make sure u write the date u faxed it, cus i was getin statements for months utnil it was about to go to collection then i called medcide for the billions of times and they lik oh we are sorry i see where u faxed and faxed ur bills i say yea i did fax like i am suppose to and the bill not gettn paid, its just str8 stupid program geesh. its either have money or just stop workn and then u will b on medicade
I have called the call center for medicaid several times, remained on infinite hold to speak to someone who is rude and really can't answer any questions. However they can send me a pamphlet...which is fine but if you can't answer my question what makes you think this piece of paper can. I have a $447 SOC, have $800 a month coming in for child support and that's it. After I meet my SOC my funds have almost been depleted. My question is how do I pay my other household expenses after I meet this ridiculously high SOC?(If I had $447 a month I would just buy health insurance and not ask for anything or jump through the rings of fire to get help!) The call center informed me that I was way above my income level for a lower SOC. So I asked how much I should have coming in for three people for a month and she told me $303. I was blown away! How can anyone make it on $303 a month? much less three people? I have also called the providers on the list they send with the infamous pamphlet and was told my their offices that they do not accept SOC. It is very disappointing to go through the hassle just to find out there is just more hassle waiting. I was told to write my congressman that he could get the information I needed and check on what the problem is. Apparently they are much more informative and coorporative to people who have authority. As for me they can send me a pamphlet.
CsMom

Ocala, FL

#29 Aug 12, 2009
"Well Mam. They just put the information in the computer. AND they can't do anything else."
We make $300 less then the monthly limit but because we have two cars, one of which was GIVEN to us our 3 yr old does not qualify, but because he technically qualifies for madicaid, he cant even get kidcare!
Carlee wrote:
<quoted text>
I have called the call center for medicaid several times, remained on infinite hold to speak to someone who is rude and really can't answer any questions. However they can send me a pamphlet...which is fine but if you can't answer my question what makes you think this piece of paper can. I have a $447 SOC, have $800 a month coming in for child support and that's it. After I meet my SOC my funds have almost been depleted. My question is how do I pay my other household expenses after I meet this ridiculously high SOC?(If I had $447 a month I would just buy health insurance and not ask for anything or jump through the rings of fire to get help!) The call center informed me that I was way above my income level for a lower SOC. So I asked how much I should have coming in for three people for a month and she told me $303. I was blown away! How can anyone make it on $303 a month? much less three people? I have also called the providers on the list they send with the infamous pamphlet and was told my their offices that they do not accept SOC. It is very disappointing to go through the hassle just to find out there is just more hassle waiting. I was told to write my congressman that he could get the information I needed and check on what the problem is. Apparently they are much more informative and coorporative to people who have authority. As for me they can send me a pamphlet.
Olga

Hialeah, FL

#30 Aug 19, 2009
Evelyn wrote:
I agree totally! I am having the same exact problem and it seems no one will help!
<quoted text>
I'm not understanding why there seem to be so many different opinions and results on the medically-needy issue but in my case, my husband has been on medically-needy medicaid and his "share of cost" is over $4,000 per month. He is a liver transplant survivor and his meds alone exceed that amount. It is not a fixed rate for everyone; it is based on your income and assessed from time to time so the SOC is adjusted as needed. We've never had to pay a penny on the SOC. I don't understand all these comments but you must dig and question. My daughter's kids are on medically needy as well and today her doctor's office told me their SOC is $2,000 because that is the amount for all. She is so wrong and I know it, but when you run into people who are stubborn and think they know it all, they oftentimes give the wrong information. Don't give up and reach further; look it up in the medicaid website, anything, but just don't take no for an answer. The plan works, it's people who don't make it work.
Yvette

Hollywood, FL

#31 Aug 20, 2009
I have sort of found the solution to the problem BUT it won't work for everyone :(

If you are taking medications that meet or exceed whatever your share of cost is, at the beginning of each month, go to your pharmacy. Tell them you need a print out of what the cost is for your monthly prescriptions so that you can fax it to medicaid. If they tell you that you need a script, explain your situation to them and they will most likely give you the printout with that medication on there. They aren't filling anything at that point so they can't get in trouble for doing this for you! My soc was $299 my medications are $635 :) Now, after finally figuring out this formula which by the way once you fax your stuff over, your medicaid will be open within 2-3 days and no you don't need referrals or any other crap because you are considered straight medicaid.....now I am going on regular medicaid...seems as though they found after I have been complaining, they screwed up...go figure....dcf screwing up? OMG! what hell I went thru too....and not even an I am sorry grrr
debbie

Clermont, FL

#32 Aug 24, 2009
I am confused and pissed. I have never applied for pulic assistance until now. I should be relieved my kids were approved for medicaid. I have a cost of share $197.00 so after reading all above I see that I would have to pay the first 197 and medicaid would pick up the remaining balance every month. If I could afford that wouldn't I just get regular insurance. WOW our country really cares. I saw this morning on GMA that a vetran needed his rotary cup replaced. He got X-Ray quotes from Japan and Germany. Those countries could do it for way under 100 bucks. God bless America our bargain price for the e-ray was like 1200.00 or something.. REALLY WRONG!!! I guess I should of checks I was Mexican and had no social security number.
Deborah

Miami, FL

#33 Sep 16, 2009
I agree 100% medically needy does not work. I have high blood pressure and I need medication but no doctors will take it, because they say they have a hard time getting paid.

Very sick!!!
Diana

Miami, FL

#34 Sep 17, 2009
Hi im still wondering what the hell is medically needy idk what website to go to, to find out what doctors i can go see i have been having health problems sence my pregnancy and my son's about to be a year old and i was enrolled in this program . i need some information on this im only 21 years old and i need medicall asst.
Mike Safety harbor

Safety Harbor, FL

#35 Sep 21, 2009
Does anyone know what the income threshold is for full medicaid vice medically needy? Because I receive a veterans pension it has put my wife off the rolls of receiving any of her ssi benefits.(a check and medical insurance) They put her on medically needy. It doesn't sound to good. These people in power are a joke and will get voted out of office. Because of our (less than $1300.00 a month) we are now left paying for her prescriptions and regularlly scheduled visits. Where do these jerks think we are going to get the money from? 0f our monthly income we are left with 143 dollars for the month. They also lowered the food stamps from 188 to 47.So basically they have put her on the statistic list of not being able to afford insurance. Sounds like another whitehouse scam. Do they really care about the people?
lisa B

Lake Worth, FL

#36 Sep 21, 2009
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 ihis system need a fix BIG TIME!!
My name Is lisa and I live In Boynton my meical need coast Is 254 dollars I am a single mom and I can not afford that, But thats not the worst thing no DR want to take IT. because they say It takes to long to get the money If they do It at lest half of what IT coast to see me. So what are people like me surpost to do. I do not Quialif for regual Medicade I have to only have Inome of 241 a month who any where can live on that. If any one out there know In the WEst Palb Beach eare or boca a DR willing to take IT drop a line hear. thank you
lisa B

Lake Worth, FL

#37 Sep 22, 2009
I agree that are goverment has to do something about the system and do IT Quicly. I was told I could go to a clinick to get a flue shot. But, It may take as little as 6 houres and as much as 8 hours before being seenc. Who as that tpy of time not me and to make matters wores I have eye problems can even get medicad to help drive me there.
Any one out there who has anwser for me please leve them hear. lisa b. BOynton beachFL
Laura

Tallahassee, FL

#38 Sep 22, 2009
Where do you mail your bills when you are medically needy.
lisa B

Lake Worth, FL

#39 Sep 26, 2009
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!!
Have you found any help yet? I fell helpless and have tryed everything. Now I tryed calling my local office IN west Palm beach. Of coures As always you Get a recording and usually a time line saying well call you with This amout of time my time up tomorrow will I get a call anyones guess. Mostly I get discutted or a person at a call center who can not anwers your Question. Yes I am above frusted. IF you had luck please shar IT. Lisa
lisa B

Lake Worth, FL

#40 Sep 27, 2009
To evely Cap coral fl. No I strongle disagreeYou can not just say you want IMformation on medicad. I tryed that got several DR to see me and when IT came Time to pay I was out of luck stuck with a bill I sent IT to the adress the meically need I got they told me I would have to pay..
I got so, frustrated I called a family member who was a lawyer. I was told that they would have to pay. I went back called up told them what I learned I was going to but, they end up paying only a Qurter of the bill since this time I can find know one IN the WEst Palm eare to take share of coast. IF you or anyone eles has any anweres please email me hear. Emai Lisa b of Boynton beach Fl.

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