How does the Medically Needy Program ...
Bob

Leesburg, FL

#428 Jun 27, 2011
I have been approved for Medically Needy and my shared cost is $740.00. I need dental work done right away and the estimated cost is between $1400.00 to $6000.00 depending on what type of dentures I get and where I have the work done. How do I find out what they will pay and can I have the work done without having to pay for it and have the bill faxed for payment. I other words can I get the work done without paying for it out of pocket because I can't pay for it in the first place
yvette

Huntington, IN

#429 Jun 27, 2011
Steven wrote:
p.s. And I've never even been told what my Medicare number is for doctors to even reference.
hey steven..if it helps....your medicare number is your social security number and at the end of it is either an A b or D...you can call social security too at 800 772 1213...if medicaid is the primary insurance...medicare only covers dialysis...if medicare is primary u will have a $162 deductible that medicaid will not meet....i am replying from my cell...if it says i am in IL...i am not lol I am in south fl
Steven

Winter Park, FL

#430 Jun 27, 2011
Sorry, I meant medicAID number, as in "case number". With share-of-cost you don't get a Medicaid card so some doctors aren't even sure how to bill it.
Steven

Winter Park, FL

#431 Jun 27, 2011
To Bob from Leesburg- Medicaid, share-of-cost or otherwise, doesn't pay for anything dental except emergency extractions unless something changed very recently. Never has to my knowledge.
Bob

Leesburg, FL

#432 Jun 27, 2011
Steven wrote:
To Bob from Leesburg- Medicaid, share-of-cost or otherwise, doesn't pay for anything dental except emergency extractions unless something changed very recently. Never has to my knowledge.
That figures,Thanks Steven
Yuliana

Boca Raton, FL

#433 Jun 28, 2011
About a year ago I took my daughter to the emergencies room, I received a 50 dollars bill has radiology and a 750 dollars bill for pediatrics services, My share of cost was 2290 dollars, so I decided to pay the bills ...We decided to apply for a home loan and they check my credit history, we realized that we owe a debt of 2946 dollars to the hospital, if we score with the three bills would have exceeded the amount paid for the program but we never received the third bill...yesterday we paid the 2949 dollars bill because they say "if you don't want to get involved in attorneys fees you have to pay now" My question: is any way to recover that money, the Medicaid program Medically Needy can return the money?
Steven

Winter Park, FL

#434 Jun 28, 2011
DANIEL wrote:
If you SOC is only $5.00. The doctors office just needs to fax the bills to the medicaid billing office.
That's part of the problem. If a doctor "doesn't participate" in Medically Needy, he WILL NOT FAX ANYTHING TO ANYONE. That's part of what "not participating" means in this case.
Donna

Palmetto, FL

#435 Jun 29, 2011
I just got Medicaid share of cost $878. I also have Medicare which pays 80%. I go to the doctor regularly for treatment. I am told my medical bills have to be over $4390 each month because I am only billed for 20% after Medicare. This is crazy. How is a person who's income is $1000 per month supposed to live if Medicaid makes them pay $878 of that each month. What help is that?!!!!
ahhaha

Englewood, FL

#436 Jun 30, 2011
So Yvette. Who is getting the money? Is it being given out with one hand and recaptured with the other?
Brenda

Saint Petersburg, FL

#437 Jun 30, 2011
DANIEL wrote:
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.
I live in FL and my share of cost is $962 per cycle, that is for myself trying to live on $1162 a month, impossible. I have 2 seriously and deadly illnesses and then some, but I never quite get up to the $962 so I'm expected to pay about $700 a month before I can get help with it. For it to start over again when I have chronic illnesses is crazy. I'm the only one to pay my house, water, electric etc.
yvette

Huntington, IN

#438 Jun 30, 2011
ahhaha wrote:
So Yvette. Who is getting the money? Is it being given out with one hand and recaptured with the other?
not sure what u mean? medicaid does not cover the deductible nor the 20% co insurance...not really sure what its there for....maybe just to waste paperwork and time?
Kia

Dallas, TX

#439 Jul 3, 2011
Everywhere in palm beach county accept it. What the deal is with SOC the doctor office or pharmacy has to submit the claim and the visit or prescription will be covered within 72 hours. Er visits are paid for if the cost doesn't exceed the SOC amount.
arthur wrote:
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@
Steven

Winter Park, FL

#440 Jul 3, 2011
It's typical of the program that they don't consider Medicare premiums a "medical expense" that doesn't count toward your share of cost for the month. The premium by definition is a portion of a medical expense that wasn't paid by anyone else. Medicaid in general and share-of-cost in particular is all about making it look like they're helping much more than tney are. It's public relations more than healthcare.
Yes but first you need to

North Port, FL

#441 Jul 5, 2011
Medicaid Area Office wrote:
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.
..
..
I have a share of cost of $700.00 per mo.
The only time i can get a share of cost is if i go to a hospital..
So when I go to the doctors I have to pay 20% up to 700.00 Rarly
do i get to 700. so I have to pay out of my SSD. which ain't much..

Since: Jun 11

Location hidden

#442 Jul 5, 2011
I have a share of cost of 313.00....My doctor visit plus meds totals close to 500 or 550, plus I need regular blood work. I can't figure out how this works....I didn't know that each doc had a choice...I thought they could just submit proof that I paid out of pocket, and that would go to share of cost. I can't seem to get any answers! If I just pay my bills, and manage to submit everything, would the medicaid reimburse me for anything over 313?
Steven

Winter Park, FL

#443 Jul 6, 2011
According to the Medicaid website, the doctor needs to fax the bill to their special fax number, where it's added to your total for the month. That's what I got out of it, anyway.
Pat

Winter Garden, FL

#444 Jul 8, 2011
I received my meedically needy medicaid card soc is 637. my income is only 800. I can use it either it just went into my junk drawer. (sorta speak) What the Hell else is it good for. IDk
Pat

Winter Garden, FL

#445 Jul 8, 2011
xxANGEL WINGSxx wrote:
I have a share of cost of 313.00....My doctor visit plus meds totals close to 500 or 550, plus I need regular blood work. I can't figure out how this works....I didn't know that each doc had a choice...I thought they could just submit proof that I paid out of pocket, and that would go to share of cost. I can't seem to get any answers! If I just pay my bills, and manage to submit everything, would the medicaid reimburse me for anything over 313?
That means yours is covered because its over 313.00 if ut was less you had to pay that first
Jessica

Tampa, FL

#446 Jul 11, 2011
Amy wrote:
Yes, unfortunately u do.... it sucks big time!
Perhaps you could think of buying health insurance instead of relying on the state Medicaid system? Medicaid is intended as a welfare program - it is not intended as top of the line "real" health insurance!

If you can't buy regular health insurance because of a preexisting health condition, you should look into buying insurance from GEHA ( a private insurance company who insures all Congressmen and women). The plan they offer, called the "Pre-Existing Condition Insurance Plan" was passed under President Obama's health care reform bill. It allows persons otherwise uninsurable to buy health insurance on the private market at really good rates.(for example, a person age 30 can buy it for around $150/month)

You can find out more information at www.pcip.gov .

Hope that helps.
WitsEnc

Dade City, FL

#447 Jul 11, 2011
The insurance Jessica mentions is what the country seems to call "Obamacare". It is the wonderful insurance program President Obama got through to allow people who have pre-existing conditions obtain quality insurance. It is not one of those hokey limited benefit plans. The price has dropped considerably from when it was first offered 2 years ago. Monthly premiums are based on age. I encourage everyone to check it out as it may (hopefully) be helpful to you now, or later when your circumstances change. www.pcip.gov or you can go to healthcare.gov

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