How does the Medically Needy Program ...
rottenhat

Lansing, MI

#62 Nov 3, 2009
TO LISA B---

Call your state senator right away. Do not wait for DCF to do anything at all ----you will go blind first. You sound like you qualify for Social Security Disability if you have a serious vision problem. Go to their site online and apply for benefits.
Florida Medicaid is the worst in the nation---they only hire the very dumbest people and the benefits do not compare with the other states. But the bottom line is that they just do not care about anyone unless a senator or a newspaper is on their back.
Good Luck.
Lindsey

Orlando, FL

#63 Nov 3, 2009
Anyone know of an Orthopedic Doctor in Central florida that deals with backs? Also looking for a doctor to work with me on the requirements for medicaid to approved the lap band weight loss surgery? I hear shands in gainesville is the best at working with medicaid patients.
Yvette

Hollywood, FL

#64 Nov 3, 2009
Lindsey, on the last page, I left you a note...also, don't run for an ortho...they are all about RX and cutting you open...if you have a serious back issue, try a Chiropractor first...and yes most of them take the SOC...I work for one but we are south florida...that's how I know how this works...I am their billing manager
Lindsey

Orlando, FL

#65 Nov 3, 2009
Yvette...you can email me at [email protected]
Lynn

Orlando, FL

#66 Nov 4, 2009
Good news. The pharmacy called. Medicaid Share of cost program approved all my prescriptions (that totaled over 170.00 which is my SOC) and I officially have full medicaid benefits for this entire month and every other month after as long as I stay on all my current medications and get refills each month (in other words, as long as i have enough meds to total my SOC). I am young, in my mid twenties and I made this crappy system WORK! I have a condition called PCOS with high blood pressure and insulin resistatnce issues. I am not 100% diabetic but am treated as such basically. I am not on any really strong expensive medications actually, it was basically 3 meds plus test strips. If my SOC was higher I might have to add some more meds to get it covered though.

For those who dont have alot of conditions or meds but need to meet your SOC. My advice is screw the system like they screwed you. Go to your doc and load up on meds, even if you dont actually TAKE them! Heck tell them you have problems in the bedroom and you need viagra and just dont take them! Atleast they will go towards getting your SOC met and get you full insurance! Im sorry you have to do whatever you can to get this horrible Share of cost program to benefit you!!!
Yvette

Hollywood, FL

#67 Nov 5, 2009
Lynn....that's exactly what I said about 2 pages ago lol glad you got it to work for ya :)
Billi

Estero, FL

#68 Nov 5, 2009
My husband is disabled and has a history of a AAA rupture. His high blood pressure will cause it to rupture again. we got approved for Medically Needy program with a Share of Cost of $1200.00. There is no way it can be met. I worked for a doctor and people's bills never came close to that in a month. Not if it is just for check ups. I am so frustrated. we came from Ohio, and at least there, even though Care Source Sucked, we still got care. Here I can't even find anyone to take it. And I HAVE asked if they accept the Medicaid Share of Cost.
Lynn

Orlando, FL

#69 Nov 5, 2009
Your husband needs to go the to the ER the 1st of every month. Plain and simple. Yes it will ruin HALF of his day but it is the only way.

Secondly, the SOC is part of your income/assets. Look at what they are looking at, make sure it matches up. If you have an extra car that is making your asset limit to high and in return causing SOC to be too high, sell it. Try to look at your stuff and see what you can cut. Otherwise, in his case he may need to try for Social security. FIght it to the death. 3 times is usually charm. Get a lawyer (free from legal aid)
Billi

Estero, FL

#70 Nov 6, 2009
Oh he is on Social Security Disability. That is why I don't understand it. He just got his disability started, they say he has to wait 2 years for Medicare, in the mean time sign up for medicaid. They put him on SOC and our income is only $1681 a month and 1200 of that is suppose to go to SOC...it aint going to happen. Not even with his meds can he run up a bill for 1200 a month. Even if he goes to the ER at the first of every month, if it don't come to 1200 on the first visit we still have to pay it.
Lynn

Orlando, FL

#71 Nov 11, 2009
You should automatically be qualified for FULL medicaid with Social Security Disability. Not sure how you applied but if you applied directly, you need to call SSD and get them to run it thru on there side or vise versa. You fell thru the cracks and now you need to fight your way out. Please call Agency for health care administration for your county. They are the ones that have the answers. You wont get them from the 1800 dept of children/families # medicaid, you need the AHCA #. I am not in your area so i dont know the #. They will get it fixed. There should not be a SOC with disability thru SSD is what im saying, adults automatically get it with a legal ssi disabiliity (if you qualify). Im thinking in your case (if im wrong) the worse case senario is that they realized you have way too many assets/income to justify the full official medicaid but then i am confused on how he got the ssd unless its the non income based one? if so, that may be why he is on soc medicaid not the fulll one
Meg

Clearwater, FL

#72 Nov 13, 2009
You need to generate a bill that is OVER your share of cost. Once you have that bill, FAX IT with a letter to you area Medicaid office along with a letter that says....We have met our share of cost for the month of --------. Please open our case immediately." Include your name and case # and ID # or social # so they know who you are!
In OUR case, we had to pay $79.00 to our DR. that accepts medicaid (we paid her out of pocket for this visit) and we kept the bill.
Then, we faxed the bill along with that hand written request to our area medicaid office. They took a week to open it, but they did open it and then it back dated to the day of service on our bill. THEN.....we went to any other (or the same) dr that takes Medicaid and they will see your approved for the rest of the month. You can then be reimbursed by your DR.s office, you know.....? They refunded us everything OVER our share of cost amount (meaning if your share of cost is $5 bucks...they would refund you $74.00 of the $79.00) and then bill medicaid for any other appointments or prescriptions for the rest of the month! This is WAY time consuming and It SUCKS to haveto do it EVERY SINGLE MONTH, but if you know how to work it, it works!
Hope that helps!
Lynn

Orlando, FL

#73 Nov 13, 2009
Meg - No, 99.9% of the time you will NOT be reimbursed. TRUST ME....tried that with 5, yes 5 orange county medicaid doctors! Maybe you got a lucky office though but its not "standard" practice of this program or providers, I even called AHCA and asked them (they say its up to the provider). I know alot of secret hand shakes and code words that usually work for other things (lol) but have not been successful on this one yet.

Meg, is your SOC 79.00? WOW. How did you get it so low?? I am unemployed and have no assets and mine is like 172
Patte

Spring Hill, FL

#74 Nov 17, 2009
lisa B wrote:
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
Lisa, PLEEESE learn to spell, your comments are painful!
Patte

Spring Hill, FL

#75 Nov 17, 2009
Yvette wrote:
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
Question....
Did you have to pay the $299,(SOC)out of your pocket, for the first $299 in scripts submitted to be applied? Or were they paid by medicaid even though you hadn't met the soc yet?
Yvette

Hollywood, FL

#76 Nov 17, 2009
the prescriptions are what makes you hit the SOC...you won't have to pay anything out of pocket if you can get them up to your SOC amount :)
Patte

Spring Hill, FL

#77 Nov 18, 2009
Yvette wrote:
the prescriptions are what makes you hit the SOC...you won't have to pay anything out of pocket if you can get them up to your SOC amount :)
How is it that you're going off SOC and onto straight medicaid? PLEASE Share...
Terri

Melbourne, FL

#78 Nov 18, 2009
I've been on share of cost for five months, and thats been interesting! I was just told today by DCF that since my daughters 18th birthday is this month, my medically needy status stops. No letter nothing! I've called everyone I could think of. I'm still in shock!! I have Pulmonary fibrosis and on oxygen 24/7. My husband has is frantically looking for a job thats got decent insurance. My question is.....where can I go from here? Help!! Do any of you have any suggestions
Yvette

Hollywood, FL

#79 Nov 18, 2009
it will cost you money but it's cheaper then getting it through an employer. It's definitely worth looking into http://www.coverfloridahealthcare.com/
Patte

AOL

#80 Nov 18, 2009
Yvette wrote:
it will cost you money but it's cheaper then getting it through an employer. It's definitely worth looking into http://www.coverfloridahealthcare.com/
You mean its not Medicaid?
Patte

AOL

#81 Nov 18, 2009
Yvette wrote:
it will cost you money but it's cheaper then getting it through an employer. It's definitely worth looking into http://www.coverfloridahealthcare.com/
don't you need to be employed?

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