For starters I am located in Arizona, some other factors are subject to change, which is the point of this post.

My girlfriend and I have always assumed we’d never be able to get married bc together we would make too much. We had come to terms with that a while ago.

However, recently, my mental and physical health has gone so downhill, I’ve been in the ER 6 times in the past 2 months. So safe to say even if I could find a job (which has been utterly impossible) I truly doubt I’d last more than a month.

So, we have been surviving purely off of her income and I’ve essentially been a housewife (which for her I don’t mind at all lol) which has lead me to wonder if getting married would actually benefit us (besides obviously wanting to marry the love of my life, this isn’t purely financial, we unfortunately just have to consider the financial side as well)

Here’s my thoughts and my understanding of how we would fit into the Medicaid requirements for a 2 person household and the benefits it might give us.

Before taxes, she makes about 2k a month, I make… absolutely nothing. So our combined income is under the 2 person limit of about $2,399. She technically has two motorcycles, but one is our primary transportation, so I believe that should be exempt. The second I’m not sure how to count it. It was shipped to her and she paid 3k, so idk if it would count how much she got it for and consider the absolutely unridable state it’s in. or if it would only consider market price.

My other concern was with the new work requirements. I don’t think the government would believe I’m “disabled enough” to make me exempt from this 80 hour thing, at least not without a lawyer which I can’t afford. I did however read that spousal income counts towards the alternative $580 a month. Her income would cover that easily.

My last point is that my girlfriend has insurance through her mom, but as you can imagine, it doesn’t do shit. I was thinking that if we, as a two person household, fall below the income limit, that she could also get on Medicaid. She has a lot of health issues that she frequently ignores bc she can’t afford the medical bills and I thought this could help.

So basically my question is, is there anything else we need to consider before we truly get think about going through with this?

Hi! So I’ve recently been having to go to the ER frequently and have had to use an EMS a few times. The first few times, my Medicaid covered it. The last month or 2 they have said my Medicaid is no longer active and bill me out of pocket. When I call the Medicaid resources they say my policy is still active, and I’m using locations that say they would accept this insurance. I’m super confused on what I need to do. I’ve called 211 and they say since it’s a foster program they don’t have information for me other than the policy is still active. I’ve asked numerous times for a new insurance card, I’ve called to change my address just as many times (at least 5) and it’s never been updated, nor will they send me a new card. My foster mom kept my card and won’t give it back to me.

Who do I call to get this resolved if it can even get resolved? I can’t afford these medical bills and I’m so frustrated for not going to the doctors sooner to handle this as I was under the impression I didn’t even have insurance until 4 months ago. No one told me it lasted until I turned 26. I’m 24 now, so I should have two more years.

My ER visits are due to intense anxiety that has resulted in extreme GERD. Now my anxiety is worse hearing and receiving all the bills I need to pay when I allegedly have insurance and only go to places they cover.

If ANYONE has experience in a similar situation I would appreciate hearing their input, whether insurance ended up covering it or not. I’d rather hear a hard truth than continue wishful thinking (shouldn’t be wishful.. I should literally have coverage).

Due to job loss my income has been very little (~$500/month), so I enrolled in Medicaid starting in December of last year. I'm due up for renewal as my coverage ends at the end of this November. I would be fine with reapplying to Medicaid, but the problem is my income will jump dramatically (~$30-40k total) in calendar year 2027 due to projected stock sales, so I will no longer be eligible for Medicaid.

I will have a 1 month gap between my Medicaid coverage ending (November 30, 2026) and projected ACA coverage starting (January 1, 2027). I haven't applied to renew Medicaid yet, nor have I applied for ACA coverage yet. I'm trying to find the best course of action to be covered for this December (whether that be under Medicaid or ACA plan), but also insuring that I will transition smoothly to an ACA plan starting in January 2027.

Regarding Medicaid, I know that I'm not supposed to report any income changes until the event actually happens. So, I'm not sure how to switch plans before I actually sell stocks in 2027. I don't want to be on Medicaid starting in January, as having $30-40k in annual income will cause an audit and likely clawback issues.

I live in New York State

I just got Medicaid. Next time I see the dr do I just give them the card or do I need to get a medical insurance company that's part of Medicaid before I see the doctor.
My husband and I are 62,I’m disabled and we have two disabled adult children.

I've seen a couple folks on this subreddit claiming that Medicaid eligibility is determined on per month income (1.38*$15650/12=$1799). Or is it per year ($21597)? I tried Googling a bit and federal documents suggest per year, but maybe it's different state level? Does anyone have links to NY State docs they could cite? I want to have my case clear before I call the city number. Per month income would make me inellegible, but that's only during the school uear when I teach at the college.

Detroit, Michigan
So this is going to sound complicated. So I used to be on my mom’s food stamps and Medicaid benefits like 3 years ago. Then I got a part-time job and removed myself because I wasn’t eligible for Medicaid anymore. I still live at home with my mom. I tried applying for Medicaid myself and I still got denied because they said I was earning too much. Jump to now where there are work requirements for Medicaid. The mail came with an application from the department of human services to renew benefits and about Medicaid benefits asking the questions if anyone is going to school, had a job, medical condition or disability. It came in my name and my mom and my brother is listed underneath my name. Also when I did my taxes this year I claimed them as dependents. Is that why the letter to renew benefits came in my name? Will I be able to qualify for Medicaid now because I still have a part-time job? I’m just so confused on how to fill this out. Why did this come in my name if I separated from my mom?

A new state auditor report says the Department of Health Care Services is at substantial risk of making improper Medi-Cal payments, pointing to 26,000 high-risk-scored providers that billed at least $12 billion and were never researched or investigated. It also describes a one-van transportation company that claimed 35 riders in a single day. The department strongly disagrees and calls the report incomplete.

👉 Read the full story on The Southbound 105 →

(x-posted to r/SSDI)

I moved to a new town about two and a half years ago, and the same week I moved I reported the address change to the state in person. Last year my redetermination was sent to my current address, and I returned it with no trouble.

The house I moved out of two years back is unoccupied. The homeowner lives across the country and only comes back a few times a year to check on renovations. A couple of days ago, she notified me that I'd gotten some important mail at that address that she forwarded to my current address.

One letter dated 9/3/26 said my Medi-Cal was renewed for the next year as of 10/1/26. The other letter came dated 9/16/26 saying my Medi-Cal would be discontinued as of 9/30/26 for failing to provide proof of property. I have not gotten a redetermination request. Furthermore, there's absolutely no reason to be sending mail to an address I reported not living at.

I tried calling my worker, but never in my life have I met or spoken to this person. They have never returned a call or corresponded with me directly. I'm planning to go to my local office in person on Monday and try to figure out what's going on, because I can't get through to my local office by phone either. I'm still within the cure period so I shouldn't get cut off completely, but if I hadn't been told about the misdirected mail I might not have even known about this until I reached the point of trying to get healthcare and being denied.

Are other people having this issue? Do you know of anyone who's experienced this? Using obsolete contact information for redeterminations, I mean?

Since taking up caregiving duties for elderly family members I've been self-employed. I've managed to keep the income up enough to be in the Pennie with subsidies band, and have a Pennie plan I'm happy with now.

I can foresee needing to forego more income in the coming years as care needs increase. I'm concerned that I may find myself going above and below eligibility lines on a monthly basis. Reading here, that seems to be a giant headache of getting kicked off of one onto the other and constantly applying back and forth.

Would opening a solo 401k and funding it monthly with any excess income above the Medicaid line be a reasonable strategy to keep MAGI eligibility and avoid the headache?

Hello, I am in Florida and was recently given a notice for a fully favorable decision for Disabled Adult Child benefits. I previously received Survivors Benefits when I was a minor as a dependent of my deceased father, and he is the wage earner of my claim for my DAC benefits, so I have a rough estimate of how much I’d be making monthly, which would be no more than 1600 a month.

I know DAC comes with Medicare, but I want to know if I would still be eligible for dual coverage with Medicare and Medicaid. I currently am on Medicaid, and will not be making any other income besides what I will make in SSDI. I am 20, turning 21 soon so I am about to age out of children’s Medicaid anyways. I wouldn’t be able to afford the Medicare copays for my medical bills either as my rent is around the same as my monthly income and I’m waiting on my grandfather to move in with me to split the rent with. Would I be able to qualify for dual coverage?

Indiana Rant/Advice wanted- i’ve been on Medicaid for 7 years now. I quit my retail job in 2021 because I’m disabled with chronic pain due to genetic spine problems and could no longer stand for a 5 hour shift. I also tried an office job but even that was too much physical labor for me. At this point even standing for an hour would most likely leave me in tears and unable to move for days afterwards. Since 2021 I’ve applied for disability 4 times, twice with a lawyer, and was denied every time, the most recent denial was just earlier this month. I actually didn’t even quality for disability benefits anymore, only SSI, because I haven’t worked in the last 5 years. Because of my disability. anyways….
In 2019 the state of Indiana sent me a letter declaring me “medically frail” but now that the new work requirements are coming out, I’m not sure if I am exempt or not because, big surprise, there is no definite guidelines on what constitutes a person being declared medically frail. I’ve been applying to places that I think I might be able to handle in a panic, but nobody wants to hire a person who hasn’t worked in 5 years. I signed up for DoorDash because I worked for them in 2019-2020 and I know I will be able to at least meet the 20 hour a week requirements with them, but I know it will cause my body to be in even worse absolute agony than I already live in.
These changes have honestly made me want to give up completely. But I need this insurance. I have 2 therapy appointments a month, at least one pain management appointment a month, and an average of 6 primary care visits a year, not to mention my thousands of dollars in prescription medications per month. I’ve had to visit the ER twice this year. And even better, my parents who I have to live with both lost their insurance through the ACA this year after it went from $30 a month per person to $300 a month per person. My mother is disabled with a similar spine problem to mine and cannot work either, but can’t get any insurance or disability because she is married. I’m at the end of my rope and honestly feel completely hopeless for any positive future.
What, if anything, can I do to figure out if I will be exempt from the work requirements? When I tried calling FSSA after getting my letter, the message said that they couldn’t answer any questions about the requirements and to check online, but none of what is online helped me either.

I did not have a job so got free insurance through NJ family care and United Healthcare. I started job and got first paycheck in June end 2026. Since then I did not use any medical service. Around July end I informed NJ family care about my income and to end my free insurance. They sent me a letter requesting paystubs to verify my income change. I haven’t sent them yet. I called NJ family care before few days and they mentioned they are still waiting for the paystubs and the coverage is active. Is it wise to use any medical service or wait until the free insurance coverage gets canceled? Thank you

My sister 24F has been disabled for 2 and a half years now. Due to complications with type 1 diabetes she is now quadriplegic, has a feeding tube and had a tracheotomy. She just became eligible for Medicare 2 months ago and was previously covered through a market place insurance we paid with her SSI. Since she became disabled I applied to Medicaid and she was temporarily covered while receiving SSDI but it was terminated once it was transitioned to full disability payments. But her Medicaid remained active just now as a Planning for Healthy babies plan that only covers gynecologist visits. When I brought this to the attention of Medicaid they had me fill out a paper form 700 to get it corrected since the online system didn’t allow online applications since she technically had a Medicaid plan. After over 5 months of review she got an updated letter saying Medicaid would be canceled because she is not pregnant, nor disabled and in a nursing home. Is there anything I can do? Medicare coverage has not really covered much it doesn’t even cover her diabetic insulin and the Plan C plans offered had a deductible of $5600 before they cover.

Hello from Georgia. We're a family of 4, two teens, two adults. My partner and I (not married) barely make over $1100 on a good month and that's even pushing it. We both work 1099 positions (delivery) and that's how much we're both taking home combined after gas and auto insurance (expenses). My oldest just turned 18 (this might be valuable information later) and works as needed after school child care and some weekends if the parents give her a call. She barely makes $300 a month before taxes and even then it was meant for her to save for college, not for food, rent, or any other household expenses. The kid's biological father is out of the picture and barely contributes to child support so I've only reported that he's supposed to pay and specify to the case worker(s) that I don't receive anything from him. Besides, they can see on their end when the last time was that he paid anything (for the sake of this post, he's ordered to pay $600 a month). One piece of info that's important is that I'm disabled and can't work but working deliveries and pushing through symptoms because I was told I wouldn't be eligible if I'm not working.

So I'm about to pull my hair out. It doesn't make sense to me that my case worker would completely close my case (both Medicaid and SNAP) even though I've uploaded all the documents she requested. When I get a notice for termination it says "a member of the household refused to provide documentation (something or other)". I've gone to the office myself a couple of times since no one is available when I call the 800 number. They just told me they'll let my caseworker know. I eventually get a call from her but she says "I keep trying to reach you and you're not answering the phone". I wish I could have had that recorded because my call history doesn't show any phone calls from her since the last time I spoke to her. This has been going on back and forth since July 1st. After talking to her 3-4 times and submitting everything she asks for almost immediately if not within 24 hours of when she requests, she closes my case 9/30. We now have no SNAP benefits or Medicaid. I had 3 appointments this month to get my teeth done after finally finding a dentist that takes my insurance and had to cancel all of them. I take 5 different medications and I'm out and can't afford to pay for refills. My therapist signed myself and the kids up for their grant program so we don't have to go without therapy sessions, so that's good but I'm still going without migraine meds, depression medication, ADHD medication, and meds to control tremors. I've been looking up food banks and going back and forth picking up whatever they have and making do.

Yes, I filed an appeal but that was on the 5th of October. I also emailed on the 6th with a picture of the appeal just in case dropping it off at the office dropbox did nothing. I haven't heard back so I went in and "reported a change". All of our income that was submitted was incorrect. She put down that my partner earns $1200 a month and that I earn $500 a month on top of what my daughter earns. Expenses weren't even included. That puts us way over eligibility for sure but none of it is correct. I printed out the pages and went ahead and made corrections to income. I got a call the next day but this time (THANK THE GODS AND GODDESSES) it was the caseworker supervisor. She asked for a new disability letter and I let her know I most likely won't have it immediately but I'll do my best. This was 10/9. I received an email that she's going to close my case because the requested documents were due 10/1. That didn't make any sense to me since we had just talked. I got any new documents she wanted plus the letter from my doctor together and submitted them on 10/13. I haven't heard back from her since or anyone else.

I'm so lost because why is it that I wouldn't be approved when not only our income level is below FPL as noted in all relevant policies and still have our case closed even though I provide everything PLUS both of my kids are under 19 and they lose their healthcare coverage, too?? In the past, if I'm not eligible, at least the kids are but now they took their coverage away as well.

I guess I just needed somewhere to vent but what even is the appeal process if no one is going to even touch it or update on the process? So sorry for the long post this is all extremely frustrating.

Virginia - specifically Medicaid Long Term Care coverage / application

I haven't lost NJFamilycare. I had admin renewal (automatic). The recent "citizenship proof" thing happened. I sent my paper on the special website. Got the GOOD NEWS letter on the 29th of September. October 1st HMO called to tell me my coverage was terminated. Called NJFamilycare and they say i'm enrolled. So does their automated system, which states i'm enrolled in Medicaid and Horizon NJ.

However this is my problem, both Medicaid and Horizon say my policy was terminated around Sept 29 - Oct 1st (i dont remember). NJFamilycare says there's an error between their system and Medicaid's system. Their phone agents working on my case have "escalated" my case with a medical thing (type 1 diabetic). It's been 2 weeks today and nothing has changed except that my case is pending review. I applied for presumptive eligibility, but the doc's office claims it'll go back to Medicaid and get denied. Maybe they are wrong.

Any experience something similar ?

Nebraskans: Have you had to prove you meet Medicaid work/community engagement requirements? Or lost coverage?

Hi everyone, my name is Arielle Zionts, I'm a rural healthcare reporter at KFF Health News, a national, nonprofit media outlet focused on in-depth healthcare reporting. I live in Rapid City, SD but travel to and report in Nebraska at times.

I'm looking to interview someone from Nebraska who lost Medicaid coverage due to the new work/community engagement requirement rules OR who kept coverage after having to take steps to prove you meet those requirements.

If you're interested, you can message me on Reddit or email me at [ariellez@kff.org](mailto:ariellez@kff.org).

I won't be using any comments under this post or elsewhere in this group, only info I directly receive from interviews.

Thank you!

Arielle

I live in Nc. I have had Medicaid for myself for the last year now with no issues. Today I get a letter stating I have to send my children’s fathers information to them for child support. He already pays it and they have this on file already. This said if I don’t provide this I’ll lose my coverage. The issue is if I do send them his information, he is going to be irrationally angry and he has been abusive to me in the past. That is why I’m no longer with him. What do I do? I can’t lose my coverage and I also can’t risk him coming after me, and he definitely will. Restraining order can’t be done because in my state they have to practically kill you before you can get one. Been there done that. This is so frustrating. I just don’t understanding the needs to be involved for myself to receive coverage. I work full time but my job doesn’t offer insurance. When I apply on the marketplace I guess I make too little to qualify for those plans also.

I live in Ohio. I know the work requirements start on January 1st, but does that mean I will be losing my Medicaid literally on January 1st or will it be during my next renewal or something? My renewals are usually in October.

I'm trying to figure out how much time I have to get all of the appointments and things I've been putting off done.

Yesterday I got a letter in the mail saying my Medi-Cal coverage would end on 11/01/26 because I essentially "make too much money". But I'm currently unemployed & the only income I have is from unemployment. & that monthly total doesn't even cover a fraction of my bills. How am I supposed to be able to afford healthcare if I can't afford food. I have several chronic conditions that need consistent management and without health insurance I am completely fucked. I'm really stressed and I don't know what to do

Hello! My partner and I live on the eastern shore of the Chesapeake Bay – she lives in Maryland, and I live in Virginia. She will undergo total knee replacement in a couple of weeks, and the plan is for her to rehab at my house (it is a much safer environment and more suitable for rehab) in Virginia. She has Maryland Medicaid (Blue Cross Blue Shield) and we are having difficulty finding a physical therapist within Network in Virginia. Physical therapy is a necessary component of total knee replacement, and the recovery time can be weeks or even months long! Our houses are about 50 miles (75 minutes) apart and the state line separates them. i’ve called our two local physical therapy centers and neither will take her insurance. They say she is out of network.

Do we have any options for using her Maryland Medicaid in Virginia?

Thanks for any advice/information!

Why do I need to provide this information? Will I be denied if I don't? This is for re applying for medicaid for myself not her. I do not work right now. This isn't disability medicaid.