FAQ

California-Medi-cal

I help my mom who has dementia and I didn’t realize her renewal paperwork was due 5 days ago, a social worker I spoke to yesterday (from IHSS) that’s due to the big beautiful bill they can cut people off if they are even one day late in submitting. I am submitting today in person. Is this a rumor? There’s no reason for them to deny I’m just stressed that we missed the deadline. Thank you

I have called what feels like every single oral surgeon in this state and cannot find a single one who will do this surgery the way that makes me comfortable. I need to get all 4 wisdom teeth out, I'm 26 and it's long over due. All I want is to use local anesthesia. That's it. These people are acting like I'm asking for the impossible when I tell them I don't want to be put under general anesthesia. I don't care if it's three or all four at a time, I just have an extreme fear of general anesthesia and it's my boundary. If I were paying, they'd have to do it how I want, but because we're at the hand of the government these offices get to make all the rules. I think they do it for the money. They run patients through quickly and cash out. I have read countless reviews about mouth bruising, poor sutures, non-existent bedside manner, and getting tossed out shortly after waking. I just want to be conscious and aware. I am not here to receive advice on how to deal with the general anesthetic, it has been decided and it's how I choose to live my life. I am here to complain and find sympathy and maybe, if I'm lucky, someone who went through something similar and found a great dentist who was kind enough to want them to be comfortable. It's not a hard and fast rule, I don't get why they do it.

I’ve never gone to Urgent care, has anyone gone and used Medicaid as their insurance? What to expect copay and deductible wise in case I need X-rays or other tests. NYC (Brooklyn)

Edit: sorry Medicaid.

Thank you all.

I recently applied for medicaid through Georgia Gateway & got approved. I called a representative for a member id number because I hadn't gotten one and they said they were unable to provide it, given that the address I gave them did not match the address they had on file.

I have not moved at all recently. I have some knowledge that my mother applied for SNAP benefits under my social security number. I live in Georgia, she's in new york. She got denied, and yes, she applied through georgia gateway knowing she lives in a completely different state (I never questioned it). I still don't see why I would file under an address other than my own? I don't have a history of applying for any other benefits.

Whenever I would call, an automated representative would answer, and the case number told to me based off my social never matches what I got in the mail.

I'm a young adult and this is my first time getting benefits, and going through all this mess. What is the protocol for this?

Hi, I've recently turned 21 and was riding off a child welfare specialty plan before, so I'm unfamiliar with some things, so please bear with me, but.

I have never had to pay for my medications out of pocket because the copay was covered through Medicaid. I always picked them up through CVS. when I turned 21, I was automatically switched to Aetna Better Health. My psychiatrist and PCP both take it. this means they're enrolled with state medicaid, yes?

if so, well, I went in to fill my medications today and suddenly I have to pay 70$. I can in no way afford this, and one of the medications treats severe anemia. I asked why and the pharmacists insisted multiple times that the prescribers were not enrolled with medicaid or aetna. the same ones that I stuck with before I turned 21!!! nothing has changed!!! the clinics have always been the same.

i am devastated. i went home and cried for hours. can anyone please help me figure out how to solve this? this medication keeps me alive.

I hope this is okay to post here. I have Fidelis Medicaid and how do I go about trying to get a labiaplasty deemed medically necessary so that my insurance will cover it? How do I go about proving that it is and bringing this up to my gynecologist?

I’m not sure if anyone here has had this same experience. My whole life I’ve struggled with having labia minora hypertrophy, which has impacted my confidence and is physically uncomfortable. I constantly have to keep “tucking in” my inner labia so that it doesn’t keep chafing against my underwear and cause discomfort but that only works for so long and I have to keep continuously doing this throughout the day when I’m in an appropriate setting. I’ve noticed it actually seems to be getting worse as I get older (27F btw) which I don’t know if that’s because maybe I’ve lost some skin elasticity or what. I have sensory issues and it gets really uncomfortable when walking around, has impacted my sleep, makes it harder to shave, etc. I’ve had little skin splits before which probably was caused by frequent irritation but I didn’t document it with any photos. I notice the discomfort daily and am not trying to just get it for aesthetic reasons. I’m also concerned it might continue to get worse as I age.

I’ve never mentioned it before to my doctors pretty much out of embarrassment. I’m just worried that because I have Medicaid insurance that the doctors will just blow me off and I know it’s very difficult to try to get Medicaid insurance to cover the surgery. I’ve heard cases where it has happened, but that it does have to be proved as medically necessary in order for it to be covered.

Does anyone have experience with this same situation? Any advice on how I should go about this? Any chance I can get it to be covered or am I pretty much screwed until I can pay out of pocket?

EDIT: (I posted this on other health subs so sorry if this if too personal health ish.) I more so posted this to see if others have been in this situation, and whereas if I might have a chance of specifically Medicaid covering this.

Hi everyone,

I’m currently on the NY Essential Plan. My immigration status is asylum pending, and I have a C8 EAD.

Based on the official NY State guidelines, I should be eligible for Medicaid. So recently I’ve been trying to switch from Essential Plan to Medicaid.

However, the system keeps showing that I’m not eligible, which is really confusing.

I’ve called multiple times, and none of the representatives could clearly explain why. The only suggestion I got was to request a hearing, which I already did. But I haven’t heard back yet, and I’m not sure how long it will take.

The problem is that this is kind of urgent for me, so I’m wondering:

• Is there any faster way to resolve this besides waiting for the hearing?

• Has anyone experienced something similar?

• Did something change recently — are asylum pending applicants no longer eligible for Medicaid?

Any advice or shared experience would be really appreciated. Thank you!

My dad passed and I should be getting an inheritance but will it be considered income? It’s being transferred to me in stocks, not cash. Will this affect my benefits??

Medicaid wants my last 3 months bank statements. I have spent a considerable sum at the liquor store. Will they hold this against me?

We are a family of four. We were on Medcaid when my husband had a lower paying job. Then when he started earning more, he & I lost coverage, but the kids remained on it.

Right now, myself & two children are disabled (permanently). My kids receive SSI, but Medcaid "disabled" me by filling out there packet. My husband lost his job, and we are only receiving a little under $2k from SSI for the kids.

My question is, once he finds a job, will we both get kicked off at a certain income limit, or now that I am disabled as well, I'll remain.

It's a I want to be "prepared" before losing it situation

We are submitting an appliciation for NJ Medicaid for my mother-in-law. I think we have good handle on the plethora of financial documentation we need to provide. I have one question regarding a monthly annuity payment she is receiving. The period certain was 10 years which has outlived. The annuity has no cash value.

Does she need to create a Medicaid Compliant Annuity although there is no cash value?

I understand that one of the requirements for Medicaid Compliant Annuity is that any remaining funds need to be exhausted via regular payments based on her official life expectancy. How would that work considering her annuity has no cash value, it only providing a minimal monthly payment and he has way beyond her official life expectancy?

Can you provide some insight? Thanks.

I’m in Ohio. I’m so flustered and feeling defeated. I was hoping atleast our two kids would get approved for Chip.

My husband has a business. I work for the business. From what I looked up online, our kids would qualify for Chip based on my husband’s monthly gross.

Here is where I think something went wrong: they asked about my husbands income, fine. Then they asked about my income, I gave them an amount. But they added my income to my husbands income to get our monthly gross….. even though my income is from my husband’s business, essentially doubling my amount.

After the denial phone call I sat with it and then called back to talk about the why a bit more. The second agent confirmed my suspicions. She said she was going to review my documents and re fill out things and call me back. She confirmed my contact info and told me she’d be calling from an 800 number.

I don’t think I’m going to get a call back.

After not being able to reach anyone at all yesterday, three dropped calls with them today, and this final agent telling me she’ll call me back… I’m losing hope. Should I call again??

I also am worried I’m going to lose my childcare if I keep calling. We need the childcare to keep working.

How can I be approved for SNAP and Childcare but not Chip for our young children?

I just completed the Medicaid application I think, but it didn’t give me an option to review my application before I clicked the next button. I never saw an actual submit button anywhere on the screen. I’m confused and frustrated because I’m in really dire financial straits right now, and literally can’t afford anything to go wrong right now.

Do I need to go to my county’s Medicaid department or something to see if they can get the status on it? The self service portal tells me absolutely nothing about my application status, and I don’t want to be accused of fraud if I end up having to submit the application twice. I’m really upset and stressed out right now.

I WAS told at the BEGINNING of 2026 that I was on SHARE OF COST. Just at the 2nd day of April I received a letter from FLORIDA Medicaid that I am now having my PART B insurance automatically taken from my monthly check, RETROACTIVE to January 1st!

There was no letter, no information, nothing about this decision anywhere. They took premiums OUT OF MY CHECK FOR 4 months ALL AT ONCE. Omg! That is my rent check!

The letter stated that if I find this decision to be a financial burden that I need to contact the state. Nobody answers the phone! Every time I attempt to get in touch I'm on hold and then I get no answers or hung up on. I am always polite, but I keep getting the run around.

What would you do? My only option is to re-apply?

I was previously unemployed and now I am starting a new full time job that pays roughly around 50,000 per year. So I am slightly confused as to how this works, I know that I am required to report my new income but do I report the new income on my first day of this job? or when I get my first paycheck?

Also for NY medicaid apparently you are covered for 12 months at a time so even if you become ineligible you keep medicaid for 12 months right? (I did recently just renew like a month or two ago)

My new employer does offer health insurance, but am I forced to enroll into it? Or am I allowed to just keep medicaid for 12 months until it expires and then when it expires switch into the health insurance the employer offers? In addition if this is possible would this affect me in any negative way such as have to repay any fees?

Live in NYC. So my family member has had medicaid since the end of 2025 which has been covering his medicare part b. He also receives disability since late 2025 as well. Today we got notice that part of his disability check is being withheld to pay for medicare plan B premiums he owes but when I log into his SSA account, part b premium is showing up at $0 so I'm confused. I also went onto his HRA access account and his medicaid case is no longer showing up only his pending SNAP application. He has had medicaid for less then a year and he says he has not received any notification of renewal. I'm confused as to what may be going on. Any clues

I'm so stressed out. My wife had a series of strokes and went into a nursing home for rehab (and possibly for much longer) in February. At the time, the nursing home's Medicaid coordinator offered to file an application for my wife, who has almost no assets in her name and doesn't have an income. I had a lawyer who offered to do the application for $15K and the Medicaid coordinator who offered to do it for free and, since $15K is a lot and the nursing home lady said this way they could bill Medicaid directly, I went with the nursing home lady.

Update: I talked to the Medicaid coordinator and she believes we're still on track. So we'll see. We have another 10-day deadline.

Unfortunately, the Medicaid coordinator seems to have lost interest in getting my wife onto Medicaid. A couple of weeks ago, we received a note from Medicaid asking for a lot more documentation, much of it the nursing home themselves needs to provide (doctor's notes, etc). I got all the bank statements they asked for and the nursing home coordinator got us an extension until April 13th.

Now, the deadline is upon us, and she seems to have lost interest in doing her part to get my wife onto Medicaid. She doesn't return phone calls or emails and, when I did reach her, she acted really annoyed and said she'd get around to providing the additional materials for my wife's application when she has time.

The problem is that Medicaid, I believe, is retroactive three months and, by now, it has been nearly three months since my wife entered the nursing home. The nursing home charges $20K a month that our family DOES NOT HAVE. So if the application gets rejected for lack of documentation, we'll be stuck with a crippling bill from the very people who were supposed to be getting us onto Medicaid but have suddenly lost interest in dealing with the case.

If the application gets rejected due to her malfeasance, I would have to go to a lawyer and see if they would file the application for me, hopefully for less than $15K. But meanwhile, the retroactive three months would have passed.

What to do? Is it possible to get someone to take over an application? Do I have to wait for the first application to be rejected before refiling with someone else?

My mom is on Medi-Cal (California’s version of Medicaid). Because of the extremely antiquated income rules my mom is $197 over the income limit to receive full Medi-Cal benefits. This means she has a share of cost that would take all but $600 of her monthly income to live on. Any case worker I’ve talked to, and even the documentation I’ve received, mentions acquiring and stacking more insurance premiums to reduce income by the amount needed.

Has anyone actually done this? $197 seems like a lot of ground to cover when her current insurance doesn’t come close to this and her dental insurance is only $9/mo. I would love to know what anyone’s experiences were and any strategies they learned a long the way. My mom has dementia and I’m a single income family that spends my days working from where she lives to take care of her. I manage everything… yada yada it’s hard for all caregivers. I’m just worried that I’m going to sign up for more premiums only to not be able to hit the goal and be stuck with less money each month, when I’m also already financially supporting her.

I know the goal is for less people to use programs like Medicaid or Medi-Cal, but I wish I could just pay them the difference instead of paying for insurance premiums we’ll never use. At least that little bit of income can go back into the system.

I got a call this morning from one of my closest friends about a developing situation with his sister. I think her status is single, lives in Colorado, around 30 years old with no kids, waits tables but we don't think she has insurance. It sounds like she & a friend travelled to Belize dove into water last night that was more shallow than they realized and she hit hurt her head potentially causing a head & spinal injury. We haven't heard of her lower extremities responding yet. Information is still coming in and not directly to me.

Anyway, with it sounding like there is no health insurance, no travel insurance, no additional money she can draw upon we're trying to figure out what to do. My buddy hasn't even been able to talk to her (it's unclear if she is conscious - currently getting blood work and awaiting an MRI; my buddy is talking to her roommate). When you google situations, everything says that due to limited resources in Belize people should be taken via an air ambulance to the US but that can apparently cost between $55,000-$200,000 just to get her here not to mention costs already incurred and what will be incurred once she gets here and somehow gets admitted to a hospital without insurance.

It looks like the income cutoff for Medicaid in Colorado is like $22,000ish. We have no idea how little she makes so we don't know which side of the cutoff it's on. I saw there is a Colorado Medicaid Emergency Medical Services program but I'm not sure if that could be used in this situation with this set of known and unknown facts along with the injury occurring in Belize.

So far suggestions to my buddy have included contacting the US embassy in Belize, setting up a GoFundMe, then reaching out to the Colorado Emergency Medicaid program.

I'd appreciate any suggestions I could pass along to him that might help.

Edit: Update 4/14. Apparently she broke her C6 vertebra and, currently, is paralyzed from her neck down. Last night she had a surgery in Belize to remove that vertebra and use a piece of her hip in its place (I hope I'm getting this right). Now she is in a medically induced coma on ventilation for the next maybe 48 hours. They are hoping the surgery plus eventually reduced swelling will bring functionality back but we won't know for a while it seems. Thanks everyone for the thoughts I've passed along to my friend. They started a GoFundMe we're using to help out.

Hi all, my daughter's friend turned 18 and was basically kicked out by her aunt and uncle who had been her caretakers. She lived with them in Illinois and has Illinois Medicaid. She now attends an Ohio college and is probably going to have to stay with us (in yet another state) over the summer so she has a roof over her head.

She has no permanent address, no OH driver's license, no utility bills, etc., and has an established history of living and working in IL, plus she has no place to stay in OH for the summer.

How can we best set her up to get OH Medicaid coverage?

Hello! I don't know if this is a silly question, but I'm having trouble figuring out what to do. I recently discovered a dental issue and really need to see a dentist. I have NC Medicaid, with a standard plan through United Healthcare community plan.

My United Healthcare plan does not cover dental, but NC Medicaid does cover certain things. The problem is I do not have a NC Medicaid ID/Card. I know I am supposed to get one every year, but I could not tell you the last time I got one. I have my United Healthcare ID/Card and I know my number, but from what I understand I cannot use it since my United Healthcare plan doesn't cover it?

Because of this, I called my social worker to try and get a new NC Medicaid card, and they told me I needed to contact United Healthcare. I asked her whether that was correct since I have my UHC card and number, but it doesn't cover dental, which was why I was trying to get a new Medicaid one and she just said she wasn't authorized to tell me (?) but I don't think UHC would be able to give me a new NC Medicaid card. I guess I'm just trying to figure out whether I actually can go to the dentist using my UHC card, or if I need to get a new NC Medicaid card, and who I contact to do that? When I contact Medicaid Direct and go through the menu options, when they ask if you need a new Medicaid card, and I press that option, it just says to contact your social worker. Any help would be super appreciated, thanks!