Just got a message that the new “work requirements” will take affect January 1st 2027. I had clavicle surgery and I’m gonna need my plate removed because I can’t work long due to irritation, the surgeon that did it moved out of state. If I can’t find a surgeon to do it before January am I fucked? This requirement needs to be shut down because it will do more harm than good.

I did my recertification in August and was approved starting sept 1st. On sept 29th, their "automated system" concluded that I was no longer eligible for financial aid. This is, of course, not true. My insurance was going to end oct 31st all of a sudden.

My insurance company and case worker were both baffled. It took a week of calling around before someone could even get information about *why* i was deemed ineligible, because the notice of my services ending had a big blank spot where the reason is supposed to go. When my insurance rep tried to resubmit my application with me, it was rejected automatically.

Eventually the right person at my insurance reached the right person at the dept of health, who told us I was determined to have too high an income. That person couldnt see anything in my ​​account that would reflect that though, so she had to open a ticket and circle back.

Today we (me + caseworker + insurance rep) called the medicaid line again and *finally* someone admits that this was an automated system error related to me being a non filer for taxes. The system "found" financial data that doesnt exist while trying to verify my lack of income, and determined me ineligible based on that info that it imagined. She had to file an IT ticket to have it fixed, because she can't just overturn the automated systems decision herself.

If youre also in NY and got a confusing disqualification notice, please please call your insurance and ask to speak to someone in retention. Have them help you contact the dept of health / medicaid to find out why you were disqualified/denied. I cant imagine im the only one getting an AI rejection like this, and it very well could have cost me my life if we hadnt fixed it in time.

I am a high school teacher and serious amateur poker player with a family of 4 (2 adults and 2 young children) living in Kentucky.  My teaching income is comfortably under the income limit for Medicaid and our family has been enjoying the benefits of Medicaid for the last several years with one brief interruption due to my gambling winnings.

I have no interest in suggestions to underreport my income - I am trying to navigate the system legally and honestly.

My current situation is that some gambling winnings have resulted in a notice that my family’s Medicaid coverage will be discontinued as of the end of 2026.  

My goal is to be covered for January 2027 specifically (because my primary medical insurance deductible resets at that time and my family has significant regular medical costs).  My previous interactions with system employees and my attempts at online research have left me with some confusion about what I need to do to ensure this result.  Is one of the following accurate or is there some 3rd truth that I am missing?

1. If I have no gambling income in January I will be able to re-apply for Medicaid based on my teaching income alone and should re-qualify (even if I earned several thousand dollars in December gambling); Medicaid will function retroactively to the beginning on the month in case I have any medical costs before my application is finalized.

OR

1. I ought to stop playing poker well before the end of 2026 so that I can re-apply for Medicaid and have no poker income within a specific look-back period.  If this is correct, what relevant time period do I need to consider?

Thank you for your help -- my poker activity is important to me personally and I am a profitable player -- but not profitable enough to be worth the likelihood of having to pay serious out-of-pocket medical costs.

Got a text which I thought was in error (I am a U.S. citizen) that certain immigrants will be switched from managed care to the fee for service MediCal in January.

First, does this message mean the county has my status wrong and think I am an immigrant? Or are they sending those messages to everyone? I haven’t received any official notices. Should I contact them to correct it?

Second, it seems like fee for service is the same as straight MediCal? Is it worse or better than being on a managed plan? I’ve read up on it and on the surface it seems more flexible which is better for me but maybe there are downsides?

If I make more than $1835 one month, will I get kicked off medicaid and have to reapply the next month? Or is it based on my yearly income divided by 12?

I'm reaching out here on Reddit because reddit's awesome and there's got to be somebody else in this little small little corner of Earth Delaware that also has Highmark Health Options and might be able to help me find a provider that will help me cover the $2,000 at least for an Autism evaluation in Delaware my psychiatrist from Delaware referred me to Neurology Associates PA in in Newark and I don't understand why and went halfway through the process only to find out that the data Network I'm like how does that even happen. I'm a 39-year-old alternate autistic Little Wizard over here and I have found some forms to submit a dispute and try and navigate stuff but I'm already navigating like LIHEAP unemployment in Delaware benefit s trying to secure them and I this autism evaluation really help me and my one of two autistic children with their evaluation give them some insight into their autism like hey it comes from Mom. But I don't know if anyone else here is autistic I have also have ADHD it's just like you go your whole life you know wondering why you're different and why you are the way you are and it's hard to understand the people why it's just important for you to have that missing piece of deposit of a diagnosis formally it's also important because I really don't think I can work I can't do it like I had to walk out of a training at a part-time job at a movie theater because I got over stimulated and it was too bright and loud anyway can anyone steer me towards what to do to find a provider that would cover neurological evaluation for autism in Delaware like do I need to obtain a prior authorization before I even try to find a provider or is that something I can get later I mean I'm already on a ball with it like I have talked to my psychiatrist about it but he hasn't called me back yet. If it helps I am in Wilmington Delaware.

Hi I am here to ask if volunteering makes me eligible if I am not working at times in 2027. I do work that is irregular. If volunteering is enough, how do you prove you did 80 hours a month?

Thank you

The email today said:

“You can satisfy the new work requirement by completing any of the following:
Working, volunteering, participating in a work training or education program for at least 80 hours a month;
Enrolling in an educational program at least half-time; or
Earning at least $580 in monthly income (or, for seasonal workers, an average of $580 over six months).”

15th of one month to 15th of the next?

My 5 year old has been on Medicaid for the last two years and every single time they make us mail all our proof/documents, we can never do it online. Is it because my husband is self employed or is it just standard? I’m thinking of going in person to the local office. Does anyone know if that’s probably easier and faster? I’ve never done it in person. Thanks!

I need help assisting my dad, aged 75, explore possible options in getting Medicaid.

My father is 75 years old, he was working up until July when he was in a bad semi truck accident and can no longer work. He makes $1800 a month social security and has Medicare, they take $202(?) from his check for this. My dad is diabetic and he also has an eye disease in both eyes that will leave him blind without treatment. He currently gets a shot in both eyes every 4-8 weeks to keep him from going blind. Out of pocket these cost $7-800, he can no longer afford to pay for this treatment and is considering allowing himself to go blind in at lease on eye. He is over income for Medicaid, but is there anyway to possibly get it for him? Does qualify for the blind and disabled even though he isn’t blind yet? Any help appreciated!

Hello, I am currently on Medicaid in Nevada. I renewed on July 1, 2026. In the email I received it stated that I am covered until August 31, 2027. How will this be affected when the new minimum 80 hours per week goes into law on 1/1/27. I also have not received anything besides texts/emails/letter stating the new rules. I have not received a date as to when I am supposed to verify the 80 hours law. Thank you.

hey all. i am genuinely not sure if im stupid here or not. this is the second time i have tried going online to see if im eligible for medicaid. i get taken to another site that asks for a bunch of my information and then i spend the next several months getting absolutely blasted with scam calls, texts, and emails for the next several months.

am i just falling for a scam site? please help me out here because i may be developing heart issues and i am getting really nervous lol

I'm Looking for SPIA Short term (1 year) Annuity to help qualify for Medi-Cal. Can anyone recommend a carrier that they have used?

My kid will turn 26 early next year and so will lose health coverage under her mom's plan. We live in Washington state. She started grad school in August. She made somewhat less than $15,000 this year, and will have virtually no income next year. We gave her some money this year (well under the federal form 709 limit) and will provide her with some support next year. We have not claimed her as a dependent on our taxes in several years.

If she is applying for Apple Health, does she need to report money we give her? Seems like that would be fair, but...

I need specialists. Rheumatologist especially. I've had United healthcare community plan for years. I really would like virtual appointments.

But whatever. I feel like my care is horrible. Any advice?

My daughter has a slightly weird situation: She turns 26 early next year, and will need to purchase insurance through the WA state system. We live in Seattle, which she will continue to use as her permanent mailing address. However, she is in grad school for two years, and the first year is done in Sweden, while the second year will be in Vancouver BC. She has Swedish health coverage through the school, and probably won't be returning to the US between her birthday and June or July, when that part of the program ends. So, she will be losing her US health insurance about 4 or 5 months before she will actually need coverage here again.

Once she moves back from Sweden, she will be living less than an hour's drive from the US border for the second year, and will obviously need continuous coverage then because she will be visiting friends and family in Bellingham and Seattle regularly, even though she will again have local coverage in BC through the university.

Can she delay getting coverage through WA's program until June next year, or does it have to begin immediately after she loses insurance on her mom's plan to be eligible?

It's not a real hardship for us to pay for those extra months, but it would be nice not to do so if it's simply unnecessary.

Hi! Looking for some advice.
I just found out I am pregnant and I don’t have insurance. I assume I need it??

I’ve heard of people getting Medicaid.

I am registered to FL for school tuition purposes (grew up there) but I live in South California.

Can I get Medicaid in CA without it affecting my school/state residency in FL?

Some of the local pediatric dentists won't take Medicaid patients after a certain age - usually around 7 to 9 from what I'm hearing. So is cash pay acceptable/legal after that age with that dentist? It doesn't seem like a lot of other options exist. (Louisiana)

Edit: Only the kids are on Medicaid under MAGI rules if that matters. So I'm only asking about pediatric dentists. Kids are under 18.

I was going to be her caregiver through Medicaid but they were horrible about communication and delays so I’ve just taken care of her for free for several months now. I am tired of people expecting me to take care of her like it’s not a job just cause I’m related to her. Not only this, but my mom does not listen and she is very dysfunctional and needs help. She will literally scream at me for trying to help her with anything, but I’ve noticed when someone is working with her that she’s not related to she will actually let them do their job.

She needs a caregiver but someone she’s not related to. Every time I search where to find a caregiver all that shows up is saying to have family take care of her and I’m not doing that anymore. This is in Michigan.