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Medicaid: How To Maximize Use

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Getting Medicaid is one thing. Keeping it, and maximizing use of it, is another. 

To maximize chances of keeping Medicaid, it is advisable to:

  • Know your worker, or case manager, or representative, or whatever the person's title is in your state.
    • You should have received, through the application process, the name and phone number of a contact at Medicaid to call with questions and changes. It is important that you know who this is. It doesn't hurt to periodically stay in touch with the person as well. See Make a Friend At The Insurance Company. The same advise applies to Medicaid.
  • Read your mail.
    • It is important to open and read all of the correspondence that Medicaid sends. The primary reason people lose their Medicaid coverage is that they ignore requests for information or fail to respond to correspondence sent to them.
    • Medicaid sends a lot of correspondence, including:
      • Questionnaires to be completed.
      • Advice about changes.
      • Once a year, Medicaid re-screens people for financial eligibility.
    • If you don't understand a particular letter or document, ask someone who does. Call your Medicaid Worker, or ask someone knowledgeable at your local disease specific nonprofit organization.
  • If you think Medicaid has stopped covering you, call immediately to find out why.  For some reason, in many states Medicaid has an ugly habit of just stopping. While it may seem like it stops for no reason, there usually is something that triggered your loss of eligibility. Whatever the reason, odds are that if this happens, Medicaid will notify you in a letter.
  • If you receive Medicaid because you qualify for Supplemental Security Income (SSI), even if you lose SSI you don't necessarily have to lose Medicaid particularly if the loss would be because of an increase in income from Social Security Disability Insurance (SSDI) due to inflation.

To maximize use of Medicaid:

To avoid penalties for fraud:

NOTE: It is worth checking to see if Medicaid in your state covers the cost of transportation to and from treatment.

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