Would a very, very poor person qualify for medicaid in America now?

Low income is not the only qualification for Medicaid at present, the person also has to be in one of the defined qualification categories, i.e., pregnant, a child, certain disabilities, elderly. And after the first of the year, it depends on what state the person lives in: it will apply to the poor in states that are participating in federal Affordable Care Act, but not in states that opted out (mostly in the South).

@zenvelo may I ask if she is not in that qualification, is there a 0 payment option for her? Her circumstance is extreme poverty, I believe.

There are 22 states that have chosen not to expand Medicaid.

In Florida, where I live, one must be a child, or the custodial parent of a child, or elderly or disabled or pregnant, and be living within 22% of the federal poverty level in order to qualify for full Medicaid. That is, basically, pittance.

Up to 125% of the poverty level (or something close to that, can’t remember exactly) one can be “covered” by what is called “Medicaid for the Medically Needy” or colloquially the Share of Cost program.

The state determines how much your Share of Cost is. Once you’ve paid your Share of Cost in medically related bills, Medicaid will cover the remainder of the month for you, provided you use a participating physician.

Ignoring entirely the fact that I have NEVER found a physician that accepts the program outside of an emergency room, and the fact that it doesn’t cover prescriptions or eyeglasses or dental care…

I’m bringing in about $1000 a month in unemployment benefits since I lost my job. My rent alone is $600 of that, which doesn’t include any utilities. My “share of cost” for a family of three, one of whom is a 5 year old, is $2000 per month – PER PERSON.

So, they can claim we’re “covered” all they want, but it’s total bullshit.

I think she should contact Komen and see if they can help her get free care for the diagnostic stage at least. Free mammograms and sometimes other diagnostic methods for breast cancer are funded by charities. Her state also might have a program for free mammograms or very low cost. You can try googling free mammogram and her state.

The one draw back is once diagnosed if God forbid she has cancer, she is now pre-existing if that might affect her getting insurance in the future. With medicaid I don’t know how that works. Medicaid she will have to apply and wait. If a charity can point her in the direction of free mammogram or even very low cost that will likely be faster. I know I have seen them advertised as cheap as $50, but if she also needs an ultrasound or other things done that could add up.

This is breast cancer awareness month and many diagnostic centers run deals and communities do outreach programs.

^^ what?? she has already had breast cancer in the other breast. I thought the whole point was to not deny pre-existing?? Add up?? Is the affordable care thing not implemented? Is there not, yes or no, a thing where you go to the doctor, get treated, and leave, 0 money? I am sorry I am in australia and alot of the websites I am trying to see seem to be shut down or not working??

As far as I know they are getting rid of or maybe have gotten rid of pre-existing obstacles, but I don’t know for sure, so Injust mentioned in case it might be a problem. Just something to consider, research. If she already had breast cancer then she might be considered preexisting anyway. I think the old rule was 6 months.

Anyway, my link will really help her I think. If she has had breast cancer she might already in the breast cancer community and might have someone from her previous treatment she can reach out to who can help her.

thank you so much, @JLeslie , actually she is quite isolated and is in no community that is why I am trying to gather info from here. I will relay what you said, thanks again.

Let us know if she finds the help she needs. I hope it turns out to be nothing.

@Seek_Kolinahr are you sure not saying you have anything mistaken I am absolutely dumbfounded did I read that right? Did you type that right??

@trailsillustrated Much of the Affordable Care Act is no yet implemented, people are just now able to sign up for it, but are not yet able to take advantage of it.

@JLeslie had a good idea; I’d recommend reaching out to the local Planned Parenthood office for a mammogram and other tests.

Just reread. Yep, I typed it right.

@Seek_Kolinahr Doesn’t FL have a special program for children? I don’t think it has to do with income level, it is just to make sure children have access to medical care. I’m pretty sure my SIL used it when she didn’t have insurance. But, it was many years ago, and I might have it confused.

Yes, it’s a state insurance program. Healthy Kids.

It’s a monthly premium thing. Ice done the math, and for my son it doesn’t make sense to be on it, since he doesn’t need regular doctor visits or prescriptions. If he’s ever seriously sick, his pediatrician charges more for annuals and checkups so he can offer a reduced rate for sick visits.

Healthcare.gov is the place to look for options under the Affordable Care Act. The options vary by state.

Each state is different. You may see if her state has an Office on Aging or Senior Services.

Wait, is she a senior? I assumed she isn’t.

Pre-existing conditions are covered as of January 1, 2014 (mostly).

She would likely get a voucher to cover most of her premium on the marketplace, but those policies do not begin until January 1, 2014.

You are correct about the websites – a combination of poor programming, high traffic and the government shutdown. They will hopefully be working soon. I have yet to be able to successfully log into the NYS website.

Several states, mostly in the south, have decided not to expand Medicaid. So these states WILL NOT have a ACA available to all people. NC 500,00 citizens with no health insurance

@JLeslie she is 55 I would consider that a senior for health care purposes.

^^^ You may consider 55 is old, but that doesn’t mean her state agrees with you. It might be helpful to google her state’s rules and regs regarding health benefits. They should have some statistics and information. You can follow up with more specific questions. Check ( State) Social Services for another likely source

@trailsillustrated What I was getting at was if she was a senior by medicare rules, she would get medicare assuming she has worked more than 10 years of her life. Elderly and senior when talking about government programs is usually 65, but some benefits can kick in a little earlier or older, healthcare is 65.

Thank you so much, @Sunny2 I have tried all that but for some reason alot of the websites I am trying to access aren’t working or something. I don’t know why someone on the other side of the world has to do this for her, but whatevs. Thanks, all.

Has she told you if she actually applied for benefits? If so, what did she apply for? Those would be my first few questions for her. If someone tells me something that I am cynical about, I would want specifics.

If she got Medicaid, they do have deductibles, but very minimal ones.

I can tell you that rich people hide their money legally through the services of attorneys and then they qualify for, and receive Medicaid.

As a Medicaid worker, I went to some incredible homes (mansions) with incredible features, on incredible properties in one of the richest counties in the country and these people were, on paper, impoverished, yet receiving Medicaid and all of the wonderful services that come with it (live in home health aides, etc.).

What state does this person live in? All the guessing is kind of pointless.

She lives in Oregon, I keep telling her to go online and apply. Thanks, all.