Time off to travel the world, going on medicaid???

[jim555]

My original yearly estimate was correct, when the UI ran out I re-estimated based on the lower monthly numbers.  If I said nothing the plan would have continued.  So I had the option of paying around $380 with a $200 subsidy or a policy which is better for $0.  If you re-estimate the web site makes changes automatically, for me it auto disenrolled/reenrolled.

[zing12]

42 CFR 435.403(j)(3)

The agency may not deny or terminate a resident's Medicaid eligibility because of that person's temporary absence from the State if the person intends to return when the purpose of the absence has been accomplished, unless another State has determined that the person is a resident there for purposes of Medicaid.

I'm being f'd with. The one thing I didn't mention to you guys that was really shady, was that the actual medicaid denial slip said "income" on it. They said something about my final paystub in January pushing me over the limit.

Then when I spoke to them over the phone, they said if I reapplied I wouldn't be eligible either because I'm out of the country. There's no paper trail of it.

I'm going to reapply I guess, though I wanted so badly to be done with this. Hopefully I can get an answer sooner than I did last time.

I'm going to leave my enrollment in the marketplace plan for now, because I don't trust any of these people. If the Medicaid goes through I'll cancel it and hopefully that doesn't cause any issues.

[jim555]

So they improperly denied your benefit.  Not surprised, social services are a bunch of noodle brains.

[zing12]

Yeah, I reapplied. I wanted so much to be done dealing with them, but at the end of the day I can't justify paying $XXX when it seems I'm eligible for a better product for free. So I toil onwards.

Not pulling the plug on the Marketplace plan enrollment quite yet, I mentioned it in my application so hopefully that doesn't cause confusion like you suggested. I just put "I am signing up for a Marketplace plan as a backup option and I'll cancel it if Medicaid is approved."

[zing12]

My last day of work, and my last paycheck, was January 15. I applied for Medicaid on January 19 and entered only my savings account interest as income.

They declined me on the basis of "income" and I guess they are using that January 15 check as their basis. (nevermind they waited til March 14 to deny.)

Does anyone know if they should be including that paycheck in their calculation of my "current monthly income?" I have been scouring federal regulations and can't find the definition of "current monthly income." In other words, is it based on the calendar month or the next 30 days from the moment of application?

To me it doesn't make sense to go by calendar month, this would mean anyone who loses their job would have to wait until the first day of the following month. But laws aren't always rational.

I'm considering appealing the denial (found out it can be done over the phone) but I want to know if I have a case.

[Axecleaver]

The actual Medicaid income calculation methodology rules differ by state, but I've worked in 12 different Medicaid programs and I've never seen a program calculate based on prior income. It has to be what you're making today, as of the moment you apply.

This is kind of the whole point of having a social safety net and converting to MAGI rules - when people lose their jobs, they're eligible for Medicaid by virtue of no longer having income.

[zing12]

Thanks. It was very strange how my denial went down. I talked to her on the phone and she said "we denied you based on the income in the pay stub you uploaded, but I wanted to talk about your trip abroad...." I was more interested in what she had to say on the trip abroad as well, because I figured I could easily resolve the income thing later on. So I never asked about it. Then they told me I was ineligible based on being abroad.

But now that I've done my own research and I don't think there's a true reason to deny me based on me being abroad, I think if I appeal the "income" rejection, I'd be good.

I also made a new application and have been trying to get through on the phone line. It's impossible to get a hold of them. I'm giving it a week, then sending in the paperwork asking for the state hearing.

(It's also better to appeal the original decision rather than apply again, because it backdates to January and I don't want to pay the fine. Even though I don't plan on working this year, I want to to reserve the right to earn some income without being penalized for their mistake. On principle. Also I want to convert my 401k to a Roth.)