Getting Approved for Medicaid is Getting Tougher

As the saying goes, stuff rolls down hill. In the situation with all the budget constraints on the federal government, comes constraints on the state and local government. Healthcare is definietly no exception. Lawmakers in Washington are looking at some very deep cuts when it comes to many programs and trying to figure out how to keep them from being deeper than they already are.medicaid appoved

One of the programs that is being looked at piece by piece and line by line is Medicare. There will definitely be cuts to that program, period. As a result, as things roll down hill, Medicaid, which is a state program but bolstered by federal dollars, is taking a big hit, too.

Not only are some Medicaid benefits being cut way back, but getting into the program, which is already on the difficult side, has become much tougher indeed. It seems as though unless you are in the most dire straits getting approved for Medicaid is extremely difficult. Even if you are in dire straits and the rope you are hanging onto is beginning to fray – a lot – it is still difficult to get approved.

Consider the case of a 60 year old woman who was disabled in an accident. Her doctors took her off work indefinitely and she has no income except for $200 of assistance money which will run out very soon because of the new cuts from 18 months down to 12. She has no money to go to the doctor and has applied for Medicaid. She suffered injuries in the accident – which happened at work – but Worker’s Comp is fighting against paying because she had some pre-existing conditions. Of course, what 60 year old man or woman doesn’t? Meanwhile, she is in constant pain, in need of surgery and walking around on crutches or a cane with a fractured hip and two badly injured knees just for starters. She has high blood pressure (which has sent her to the ER 6 times in 3 months because it was at stroke level or higher), osteoporosis, arthritis, degenerative¬†disc disease and possibly diabetes. She has doctor’s letters, medical records and more that were sent to Medicaid. She applied for Medicaid and was turned down.

This individual did everything by the book and is having to go through hoops all over again trying to get help. This is before the new budget cuts that are on the way.

This is not to say that Medicaid is unfair or that it is a bad program. It is a good program and was designed for people like this 60 year old lady who has fallen through the cracks – badly. Each state deals with their own Medicaid program so it can be a little easier or a little harder depending on the state a person is in. Even if you have all your ducks, doctor’s notes and medical information in a row, it can be tough to get Medicaid.

Do not give up, re-apply, call and talk to your worker and do whatever is necessary to give them the information so that you will get approved. Eventually, most people do get approved. It is simply a tedious road sometimes to getting the coverage you need.

3 Responses to Getting Approved for Medicaid is Getting Tougher

  • Debbie says:

    I was denied Medicaid because I was not pregnant, an immigrant, or have children under age 18. It did not matter that I also had numerous health issues that landed me in the hospital.
    I was destitute and soon to be homeless and still was denied. I appealed and was finally approved after 2 years.
    In that 2 years I had 3 hospital stays that Medicaid then had to pay for, which could have been avoided had they just approved my application in the first place. As benefits were retroactive to the date of the application, all these medical bills became the responsibilty of Medicaid.
    Follow-up care would have been much cheaper than the hospital care, but since Medicaid took 2 years, I could not get any.
    Government waste at its best.

  • vera says:

    people use cane and who have back trouble is it easly to get medical

  • Mona says:

    So let me get this right…my Grandmother, who mind you has worked all of her life and paid dues, needs to get approval for care in a nursing home…however, she has to jump through hoops, be put on a “waiting list” while the lazy and scum of this earth get handouts and asked if they need anything else? How about the unemployment for the undeserving who can sit on their dead ass and collect but my Grandmother needs care and SHE HAS TO WAIT????? wtf!!!!@!

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