Medicare/aid Query

Factual Questions
1

I need some advice from someone who works for Medicare/Aid or, as a result of having been a recipient of the programs, is knowledgeable about it. I am not currently enrolled, nor have I ever been part of the program. I am attempting to fill out the application for the first time.

My health problem? I’ve got some palpable cavities in my wisdom teeth. I can’t get a good look at them in the mirror, even with the aid of a flashlight, but from what I can feel with my tongue I’d say they’re large enough the teeth will need removal rather than drilling and filling. (They don’t hurt; which is actually more worrisome than if they did… :eek: ) I want to get this taken care of with all due speed. I cannot possibly afford to pay for this on my own.

Right now, I’m unemployed, although I expect to be starting a new job in a few weeks. Said job is a flex position, will likely never give me more than 25-30 hours a week, and offers zero benefits. Not ideal, but I need the money.

I’m surviving partly on my small savings, and partly because I’m living with my boyfriend. He’s in the AF, and is currently deployed. Most of our household expenses come from his pay and housing stipend. The little remainder is going towards paying off his truck. We plan on marrying eventually; but we want to wait til we’re sure this is right for us, rather than get married too soon and end up divorced in a few years like too many military couples who rush into marraige. The separations and stresses can be hard on a relationship. So I will probably be off Medicare within a couple of years. (I’d prefer to leave the program because I found employment that gave me my own coverage, but in this economy I’m not holding my breath.)

I’ve come to the Dopers because of some aspects of the Medicare application I just downloaded in PDF. Specifically, the parts about all members of the household’s income and assets.

How much influence on my elegibility does my bf’s income/assets have? Do I have to list it at all, or is that considered more of a fellow room-mate situation since we’re not married? What about his (rather beat-up and currently not even running) truck? Am I better off trying to claim I live alone? Does that constitute fraud? The application’s unclear, and the State of NE’s website I got the application from has a veritable sea of clauses, sub-clauses, and paragraphs about elegibility. I got rather lost.

I’d really like to get into Medicare if I’m elegible; being uninsured has scared me silly since my last birthday removed me from coverage under my mother’s work insurance. I don’t plan to abuse the system. I just want these teeth taken care of before they get really bad and possibly spread the rot to other teeth. I would also find it reassuring to have at least a tiny bit of coverage in the event of an accident.

Thank you, everyone.

2

I tried to respond yesterday but the hamsters ate it.

I don’t know about the Medicare aid, because all Medicare I’ve received so far has been automatic. (Medicare Part A kicks in automatically with end stage renal disease.)

The Medicaid sounds as if it is similar, though.

I would definitely list your boyfriend as being a member of the household. You are not married, so it’s probably assumed that you have a roommate situation. (That is, you do not rent a room from him.)

When I applied for Medicaid, the only assets they were worried about were checking, savings, retirement accounts and CDs and investments (and so on), real estate, and if I had more than one car to my name. Medicaid did not count as assets my car, my computer, or my electric piano. Your boyfriend’s truck shouldn’t count against you if your name isn’t on the title, and even if it is, I don’t think it counts. (You’re allowed one vehicle.)

Be very careful about the documentation you provide. I wrote down that I had a Roth IRA for $1000 that I had just bought, but my bank statement showed that $1000 check hadn’t cleared yet. I was dinged twice for the same money and I was declared to have “too many assets.” I think in Washington State the cutoff is something like $1500, but it’s not like they tell you the number. :slight_smile:

Medicaid also didn’t count that I was living at home at the time—I had a rent-payment thing with my parents—as a tangible asset. My stepsister was also living and working from there at the time, too, and although I had to list her, it didn’t count against me.

Stupid bookkeeping. I told them it was the same money in two places, but they counted them both anyway.

I hope you have better luck than I did. :slight_smile:

3

Are you sure Medicaid will even help? When I was on Medicaid in Colorado, nothing dental was covered for adults except emergency extraction. And even that was incredibly difficult to get. I had a horribly painful abcess, and after two days of trying to get in for an emergency extraction, I gave up and went to my MD for painkillers and antibiotics. There were only a few dentists who took Medicaid, and they only had a few Medicaid slots open each day. You had to call as soon as they opened to get an appointment. If they were already full up, you were SOL for the day. I called each day right at 8 a.m. when the office opened, and each day all the slots were already filled by the time they answered my call. I wonder if they didn’t just tell everyone that the slots were full.

There was also the time I had to go to the ER for something that I really didn’t need to. I was coughing up a very tiny amount of blood. I knew it wasn’t life-threatening, but I also knew I had to see a doctor soon (since I’m asthmatic, a lung infection is much more serious for me than non-asthmatics). I called up the clinic I had signed up with (through Medicaid) not three weeks earlier and they were all ready for me to come in… until they found out I was on Medicaid. They had decided to stop taking it in the three weeks since I signed up. Not they they wanted to tell anyone about it, or anything. I tried to get another appointment all day, and finally at the end of the day I had had it and went to the ER. They gave me an X-ray, said I had the very beginnings of pneumonia, gave me prescriptions for antibiotics and cough syrup, and sent me on my way. All of which could have been done by a doctor or a nurse practitioner, but no one would see me. And people wonder why people show up at the ER with minor complaints. (Because it’s apparently the only way you can get a doctor to see you if you have Medicaid.) And why Medicaid programs are strapped for cash. (Because they pay four times as much for people to get seen in the ER because they can’t get an office visit.)

OK this has wandered a bit off the topic… but are you sure Medicaid will actually do anything for your teeth? Or is Colorado’s Medicaid just particularly awful?

As far as what you can count… sometimes the workers will kind of tell you stuff between the lines. They’ll give you hints that if you phrase things a certain way, it might make a difference as to whether you are eligible or not, so be alert for that. They won’t break rules for you, but they might give you hints on how to bend them.