Just got a message that the new “work requirements” will take affect January 1st 2027. I had clavicle surgery and I’m gonna need my plate removed because I can’t work long due to irritation, the surgeon that did it moved out of state. If I can’t find a surgeon to do it before January am I fucked? This requirement needs to be shut down because it will do more harm than good.

I did my recertification in August and was approved starting sept 1st. On sept 29th, their "automated system" concluded that I was no longer eligible for financial aid. This is, of course, not true. My insurance was going to end oct 31st all of a sudden.

My insurance company and case worker were both baffled. It took a week of calling around before someone could even get information about *why* i was deemed ineligible, because the notice of my services ending had a big blank spot where the reason is supposed to go. When my insurance rep tried to resubmit my application with me, it was rejected automatically.

Eventually the right person at my insurance reached the right person at the dept of health, who told us I was determined to have too high an income. That person couldnt see anything in my ​​account that would reflect that though, so she had to open a ticket and circle back.

Today we (me + caseworker + insurance rep) called the medicaid line again and *finally* someone admits that this was an automated system error related to me being a non filer for taxes. The system "found" financial data that doesnt exist while trying to verify my lack of income, and determined me ineligible based on that info that it imagined. She had to file an IT ticket to have it fixed, because she can't just overturn the automated systems decision herself.

If youre also in NY and got a confusing disqualification notice, please please call your insurance and ask to speak to someone in retention. Have them help you contact the dept of health / medicaid to find out why you were disqualified/denied. I cant imagine im the only one getting an AI rejection like this, and it very well could have cost me my life if we hadnt fixed it in time.

Louisiana, Male, Single, No Kids, No Disability.

Hello! Here’s my situation: I currently make around $67,000 a year and in August I’ll be entering a program at school that lasts for 16 months. It’s full time and I cannot work during this time. I have been very good about budgeting and tracking expenses and am on track to save up about $35,000 which I will be able to live off of during this time. My issue is that medical insurance is required while I’m in this program and I would like to be on Medicaid since I technically won’t be earning income and, if adjusted as income, what I have saved is roughly $2,100 a month.

Any input is greatly appreciated!

My mother who is a 75 years old green card holder got a letter from NY state of health to apply for Medicare to continue keeping her Medicaid.

She has only been a green card holder for 2 years so she is not federally eligible for Medicare. ( you need to have 5 years).

We called NY State of health a week ago letting them know she is not eligible for Medicare. They created a ticket and are still processing it.

Should we just continue to wait? Deadline to respond is coming up in 2 weeks. Or should we upload a letter on her account stating again that she is not federally eligible for Medicare?

Has anyone come across this before or any advice?

I am a high school teacher and serious amateur poker player with a family of 4 (2 adults and 2 young children) living in Kentucky.  My teaching income is comfortably under the income limit for Medicaid and our family has been enjoying the benefits of Medicaid for the last several years with one brief interruption due to my gambling winnings.

I have no interest in suggestions to underreport my income - I am trying to navigate the system legally and honestly.

My current situation is that some gambling winnings have resulted in a notice that my family’s Medicaid coverage will be discontinued as of the end of 2026.  

My goal is to be covered for January 2027 specifically (because my primary medical insurance deductible resets at that time and my family has significant regular medical costs).  My previous interactions with system employees and my attempts at online research have left me with some confusion about what I need to do to ensure this result.  Is one of the following accurate or is there some 3rd truth that I am missing?

1. If I have no gambling income in January I will be able to re-apply for Medicaid based on my teaching income alone and should re-qualify (even if I earned several thousand dollars in December gambling); Medicaid will function retroactively to the beginning on the month in case I have any medical costs before my application is finalized.

OR

1. I ought to stop playing poker well before the end of 2026 so that I can re-apply for Medicaid and have no poker income within a specific look-back period.  If this is correct, what relevant time period do I need to consider?

Thank you for your help -- my poker activity is important to me personally and I am a profitable player -- but not profitable enough to be worth the likelihood of having to pay serious out-of-pocket medical costs.

I am a 19yr full-time college student right now. I work a part time job making at most 9k a year. I am filed independent on my taxes from my mother and she tells me i can get medicaid for basically nothing. I really need this for clinical onboarding and im really scared that things won't be okay. Is what she said true? and if so can i get it before November 1st?

Got a text which I thought was in error (I am a U.S. citizen) that certain immigrants will be switched from managed care to the fee for service MediCal in January.

First, does this message mean the county has my status wrong and think I am an immigrant? Or are they sending those messages to everyone? I haven’t received any official notices. Should I contact them to correct it?

Second, it seems like fee for service is the same as straight MediCal? Is it worse or better than being on a managed plan? I’ve read up on it and on the surface it seems more flexible which is better for me but maybe there are downsides?

If I make more than $1835 one month, will I get kicked off medicaid and have to reapply the next month? Or is it based on my yearly income divided by 12?

We just received notice of the work requirement for my nephew. He is a disabled adult, has a self- directed budget through the state but does not currently receive SSI. He has been evaluated as not being able to work many times, but does attend programs at the local autism center. I have a message in to his case worker, but it could be a while for his response so I am wondering if anyone knows if this work requirement will apply.

We just certified him again in August and his budget year is October if that makes a difference.

Hi I am here to ask if volunteering makes me eligible if I am not working at times in 2027. I do work that is irregular. If volunteering is enough, how do you prove you did 80 hours a month?

Thank you

The email today said:

“You can satisfy the new work requirement by completing any of the following:
Working, volunteering, participating in a work training or education program for at least 80 hours a month;
Enrolling in an educational program at least half-time; or
Earning at least $580 in monthly income (or, for seasonal workers, an average of $580 over six months).”

I'm reaching out here on Reddit because reddit's awesome and there's got to be somebody else in this little small little corner of Earth Delaware that also has Highmark Health Options and might be able to help me find a provider that will help me cover the $2,000 at least for an Autism evaluation in Delaware my psychiatrist from Delaware referred me to Neurology Associates PA in in Newark and I don't understand why and went halfway through the process only to find out that the data Network I'm like how does that even happen. I'm a 39-year-old alternate autistic Little Wizard over here and I have found some forms to submit a dispute and try and navigate stuff but I'm already navigating like LIHEAP unemployment in Delaware benefit s trying to secure them and I this autism evaluation really help me and my one of two autistic children with their evaluation give them some insight into their autism like hey it comes from Mom. But I don't know if anyone else here is autistic I have also have ADHD it's just like you go your whole life you know wondering why you're different and why you are the way you are and it's hard to understand the people why it's just important for you to have that missing piece of deposit of a diagnosis formally it's also important because I really don't think I can work I can't do it like I had to walk out of a training at a part-time job at a movie theater because I got over stimulated and it was too bright and loud anyway can anyone steer me towards what to do to find a provider that would cover neurological evaluation for autism in Delaware like do I need to obtain a prior authorization before I even try to find a provider or is that something I can get later I mean I'm already on a ball with it like I have talked to my psychiatrist about it but he hasn't called me back yet. If it helps I am in Wilmington Delaware.