So my question is - is Medicaid the same as SSI? I live in VA. Today I spoke with the hospital about a few of our medical bills (estimated over 10K alone) and she said that our application for Medicaid was denied because we make too much money. We are a family of 7 living on 60K/yr and living paycheck to paycheck if you know what I mean? Our mortgage is at a hefty 10.25% intrest rate which has to do with a huge chunk of $ that goes out of our pocket monthy. So we are hoping to refinance or sale our home for a lower intrest rate and possibly even a lower-cost home just to help us out with the finances. The hospital was fairly kind when I talked with them over the phone. They have agreed to allow us to pay $150 month towards our bills, but that doesn't even include the 5K or so that we owe the NICU. Anyhow, I guess I'm just curious to know if there are any other programs out there that we could apply for? All 3 of our babies have been diagnosed with PVL.

Thanks for any help!

Melanie, SAHM to:

Andrew (adopted) 12/2/94
Jeremy 7/25/02
Mariah, Ethan, & Savannah 4/14/04
Born @ 30 weeks-
3lbs, 5oz. 3lb, 3oz. & 3lb's.

I'm sure it all depends on what State you live in. I'm in Michigan and we have a "30 day" Medicaid law. Anyone who is in the hospital for 30 consecutive days automatically gets Medicaid regardless of their income. My 27 weekers easily qualified for that one so we had absolutely no bills from their NICU stay.

They also qualified for SSI based on their low birthweight (I can't remember what the cut-off was, somewhere around 3lbs I think). That qualified them for SSI as long as they were in the hospital regardless of our income. They got very small checks - but it paid for gas. Once they were home we had to qualify based on income which we did. We got fairly decent checks for the first year, it allowed me to stay home with the kids fulltime. After the first year we had to "prove" that they were still disabled. The only one who qualified was Noah (IVH, PVL and CP) but we no longer qualified due to income -- you are given a income allowance for each individual in the family and "disabled" family members get a much larger allowance. Once we dropped from 3 disabled members to only 1 we were allowed a considerably smaller income.

Michigan also has Children's Special Health Care which we have as a secondary insurance for Noah. It's income based but the guidelines are very generous. It also allows you to pay a co-pay if you make more than the cutoff. It pays for everything that insurance doesn't cover including co-pays, deductibles, etc.. They also provide diapers and pullups for any child over 3 years old with a qualifying diagnosis (yes, for almost 3 years the UPS lady brought me diapers and pullups every month). Of course this wouldn't help with bills that you've already incurred but it might be helpful if the boys need further services.

They seem to try to keep all of these services "secret". Try talking to a hospital social worker to see if they can be of any help. Also try Early Intervention, they may have knowledge of the programs in your state.

HTH -

Lori --
Mom to Zac (9/91) and triplets Noah, Karissa & Jazmine (5/98 at 27 weeks)

Lori --
Mom to Zac (9/91) and triplets Noah, Karissa & Jazmine (5/98 at 27 weeks)

DEFINITELY talk to a hospital social worker or EI. We were denied Medicaid/SSI based on the same reasons as you were. Thankfully, our EI coordinator gave us info on a program called "Katie Beckett". It provides the same benefits as medicaid but doesn't require you to qualify based on income, just disability. I believe this is based in Wisconsin only, but there must be something similar in your state. As the previous poster stated, you really have to "dig" sometimes to find the benefits available to you. Good luck!

Gina
SAHM to Spunky 7/10/94
Mojo 6/29/97
RinRin 6/29/97
Kakiecakes 6/29/97(DS)
"I looked on child rearing not only as a work of love and duty but as a profession that was fully as interesting and challenging as any honorable profession in the world and one that demanded the best that I could bring to it." Rose Kennedy

trpsn1
SAHM to Spunky
Mojo
RinRin
Bugaboo
"I looked on child rearing not only as a work of love and duty but as a profession that was fully as interesting and challenging as any honorable profession in the world and one t

it seems like with your family size and income you should be able to find some help. an attorney told me that SSI almost always denies you the first time, so she told me the second i got my denial notice to re-apply immediately. i haven't applied yet, but plan to do it this week.
Good luck, and yes, like the other posters said, find people (like EI or social worker) that can fill you in on the services. i have noticed in our state that NOTHING is presented to us--we have to do all the sleuthing and find out on our own what our son is eligible for. Good luck!

Meg

Medicaid and SSI are different.There's really 2 kinds of Medicaid. There's the one you can applyfor thru social services for yourself if you lack health insurance-I didn't qualify for that either as a single mom . In Texas,if you make over $250.00 (yes, two HUNDRED and fifty dollars) a month, you don't qualify!! Outrageous!! }> And child support COUNTS as an income!!

Anyway, your children should qualify for SSI based on the PVL and possibly birthweight and gestation too. If they were under 4 pounds, I think it is, they automatically qualify. Once a child is on SSI,they AUTOMATICALLY qualify for Medicaid. It's still Medicaid but they consider it a different branch, I suppose. I've been around this tree 3 times now! LOL! If your children were turned down for SSI, then reapply.My DD was dumped off it this year after almost 4 years on it and I appealed and got it reinstated. In fact,I need to call the caseworker today about another matter....LOL!

My advice, try again to get the children on SSI if you haven't already. Screw "traditional" Medicaid. SSI is the way to go!

Korrie~
^i^B/G/G 24 w 3d,1/17/00
B 10/31/01
B 1/27/03

<a href="http://lilypie.com"><img src="" alt="Lilypie Kids birthday Ticker" border="0" /></a>

Thanks so much for this info everyone! I will defintely start playing "hardball" to get to the bottom of this. Something definitely seems shady to me. The hospital is the one who has told us we did not qualify based on our income BUT we have NEVER received anything in writing saying that our application was denied. In fact, I'm starting to wonder if the social service worker at the hospital actually even sent our application to the state. From what I've been reading online you ALWAYS get a notice in writing one way or the other. Part of me feels like perhaps the hospital people know that they will not get as much money from SSI? so instead they want to tell me that I HAVE to pay b/c we were denied, when really maybe we weren't?... I don't know. Something just doesn't feel right. Tomorrow I will be putting a call into the social services at the hospital and I will tell them to send me whatever paper/letter it is that they have stating that we were denied. If they don't follow through then I guess I'll go directly to social services myself.
Thanks again for the help and advice! I'll keep you all posted.

Melanie, SAHM to:

Andrew (adopted) 12/2/94
Jeremy 7/25/02
Mariah, Ethan, & Savannah 4/14/04
Born @ 30 weeks-
3lbs, 5oz. 3lb, 3oz. & 3lb's.

Skip the hospital altogether and call Social Security directly. The number is 1-800-772-1213. Tell them your children were born prematurely and you want to apply for SSI-Disability for them. They can tell you whether an application has been received or give you the phone number for your local Social Security office and you can call them also since they may be the one processing your application. If you applied for SSI you should have had a phone interview too. Keep us posted. You can get Medicaid if they qualify for SSI but you have to make sure they enroll your children in it also...it is separate from SSI. SSI is a federal program and Medicaid is a state program run by each state.

Becky
Mom to Andrew, Cheyenne and Rheanna 8/13/01

Becky
bgg 8/2001

I agree with calling SSI directly. But I also wanted to let you know that Medicaid/SSI are both only good from the date on your original application. So if no one has actually applied for you, then your existing bills are yours. You need to find out if an application was made and what date it was made on.

Lori --
Mom to Zac (9/91) and triplets Noah, Karissa & Jazmine (5/98 at 27 weeks)

Lori --
Mom to Zac (9/91) and triplets Noah, Karissa & Jazmine (5/98 at 27 weeks)

I just got off the phone with Social Security. She took all our info over the phone and has scheduled us to meet in person at the SS office on the 21st of this month. Did you all take your babies in with you? I wasn't sure if that was necessary or not since I'm applying for them? She looked and did not see a previous application for SSI. Do most hospitals not tell you about SSI? and just Medicaid? I think they probably applied for Medicaid alone for us and not the SSI, but still, I don't understand why I never received a notice in the mail from anyone stating that we were denied.
Lori, are you saying that they will not cover any pre-existing bills and only new/current ones? Why is this? I guess the good part is that if we do get SSI then that $ will go directly to paying of the old bills...

Melanie, SAHM to:

Andrew (adopted) 12/2/94
Jeremy 7/25/02
Mariah, Ethan, & Savannah 4/14/04
Born @ 30 weeks-
3lbs, 5oz. 3lb, 3oz. & 3lb's.

Ok, I just asked her about SSI covering the existing bills and she said that that would be a "Medicaid" thing -- so I think she's saying that we'd more than likely qualify for Medicaid after geting SSI and Medicaid would be the one to cover any existing bills. I could be wrong, but this is what it sounded like....

Melanie, SAHM to:

Andrew (adopted) 12/2/94
Jeremy 7/25/02
Mariah, Ethan, & Savannah 4/14/04
Born @ 30 weeks-
3lbs, 5oz. 3lb, 3oz. & 3lb's.

It will not go back and cover existing bills. It is only valid from the day the application is made. Our NICU social workers made sure to get our application in VERY quickly so we wouldn't end up with a problem. Even if it takes months (or longer) to get approved it would revert back to the date of application (you also get the SSI back to the date of application)

I'm guessing that she meant that hospital bills are a Medicaid thing not Social Security. And yes, you automatically qualify for Medicaid if you get SSI (also WIC).

Lori --
Mom to Zac (9/91) and triplets Noah, Karissa & Jazmine (5/98 at 27 weeks)

Lori --
Mom to Zac (9/91) and triplets Noah, Karissa & Jazmine (5/98 at 27 weeks)

Melanie,

It looks like you are on the right path- first apply at Social Secuirty office for SSI, then you go to Social Services Office for the Medicade issues. The amount of money you make for the family of your size for this area (state) does not sound like to much. Ask what the maximum amount is for a family of 7. Also as someone else said- they usually do denie every application the first time. Appeal the discission and re-apply. Make sure you have a record of all your expenses(mortgage, car payments, insurance, utilities etc.. and your total income.

P.S. You do not have to bring the babies to the appointment- just have the birth certificates and their Social Security cards/numbers.

Good luck
Krista

Mom to^Eugene^-8-16-81-2-7-87
Tina 11-7-83
Sarah 2-26-91
Grandma to James- 2-28-2003
Aunt GGG triplets 10-02-02

Mom to^Eugene^-8-16-81-2-7-87
Tina 11-7-83
Sarah 2-26-91
Grandma to James- 2-28-2003
Aunt GGG triplets 10-02-02

You should not have to bring the babies with you. ALso I heard Medicaid paid for any bills 90 days prior to being approved.
Becky
Mom to Andrew, Cheyenne and Rheanna 8/13/01

Becky
bgg 8/2001

If your income is too high to qualify for medicaid look into a mediaid wavier which is based on the childs disablity not the parents income. Mediaid paid back bills on my dd.

Good luck