how likely to get Medicaid while applying but not yet approved for SSDI? (coverage, benefits)

[existant]

In a state without the Medicaid expansion, where a single adult would normally not qualify for Medicaid. I notice the applications ask if you think you're disabled and if you've applied or been approved for SSI/SSDI. But I don't know if states ever approve Medicaid in that case, or if they only approve it after you've been awarded SSI/SSDI.

Anyone have had experience with this?

A friend is currently applying for SSDI. She lives in a state that expanded Medicaid to single adults, so she gets Medicaid. She has a low income housing opportunity in a neighboring state, but that state hasn't expanded Medicaid. She has serious health problems and needs regular treatment from specialists.

[Flamingo13]

If the state hasn't expanded Medicaid, she won't get it.

[lenora]

Originally Posted by existant

In a state without the Medicaid expansion, where a single adult would normally not qualify for Medicaid. I notice the applications ask if you think you're disabled and if you've applied or been approved for SSI/SSDI. But I don't know if states ever approve Medicaid in that case, or if they only approve it after you've been awarded SSI/SSDI.

Anyone have had experience with this?

A friend is currently applying for SSDI. She lives in a state that expanded Medicaid to single adults, so she gets Medicaid. She has a low income housing opportunity in a neighboring state, but that state hasn't expanded Medicaid. She has serious health problems and needs regular treatment from specialists.

All states have Medicaid for the disabled. The usual criteria is "unable to engage in substantial activity" and at least low income. If you identify the state I may be able to provide a little more info or at least a link to the relevant information.

[existant]

Originally Posted by lenora

All states have Medicaid for the disabled. The usual criteria is "unable to engage in substantial activity" and at least low income. If you identify the state I may be able to provide a little more info or at least a link to the relevant information.

Wisconsin. She's applied for SSDI but not yet approved for it. I heard that states can do their own disability determination for Medicaid but I know nothing about that.

[existant]

Originally Posted by Flamingo13

If the state hasn't expanded Medicaid, she won't get it.

Thanks Flamingo may I ask how you know this? Sorry, it's just really important and it's not like a DHS worker is going to give a clear answer (unless I ask one on their day off, as I'm trying to do here!) without living there and applying first.

[Inquring81]

Dear Existant:

Found some very interesting information for you, and have some resources, both internet and also ways to talk to a human being who is well versed in the particulars of Wisconsin's system. According to this site, while Wisconsin did not expand Medicaid, they claim that there is no coverage gap: https://www.healthinsurance.org/wisconsin-medicaid/

Looking at Wisconsin's Medicaid site, it looks as though there are a range of different services that are close to/not exactly Medicaid (https://www.dhs.wisconsin.gov/medicaid/index.htm).


These may or may not cover the particular services, providers or medicines that your friend needs. If you're inclined to do some reading, Wisconsin put their eligiblilty determination manual on-line: MEH

Another point that was raised by another poster is whether the state will consider someone "disabled" if they are not yet receiving SSI or SSD. Here's a link to Wisconsin's Disability Determination page.: https://www.dhs.wisconsin.gov/ddb/index.htm

There is a Medicaid-entry program called "Badger Care Plus" -- I've heard of it before, but know little about it and how it compares to WI Medicaid. Here's a link to details about Badger Care: https://www.dhs.wisconsin.gov/medica...ns/p-10052.htm

While there is a lot of information on these various sites, this is a crucial decision. You earlier pointed out that you'd love to talk to a DHS staffer on their own time, presumably because they would know the answer and might give you the real truth when they aren't at work.

I'd like to suggest a more creditable source of detailed, specific information about Wisconsin's Medicaid program. An excellent place to find such a person is the Independent Living Centers for people with disabilities. Every state has these, and all of them provide case managers who are extremely well versed in Medicaid and disability benefits issues. Here's a link to the eight centers in Wisconsin. Give one or more of them a call and see what they advise. Scroll to the bottom of the page and there are links to all eight of the centers: http://www.il-wisconsin.net/centers/


Best wishes and best of luck to your friend!

[existant]

Inquiring81, thank you so much! I would hug you if I could! Seriously this means a lot.

[Inquring81]

Thank you for your kind words. You're very welcome! Happy to help.