Medicaid for Children Covered under NCP medical plan?
I wasn't entirely sure where to post this. I hope I am in the right place.
My husband has medical insurance via his employer. It covers my husband, myself, my stepsons and our daughter.
His sons have been on my husband's medical since birth, and have remained in there since birth. They have not been removed at any time.
The CO also states that my husband is to carry them on his policy as long as he is employed somewhere that has medical available and does not put him below a certain percentage of his gross income. Blah blah.
Anyway, our insurance is wonderful. All of the children are covered and do not require a copay regardless of service. (Husband and I have a small copay). I have never had coverage this great and low cost.
The even help offset the cost of IEP services for my older stepson.
Anyway, I found out quite by accident that my husband's ex-wife has the boys on Medicaid. First I am not understanding why she would even apply for them. They have excellent coverage and no out of pocket cost to her.
Second, I do know that were my husband fail to provide medical and she were to have them on Medicaid, he would be in debt to the state of NY for it.
Does anyone know if that would apply in this case? Should she even be receiving it for them since he provides coverage?
Sometimes the schools push
Sometimes the schools push parents whose kids have IEPs to apply for Medicaid in order for the school district be be reimbursed for the services. Generally, it is not a good idea to do that, as there can be a lifetime cap on Medicaid services and you will be exhausting it early on. So yuor SKs BM might have given the school permission to apply on her kdis' behalf. There could also be another explanation. NYS has very liberal Midicaid provisions. You may want to ask a lawyer about the ramifications.
Thanks! We have an
Thanks!
We have an appointment with our lawyer next week, and I definitely plan on bringing this up. If its legit, I'm fine with it. I'm just hoping it wasn't fraud on her part and that DH will get dinged for it.
Strangely enough, I found out when taking OSS to the pediatrician and they asked me if he was still on Medicaid and I was like what? No... They're on my husband's insurance. I had to give them the card to enter into the system. I was taken way off guard!
The specific details of
The specific details of medicaid vary from state to state, however, the basic guidelines seem to be the same. Any time a head of household applies for medicaid or any other state benefits, they are required to list everyone in the household. Therefore, if she was without insurance and was approved the children were automatically approved also.
Your husband would not be in debt because he is not the CP who applied for the medicaid, she is. Any person who applies is required to notify the state of any additional private insurance. Therefore, if there are penalties, she would be responsible since she applied and approval was based on her info that she provided. If a person has private insurance, sometimes medicaid will pay a portion of the premiums based on income. At any rate, she is supposed to provide a copy of the children's insurance cards to her case worker. Not doing so could cause her to loose her benefits.
Does your husband have a CS order with her through the state or does he pay CS on his own? I ask because my ex husband has a CS order for BS11 through the DFCS and I have used medicaid for a year when I wasn't working. Therefore, I know that if there is a CS order in place and the CP is receiving benefits for a child, investigations of the NCP are conducted. The state wants to make sure that children aren't receiving benefits while an able bodied NCP flaking out on their responsibility.
With all that being said, the ex wife needs to report that the kids are covered under private insurance because they will eventually find out.
Here is some information for NY:
http://www.health.ny.gov/health_care/medicaid/#cancel
Thank you! He does have a CS
Thank you!
He does have a CS order through the state. What happened was that when he moved out, he was paying her $200 per week via check and they had a CO for custody and visitation and the $200 was written in by the judge along with him maintaining the medical coverage he already had on them.
When I came into the picture, she quit her job, went on DSS and DSS took him to court for child support. On the forms that were served to DH, she put in her application for benefits that DH was not paying her child support or providing medical for the children and for some reason WROTE IN her application than he stopped paying when he met me (uh no).
When they went to court and he provided proof that he was in fact paying her, and that they were on his insurance, they put his child support order through the state (less than he was paying on his own). The original court order was then rewritten to include this.
I'm not sure what happened to her for lying on the initial application though.
It may simply be to cover her
It may simply be to cover her ass.
It may also be that she applied for herself and, as a result, they included her family.
Medicaid is *always* secondary; regardless of what other coverage is provided, so your DH's insurance will always be billed first.
Also, medicaid does not concern itself with wether or not the applicant(s) has/have medical covereage elsewhere; it is entirely income based.
Anyway, this won't come back to bite your DH, if that's what you're worried about, so don't worry. Instead, enjoy the fact that your out of pocket expenses are reduced by the amount covered by Medicaid.
The funny thing is - we have
The funny thing is - we have no oop expenses for the kids.
She could of had them on
She could of had them on medicaid before he even had the insurance. We went through the exact same thing. When we told BM that we would take SD to the doctor we were a little suprised how pissed off she was. Turns out she didnt want us taking SD to the doctor because she didnt want us using our insurance. If we did that then she would have to pay the court ordered balance of the bill that insurance didnt pay ( she of course was hiding the fact she had them on state insurance). She secretly kept SD on medicaid so that when she took her to the doctor (which was never, she just didnt want us to take SD either) then she wouldnt have to have a copay or balance to pay. After we got custody of SD then the state found out that SD was living with us then they kicked SD off of medicaid and sent BM a letter stating her foodstamps were also going to go down because she would not get monthly assistance for a child that doesnt even live with her. However, she didnt recieve that letter in time. Long story short, BM went to Walmart to buy groceries, ended up not having any food stamps, (because state kicked sd off) and bm ended up leaving 2 carts full of food by the register while she ran to her car and screatched out of the parking lot. If I were your DH I would be contacting the family support division and telling them the kids are already covered. No reason for skids to be on medicaid if they have insurance already. Leave the medicaid funds to the parents of the children who cant actually afford medical insurance and are in need of the assistance. I hate to tell you but if your DH doesnt atleast TRY to report it then he is just as bad as BM in that aspect.
Are you sure she's using it
Are you sure she's using it for them? Laws may vary state to state. From our experience, when DH and BM presented health insurance and medicaid cards, respectively, the medicaid card was shoved away. It is my understanding that if a person is covered or able to be covered under regular health insurance, they are not allowed to use medicaid. I would hope that medicaid would go after BM and not you guys since you can prove the children have been covered since birth, and obviously the mother knows since it was since birth and sounds like your husband hasn't switched jobs. Best of luck to you!!