Free medical insurance isn’t welfare

When I reported to my office fresh from training my supervisor sat me down in her office and proceeded to explain to me why Medi-Cal (Medi-caid, in other states) isn’t welfare as well as the thousand of others things that happen that are not covered by training (sounds like all the many other jobs I’ve had). It wasn’t till several months later that what she said about Medi-Cal not being welfare struck home.

I had been assigned a case where the clients consisted of a pregnant woman with one kid and a husband. The spouse was working but his hours had been severely cut, so much so that paying the mortgage was about all that was getting paid. Food for the household was usually by donation from a local church, friends and neighbors and utilities were about to be turned off.

At first glance I thought that this was a slam dunk case. WRONG, under the rules of Medi-Cal primary residence (the house) is exempt therefore the house payment was not a deduction to his income, so his entire income was counted. This put their total monthly income over the 100% FPL (Federal Poverty Level) allowed for the spouse and child and over the 200% FPL for the pregnant woman. In a nutshell, they didn’t qualify and were denied.

This didn’t seem right. They were living hand to mouth and I still had to tell them no. I thought I must have done something wrong so I asked my supervisor for an immediate case review. It took all of about 60 seconds for her to run the numbers and agree that I was right and they were denied. As I turned to leave with disgust for the giant government machine I found myself in, she stopped me and explained again what she had said before. Medi-Cal is not welfare.

Medi-Cal is like private insurance (Blue Cross, AETNA, Kaiser) only harder to qualify for in some cases. With the private insurances you don’t need to qualify, you just need to pay the premiums. Not so with Medi-Cal (Medi-Caid). With Medi-Cal there are property and income limits as well as semi-annual and annual reporting requirements. You must also prove US citizenship, residency in the state you are applying in, identity, all income and all property. Property being vehicles (not just cars but boats, sea-doos, motorcycles, etc), bank accounts open or recently closed, life insurance, retirement plans, stocks, bonds, IRA’s, 401k’s, even burial trusts. I dare a private insurance company to even attempt to ask for so much.

Welfare is a hand-out, qualifying for Medi-Cal is work, sometimes a lot of work, it ain’t no hand out.

Some Medi-Cal cases have what is called a SOC or Share of Cost. This means that every month you have to pay what is called by private insurance companies, a deductible, before Medi-Cal will start to pay medical bills. This amount can range from a hundred dollars to several thousands of dollars. Yes, I said thousands of dollars. Considerably more than most private insurance plans monthly premiums and this is every month and potentially every person on the case.

Now you be asking yourself, “If it’s so much work and potentially so expensive, why bother applying?” Well, thats a question everyone must answer for themselves but let me help with some thoughts.

• Medi-Cal without a share of cost is 100% free. That includes your doctors (general practitioners and specialists), prescriptions, vision and dental.
• Medi-Cal is available to qualified individuals for as long as they qualify. As your income changes (as long it stays within the allowable limits) your benefits will not change.
• Medi-Cal is federaly funded. Which means as long as the Federal government is running than so will Medi-Cal.
• Medi-Cal is administered by the state. This means that once you qualify you can move anywhere in the state and will not have to reapply, your case will follow you. When you move to another state you unfortunately have to reapply, sorry.
• Income qualifications are different for kids then they are for adults, so it is very possible for adults to have a SOC and children on the same case not to. Many parents I deal with are more then happy to overlook there SOC as long as the kids are covered for 100% free Medi-Cal.

regardless of wether you decide that Medi-Cal (Medi-Caid) is right for you now or maybe sometime down the road or not at all I hope I have helped you look at Medi-Cal in a new light.

Please feel free to ask and I’ll do my best to answer.

God Bless…MCET1

Hello world!

Todays economy makes it hard and sometimes even impossible to provide food and medical insurance for your family. There are lots of places to go for this help. This blog is not to list them all but to talk about the more obvious ones Medi-caid (Medi-Cal, in California) and food stamps, and give you tips on how to make things go faster and smoother. To ease peoples minds about the “Welfare” stigma and help people get the benefits they are entitled to as US citizens (I’ll cover the whole illegal alien issue later).

About myself, I am a Medi-Cal (Medi-caid) Eligibility Technician or ET, which means I am the person who evaluates your application and along with verifications you provide and following Federal guidelines decide whether you qualify or not. As I said I am a Medi-Cal specialist and do not deal with Food Stamps and Cash Aid too much I will try and answer your questions but if I cannot than I will have an specialist from Food Stamps or Cash Aid step in and answer your questions.

As an ET, I cannot tell you how to cheat the system, although many people try and most get caught. I can tell you what is required, what will be asked of you and the timelines for you to provide. I will try to answer any questions you may have as to the application process and what to expect while you are on Medi-Cal.

Every state is different and every county is different. I am employed by the County of Riverside in California, so I can tell Riverside residents whatever they need to know. For other counties I can tell you Federal Guidelines and may even be able to tell you specifics if I can get hold of a worker in the county and state you live in.

My hopes for this blog are to reach the people who I will never see across my desk and help them during a time when they need it the most.

God bless, MCET1