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My friend has IA Medicaid and is 28 years old. She had it for 4 yrs and can she get a copy on what she wrote on her application paper? She gets a renewal every year and are they checking her bank accounts every year for eligibilty? On her 5 yr look back will she have to reapply on application how she did 5 yrs ago or do they just check tax income or bank accounts also to see if she can still be on it?

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Isthis made a point. She may not lose her coverage but she may pay more with deductables and copays until she gets back under the cap.

All she needs to do, like said, is be truthful. Send all paperwork requested.
And keep copies of everything sent. This way if the caseworker calls she has the info she sent in front of her.
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Recorder101 Feb 19, 2020
Ok so see what the state (caseworker) says for how much of gifted money qualifies? So there is a way she can still have some coverage but pay some deductables/copays where she would have to pay in? So what counts as a year for Medicaid say ex. 2019 til 2020 would be 1 year, but if she renews in 2020 its a 2nd renewal so is it 2 yrs then, or does it defer for each state since your nephew is in NJ?
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She needs to fill the application out truthfully. Exactly what she has and earns now. They don't care about 5 years ago, they care about now.

Maybe she will lose some coverage or have to buy insurance, that is what she may be facing, but if she lies to protect her savings she could be facing losing her coverage and losing it forever. Fraud is a crime and a conviction can make you ineligible for public assistance for life.

If she has to pay a share of costs until she is eligible that is far better than the alternative.
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It doesn’t matter what she put on the forms in the past. She has to report the money she has NOW. There is no lookback period involved here whatsoever. If she has $20,000 in the bank now then that’s what she reports now. Medicaid needs to know where she stands financially RIGHT NOW. However Medicaid eligibility for the type of Medicaid she on is determined by her income not her assets. The money in her savings account will not disqualify her from Medicaid. She’s eligible for no-cost health insurance through Iowa Medicaid because her income is below the $15k cap.
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Recorder101 Feb 19, 2020
Ok so for IA's type of Medicaid is a wellness one so she is good since she makes under the income and the gifting is fine? So what other types r there because there are scales of it?
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I read ur responses. It does not matter what she originally put down 5 yrs ago. Its what her bank accts and wages look like now.

My nephew is on "workability" with Medicaid in NJ. There is a cap on what he can make and what he can have in the bank. Have ur friend call her caseworker and find out what she is allowed to have in savings and cap on her earnings.

Gifting is not wise when a person is getting help thru Medicaid. It can effect them being able to continue getting help. If she is over what is allowed, maybe she "can" give the gift back.
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worriedinCali Feb 18, 2020
Gifting is only an issue when it comes to LTC Medicaid. The type of Medicaid she is on now is income based. Medicaid will not be looking at gifting. They will only look at her income. People on Medicaid health insurance CAN receive monetary gifts. Because once again, eligibility is based on income only. There is no reason for the friend to give the money back.
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This website has useful information and a range of contact details for Iowa.
https://www.benefits.gov/benefit/1388

Why not help your friend ring them up and ask them?
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worriedinCali Feb 18, 2020
Her friend has a caseworker who determined her Medicaid eligibility and that’s who she should call. It’s not that easy to just call Medicaid and get questioned answers. Medicaid is state specific too so she needs to speak to her local Medicaid office.
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I always thought you could not have more then $2000.00 in a Savings/Checking account to qualify for Medicaid. I do not know how your friend qualified with $10,000 and now has $20,000 and looking for a way to still be able to qualify for Medicaid! Tax payers are paying for your friends medical bills while your friend is building a nice little bank account for themselves. That friend needs to report that money when renewing Medicaid. It seems to me that friend should be paying some of those medical expenses themselves.
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worriedinCali Feb 18, 2020
It’s because regular Medicaid is based on income. Not assets. Long term care Medicaid is based on assets and income. And the amount of assets you can have varies by state.
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This is confusing.

I have never done a 5 year look back on my nephew's medicaid for healthcare. Once a year he gets paperwork from Medicaid. He works, so he sends in a month of payroll checks. Copies of statements of his bank accounts which are the current month.

There is no need to know what was on her initial application. The yearly eligibility forms are updates to the initial one. Her continuing Medicaid is based on the yearly eligibility not on the initial one.

Medicaid 5 yr look back is for Long term Care. That's when you need to provide 5 years of bank statements. With these, they look for large amounts of money going out of the acct. These will be questioned.

I always make copies of everything I send to Medicaid. Never know when they will get lost in the mail.
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Recorder101 Feb 18, 2020
Hi JoAnn,

She is on a cycle where they renew her every year, so she doesnt fill out any paperwork. So even though she is on the renewal cycle for 5 years. On her 5th year they dont do a look back, thats only for long term care right?
Yes that is a good idea because she realized it now. The only issue is that she is not sure what she sent in as far as bank statements go, that is why she wanting the records, to see what she put down. Because she has probably $10,000 in her savings whenever she initially started for Medicaid and maybe a $1,000 or so in her checking account. Is savings has built up to around $20,000 but she still makes less than $14,000 in income each year because some of the money in savings is a gift. The issue is that she does not work a lot so she does not make a lot of income per month because she has several mental health issues and intellectual disorders where she sees several doctors in a month. And without Medicaid can't afford paying for it because then her savings would be wiped out. So whenever she reapplies how will she do it because she is not sure if she remembers that she wrote at the beginning of application $10,000 in her savings account and they let her on. And now she has $20,000 in her savings. And if they keep renewing her for the past 5 years would they have already known that she had this money in her bank or do they just go off by tax income what you make monthly?
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Is your 28 year old friend going in to a nursing home? Because if not then there is no lookback. The lookback period for us for long term care. And.....even if she is subject to the 5 year lookback period, what she wrote down 5 years ago wouldn’t apply not. Not the financials anyway which is what would be looked at. They are looking at her monthly income for eligibility. So she doesn’t need a copy of what she turned in previously. She needs to report her current income.
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Recorder101 Feb 18, 2020
No she isn't going into long-term care. She is on a five year cycle where they were you her for Medicaid each year without turning in paperwork so I'm not sure if by looking at her taxes that is how they determine that she is eligible since she has low income. She is wanting a copy of the previous application to see what she put for the amount in her bank account because she has $20,000 and the application she might have wrote she had $10,000 in saving. And wonders if she can still be able to be on it because some of the money is a gift and also she is still low income each month where she qualifies but with the amount in her account of her savings she is not sure because she had several mental illnesses and intellectual disorders where she needs Medicaid to copay for doctor visits that she goes to several times a month and if she uses that savings it will be wiped out. So for her renewal she is not sure what to do or what to write on that plication because she was wondering what she wrote when she first applied?
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