Medicaid fraud?

[bigearl67]

Indiana

Me and my wife are separated, going through a nasty divorce. I am paying ALL the bills while she is living in the house and taking care of our children about four days a week (I have them the remainder). I am employed and carrying insurance on the wife and kids.
Yesterday my son was admitted to the hospital and I found out she has him on medicaid. OK, so is this fraud? I’m concerned they will come after me while I am covering my children. Earl

 

[Antigone*]

Indiana

Me and my wife are separated, going through a nasty divorce. I am paying ALL the bills while she is living in the house and taking care of our children about four days a week (I have them the remainder). I am employed and carrying insurance on the wife and kids.
Yesterday my son was admitted to the hospital and I found out she has him on medicaid. OK, so is this fraud? I’m concerned they will come after me while I am covering my children. Earl

Why would they come after you, you didn't do anything. Call the hosptial and make sure they have your insurance information for your son.

 

[single317dad]

State insurance in Indiana isn't as simple as "they're on Medicaid"; the provider generally doesn't know which state plan the patient is on, unless they bill something and just happen to know which plans pay what amounts for certain procedures. The child could be on HIP, which is based on income but isn't free. There are also several carriers under Medicaid/HIP, each of which pays differently for different things (like choosing your insurance at work, there's an election period every year). Chances are that FSSA won't talk to you about the account, since you're probably not listed on it. Best action would be to try to discuss it with the other parent, despite the hostility.

One thing to keep in mind is that when someone is on Medicaid here, they MUST use it for all medical issues. So if your child is on Medicaid and he went to the hospital, they have to bill Medicaid.

 

[commentator]

And believe me, if there is a needs based assistance program in place for this child, it was not gotten because your soon to be ex wife went in and casually lied about her income. They require an applicant to sign statements releasing all sorts of information, including bank accounts, payments, income tax forms, etc. They can look and see, very easily, what your family's income is, exactly how much is being paid and by whom and for what.
So you don't need to wring your hands too much to see if she's committing fraud, and you fear you'll be charged or something. That's a bit of a stretch.The one thing they certainly will do, if there is any kind of public assistance involved, is make very sure you keep your child support responsibilities up to date.

 

[ecmst12]

Medicaid will be secondary to any commercial insurance that is in place for the child, and in most cases will pick up the copays and deductibles.

 

[AnonUserName]

Indiana

Me and my wife are separated, going through a nasty divorce. I am paying ALL the bills while she is living in the house and taking care of our children about four days a week (I have them the remainder). I am employed and carrying insurance on the wife and kids.
Yesterday my son was admitted to the hospital and I found out she has him on medicaid. OK, so is this fraud? I’m concerned they will come after me while I am covering my children. Earl

You can call the FSSA and confirm if they know your child has insurance.

 

[bigearl67]

Thanks for all the responses, it sure did help. I have no child care responsibilities other than what I am already doing.

Could my wife get medicaid even though I already have insurance for the children and make seventy thousand a year? That seems a stretch.

I will contact FSSA Monday. Thanks again, Earl

 

[ecmst12]

It wouldn't be based on your income, it would be based on HER income, and yes it's possible the child could qualify for medicaid even if he already has insurance. Especially if he has any medical conditions. It wouldn't affect your insurance and your policy would still pay first.

 

[LdiJ]

It wouldn't be based on your income, it would be based on HER income, and yes it's possible the child could qualify for medicaid even if he already has insurance. Especially if he has any medical conditions. It wouldn't affect your insurance and your policy would still pay first.

Also, in Indiana they don't go after the non-custodial parent for support/reimbursement for Medicaid. They only do it if the parent is receiving TANIF (cash benefits), or for birthing costs for Medicaid. What they might do is instruct your employer to make you add the children to your insurance, but since that is already the case, its a moot point.

Again, someone suggested that you provide the hospital with your insurance information, and I echo that suggestion.

 

[bigearl67]

It wouldn't be based on your income, it would be based on HER income, and yes it's possible the child could qualify for medicaid even if he already has insurance. Especially if he has any medical conditions. It wouldn't affect your insurance and your policy would still pay first.

Would this be so even while we are still married? Her income is nill (she works under the table). Thanks, Earl

 

[ecmst12]

You're living separately, right?

 

[bigearl67]

Custody has not been determined and when it is I will have full physical custody of the children. I will be at the hospital tomorrow and make sure they have my insurance information. Thanks,Earl

 

[ecmst12]

I don't think you can know that for sure. But I don't see any fraud and making sure that the hospital has the insurance info is all you need to do.

 

[bigearl67]

You're living separately, right?

Correct, due to a restraining order filed by her. Earl

 

[Proserpina]

You're living separately, right?

Correct, due to a restraining order filed by her. Earl

Mom has them 4 nights per week? What makes you so sure you'll get primary custody?