ADA and Medicaid

[CuriousBystande]

What is the name of your state (only U.S. law)? Ohio

Okay, I realize this is probably too late to act on but I am still wondering the validity of acting on this if necessary. I applied for Medicaid coverage as my income is actually /nothing/. I am not homeless and my parents have been amazing in helping me with my medical bills. Unfortunately, I was denied coverage based on the fact that my disability is mental, not physical, I am not pregnant, and I did not already have children. I noticed that in the Americans With Disabilities Act, it describes eligible individuals with a "severe" mental impairment which limits one or more major life events of an individual. Title II mentions: "A state or local government must eliminate any eligibility criteria for participation in programs, activities, and services that screen out or tend to screen out or discriminate against persons with disabilities, unless it can establish that these requirements are necessary for the provision of the service, program, or activities."

Can this apply to Medicaid? Is there a certain amount of time before a case becomes invalid?

 

[TheGeekess]

What is the name of your state (only U.S. law)? Ohio

Okay, I realize this is probably too late to act on but I am still wondering the validity of acting on this if necessary. I applied for Medicaid coverage as my income is actually /nothing/. I am not homeless and my parents have been amazing in helping me with my medical bills. Unfortunately, I was denied coverage based on the fact that my disability is mental, not physical, I am not pregnant, and I did not already have children. I noticed that in the Americans With Disabilities Act, it describes eligible individuals with a "severe" mental impairment which limits one or more major life events of an individual. Title II mentions: "A state or local government must eliminate any eligibility criteria for participation in programs, activities, and services that screen out or tend to screen out or discriminate against persons with disabilities, unless it can establish that these requirements are necessary for the provision of the service, program, or activities."

Can this apply to Medicaid? Is there a certain amount of time before a case becomes invalid?

Medicaid does not discriminate against the mentally disabled.

 

[OHRoadwarrior]

To be eligible for Medicaid by this criteria you must be "an individual with a disability (as classified by the Social Security Administration)". You do not meet the criteria.

 

[CuriousBystande]

I think my "favorite" part of all of this is all the person could do was suggest I apply for SSI. The problem there? If I don't qualify as disabled under the SSA how the hell would I get SSI? *totally not bitter... Okay maybe a bit*

 

[OHRoadwarrior]

How old are you?

 

[CuriousBystande]

Not sure if my last post went through:

29 going on 30 in a few months.

Technically, I would be eligible for Medicaid IF Kasich opts into the expansion with approval from, I think, State Congress. However in the meantime? Someone else's finances are getting harder and harder to manage. Seriously, even if I just had prescription medicine benefits at the moment, it would save us tons of money.

I'm lucky. I do have people that help make sure I have what I need to function in life. Unfortunately, I'm tired of costing them craptons of money.

 

[OHRoadwarrior]

Generics are your friend. They even have them for mental issues. I was thinking you could possibly make the parents insurance age.

 

[Proserpina]

Generics are your friend. They even have them for mental issues. I was thinking you could possibly make the parents insurance age.

Just FYI. Not everyone can tolerate the generic version of a particular med. Some people actually do need the brand name drug.

 

[commentator]

I think my "favorite" part of all of this is all the person could do was suggest I apply for SSI. The problem there? If I don't qualify as disabled under the SSA how the hell would I get SSI? *totally not bitter... Okay maybe a bit*

If you have applied for social security disability benefits and were not qualified based on your lack of wage credits or failure to be determined handicapped enough, yet you do have some sort of handicap or disability, SSI would be the other possibility. It is for the low income disabled or disabled people who do not qualify for SSDI because of lack of work credits. Research this. Medicaid isn't the only program you might possibly apply for. But is your disability such that you are unemployable? Do you have medical documentation of this? You have applied for SSDI? What was the reason for your denial?

 

[CuriousBystande]

I have researched SSI and my problem is that the max payout figures have never said the frequency of said payments. Also, as I understand it, they deny everyone and wait for an appeal. Backpay is nice but when you shell out $5000 a year already, unless a lawyer takes me on pro bono...

This is just something that I thought of.

 

[Proserpina]

I have researched SSI and my problem is that the max payout figures have never said the frequency of said payments. Also, as I understand it, they deny everyone and wait for an appeal. Backpay is nice but when you shell out $5000 a year already, unless a lawyer takes me on pro bono...

This is just something that I thought of.

It's absolutely false that they deny everyone the first time around. In fact, the number of first-time approvals would shock most people. It's a myth.

 

[CuriousBystande]

The number might shock but what about in relation to the number of applicants? Also, are you in Ohio? Everything I've heard is that the denial depends on where you live. The approval process here in Ohio can take anywhere from 2.5 to 3 years especially when you have to get a lawyer involved. I'm currently weighing the payout benefits vs. the cost for a lawyer if there's a need as well as the wait time for approval.

 

[ecmst12]

You have nothing to lose by applying for SSI. Does your psychiatrist/therapist think you will be able to return to work eventually?

 

[Proserpina]

The number might shock but what about in relation to the number of applicants? Also, are you in Ohio? Everything I've heard is that the denial depends on where you live. The approval process here in Ohio can take anywhere from 2.5 to 3 years especially when you have to get a lawyer involved. I'm currently weighing the payout benefits vs. the cost for a lawyer if there's a need as well as the wait time for approval.

The latest figures available (2010 I believe), still show Ohio having an initial approval rate of almost 1/3 .

http://www.ultimatedisabilityguide.com/ssdi_ssi_denial_rates.html

 

[OHRoadwarrior]

Just FYI. Not everyone can tolerate the generic version of a particular med. Some people actually do need the brand name drug.

"I spend $100 a month on my mother every month that says you are CORRECT!!!