Medicaid mistakes?

  • by jergen
  • Sep 09,2018
  • 13 answers

I got a letter saying i owe them 21k cause from a certain period of time i wasn't eligible for medicade but i never received a letter saying i wasn't eligible, instead i always got letters saying that im eligible & my benefits will continue. Why would they bill me if i was never told i wasn't eligible? Can i fight this? Is it a mistake in there system? Im scared. Please help!


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Insurance Answers (13)

B last month

Are you sure you were originally signed up for Medicaid? Being eligible is not being covered. Perhaps they are saying you never actually signed up for Medicaid. Call the number on the notice (assuming it is a legitimate notice, right?) and work out a payment plan.

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Ladyluck317 2 months ago

Its probably a premium amount they are calculating that they paid for you for that long

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David 14 2 months ago

Welcome to the government. You can try to appeal but very few are accepted.

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Beverly S 2 months ago

Call them. Don't they require you to re-certify periodically? Unless you gave them incorrect info (lied about income) I would say this is their fault. If you gave them wrong info they you will have to re-pay them.

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lucy 2 months ago

Medicaid is based on household income of everyone living there. If you failed to report your GF income or anyone living with you, then that could make you ineligible.
If in fact you have not been to a doctor in 2 years, then prior to that what kind of treatment did you receive? For $21,000, would seem like surgery or a expensive procedure that was done, or multiple trips to the ER.
It could be that due to this being Medicaid and they are slow in processing claims, or did an audit and found these charges and questioned them, thus the letter. Or, it could be a possibility that someone else has used the Medicaid fraudulently and you were not aware of this.
You will need to make an appointment with your case worker to work this out.

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Flower 2 months ago

You can appeal any decision made by them. Send a copy of the letter saying you are eligible. You can get legal help for low income. I know where I live Legal Aid will help in this type of situation. Good luck.

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Casey Y 2 months ago

You cannot base your argument on not receiving any mail...that's an invalid argument.
What you need to do is to figure out why they are saying your were ineligible and fight their determination.

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curtisports2 2 months ago

My sister in law also got letters telling her that she was eligible - BUT SHE NEVER WENT AND APPLIED FOR MEDICAID.
As soon as she did, all of her expenses were covered. Anything from before that is not and will not be covered.
Being eligible and being signed up and in the system are two different things. My wife is eligible for Medicare - but she has not yet enrolled in Medicare. That means she does not have Medicare coverage.

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Judith 2 months ago

WHY were you ineligible? 10 to 1 it was because you didn't report something which made you ineligible which you should have and are to blame. As long as beneficiaries don't report events which they know they are supposed to report, people will be overpaid or will receive benefits they have no business getting in the first place. Not welfare's fault if you failed to report something you should have reported. They aren't mind readers.
And if you used your Medicaid to cover expenses knowing you were ineligible or suspected that you were ineligible then that is fraud and I hope they decide to pursue prosecution.
If the IRS erroneously sends me a refund of one million dollars and I spend it knowing that they made a mistake, I am guilty and must repay it. Same thing with receiving any type of benefit you should have known you weren't entitled to.

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babyboomer1001 2 months ago

You aren't perfect, are you? Nobody is. Obviously, someone made a mistake. You got money that you were not entitled to. You have to pay it back, all of it and asap. Otherwise, you could find yourself up against criminal charges - not for getting the benefits in the first place but, for failing to return the money promptly. If you cannot pay it off within the next few months, call them and work out a payment plan.

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Elaine M 2 months ago

So contact them.

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Erik 2 months ago

Hope you held on to those letters. As always, babyboomer1001 has horrible answers. There is zero chance of criminal charges (she blocked me).

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D J 2 months ago

Ask them to resubmit the bill. It you are on Medicaid, you have nothing for the to sue your for.

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