Right now I am staying with my niece and I moved to Addison NY from Texas. While I was in Texas I was living in a nursing home. Right now I am still trying to get my Medicaid because I am having major health problems and I am in dire need of home care help.
Medicaid usually will not pay for in home help more than a few hours a week.
All I can suggest is call them and see if you have been assigned a caseworker. If so, then talk to that person. With COVID I would think even government agencies are slowing down. Just may mean by calling u go to the top of the pile. If you continue to have problems, call County Office of Aging to see if they can help.
Are you on Social Security Disability?
If it’s SSI, if I’m not mistaken, State of residency will matter big time as the type of benefits eligible for are based are on state of residency income demographics. SSI is means tested first for income based on residency and only if you pass the states means test for income (to be eligible for SSI) do you get Medicaid to accompany your SSI; you don’t have to show to be at need for health care under SSI to get Medicaid. There was a TX claim examiner that did her determination based on TX residency.
Add to this that Addison, NY is kinda close to PA. So billing could be crazy if they go to a nearby hospital across state line.
if it’s SSI, to me it’s way too complicated to DIY the paperwork. Ditto for SSDI, although this is more straightForward based on work history / fica records. They need an atty who does SSA work.
- Each state administer their Medicaid programs uniquely.
Medicaid is a joint state & federal program but each state determines how the $ is divvied out except for those programs on mandated coverage.
- you have changed the type of care you are seeking.
In TX you were in a NH which is skilled nursing care and IS mandated coverage if you are determined to be “at need”; so you were determined to be “ar need” both medically and financially for TX Medicaid to pay for your room & board at the NH. But now you are looking for in home healthcare services (IHHS) and to have NYS medicaid pay for it. IHHS are done on “waiver programs” by all the state and the “at need” requirements will be set by NYS. Just what NYS offers as waivers seems to vary by city and county. There may be very extensive IHHS in NYC for those who otherwise would need care in a NH as it makes sense to do this financially. But perhaps not so much in so Buffalo.
- You need to have some sort of address or residence in the State to which you are applying for.
Just what is needed for that for NYS & get a State of NY ID to clearly establish legal residency, you have to find out how to do and get started on that. Like it might be you need to have an existing TX ID or old TX driver’s license to turn in and 2 (or maybe 3) current accounts in your name being sent to you at your new NYS address, eg monthly cable or phone bill, monthly banking statement. States do allow time for you to “bridge” from 1 address to another but things will have to be done to establish NY intent to or legal residency eventually.
Imo you will need to have a “needs assessment” done by a health professional with the state of NY to determine the level of care you need. If you are right now are still a TX resident, state of NY can’t justify doing a needs assessment on you; so not a resident = no needs assessment = no program to apply for = not eligible for Medicaid.
at 59, you’re pretty young.
So is / was TX Medicaid your only source of health insurance coverage? How did you get onto TX LTC Medicaid to begin with?
Like were you disabled, got SSDI and then seguewayed onto LTC Medicaid and somehow determined to be ok for SNF in a facility?
When you left the NH, what was your status when you left?... like did you leave AMA (against medical advice)??... or leave with an IHHS care plan?... & have a agency set up to do this at your old TX address??
If your being in a NH was a disability related benefit, imo you really want to find a disability rights attorney in NY to work with you on your status to be viewed as disabled for NYS criteria. You moved states, that TX disability won’t matter unless it’s one of the federally mandated for coverage disabilities, like ALS.