Understanding Medicare and Medicaid Coverage After Receiving Inheritance

What is Medicare and Medicaid?

Medicare is a federal health insurance program primarily designed for people over 65 years old or those with certain disabilities. Medicaid, on the other hand, is a government-funded program that provides health coverage for low-income individuals and families.

Did User Commit Medicare Fraud?

The user in the provided post mistakenly thought they were on Medicare. However, they were actually covered by Medicaid, which is primarily designed for low-income individuals and families. When the user received a life insurance payout from their father-in-law (FIL), they mistakenly thought that they no longer qualified for Medicaid. They informed Medicaid of the payout but made the incorrect assumption that their coverage would be terminated.

The user continued to pay for health insurance and medical expenses out of pocket, believing they were no longer covered by Medicaid. However, it is important to note that Medicaid is a needs-based program, and receiving an inheritance generally does not disqualify someone from coverage.

Why Did User Receive a Fine?

It seems that the user received a $10,000 fine from the federal government for not having coverage when they were required to. It is likely that the user was erroneously enrolled in a marketplace plan and received a subsidy for the monthly premium. When they received the inheritance, their income exceeded the threshold for receiving the subsidy. As a result, they were required to pay back the premiums they had received.

Rectifying the Situation

The user can rectify this situation by contacting legal aid, who can assist them in navigating the complexities of the Medicaid and Medicare systems. Legal aid can also help the user determine if they were overcharged for their insurance and assist them in seeking appropriate remedies.

Getting Back on Medicaid

To get back on Medicaid, the user will need to reapply and provide proof of their current income and assets. Depending on the state’s Medicaid eligibility criteria, the inheritance may not affect their eligibility. However, it is important to note that there may be a waiting period before coverage can be reinstated.

Key Points to Remember

Medicare and Medicaid are distinct government healthcare programs with different eligibility criteria.
Receiving an inheritance generally does not disqualify someone from Medicaid coverage.
If you are on Medicaid and receive a large inheritance, it is crucial to contact Medicaid to inform them about the change in income.
If you are required to pay back Medicaid premiums due to an overage in income, legal aid can assist you in seeking appropriate remedies.
If you need to reapply for Medicaid, contact your state’s Medicaid office to determine eligibility requirements and the application process.