General Question

serenityNOW's avatar

Can I expect any grief in dropping my Medicaid in NYS (some brief details, I promise!)

Asked by serenityNOW (3631points) April 30th, 2014

I take expensive drugs. They’re supplied by a company that advocates on the behalf of patients to get said drugs. They only help out those with no insurance. Now, medicaid won’t pay for the drugs I need, hence I am dropping my Medicaid. Does anyone have experience with this? Is there some reason I should give, i.e. repeat to them just what I said to my Jellies? Or, do I make to make up some silly b.s. I mean, they can’t force me to stay on, right? I just don’t know what to expect, am running out of meds and generally going batty. Thanks in advance!

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8 Answers

Hawaii_Jake's avatar

Now that the ACA (Obamacare) is in effect, I would triple check that the organization is still giving medicine to people with no insurance. There aren’t supposed to be that many people left who have no insurance. The organization may not offer this anymore.

Tropical_Willie's avatar

You need to consider ACA. ^ ^ ^
You have to have some form of health insurance or be prepared to pay the penalty.

Dan_Lyons's avatar

^ ^ ^ What penalty?

turtlesandbox's avatar

You can’t be forced to stay on Medicaid. It is difficult to find doctors that take Medicaid as payment, and even more difficult to find specialists. If the state wants an excuse you can tell them you would prefer to have insurance that gives you more choices in who you can see.

serenityNOW's avatar

@Hawaii_Jake – I’ll touch base with them soon, but I spoke to them last week and they didn’t mention anything.
@Tropical_Willie – in likelihood with the medicine in question, a one month prescription would cost more than the nominal fine that I might incur.

BosM's avatar

Have you researched options? and‎
Here are two links to articles on Prescription Drug Assistance Programs (PAP’s)
From NAMI.Org –

Some Patient Assistance Programs will help those who have insurance if they meet program hardship requirements or their medication is not covered by their insurance.

Giving up Medicaid would mean you have no insurance for doctors, hospitalizations, etc.
Just trying to be helpful. Good luck.

serenityNOW's avatar

@BosM – Well, the company that helps me out basically do all the heavy lifting. It is scary risking all that coverage you’ve mentioned, but I think it’s more prudent to keep my meds going. I don’t intend to be melodramatic, but I really risk hurting myself or others if/when I go off my meds.

bolwerk's avatar

@Tropical_Willie: I don’t think there is a penalty if you’re medicaid-eligible.

@serenityNOW: I don’t understand exactly why you’d drop Medicaid. You don’t say whether you plan to move to another insurance. AFAIK, Medicaid is free and you will need care at some point, so what is the penalty with keeping it?

You also don’t say where you are in NYS, but in the city (maybe this is statewide) you can visit Health Insurance Enrollment Program offices and get advice. If Medicaid really doesn’t cover your needs under any circumstances, maybe they can help you find a plan that would.

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