Medicaid Can Help with Past Medical Costs

 

Can I get money back for bills I paid?

Medicaid may cover past costs. Costs may include bills you paid.  Bills must be for things Medicaid covers. They can be from before you got your Medicaid card. They can be from before you applied for Medicaid. They must occur within three months before the month you applied for coverage.

  • Here is an example: You pay for your medical services. You apply for Medicaid on October 11. Costs after July 1 may be covered. If covered, Medicaid will pay you for those costs.

Medicaid may cover your costs caused by error or delay.

  • Here is an example: Your Medicaid was cancelled by mistake. You paid for covered services. Medicaid will pay you back for those costs.

Costs before you apply for Medicaid can include all providers.  A provider is a doctor, hospital, or health setting that offers medical care. After you apply for Medicaid, only Medicaid providers are covered. After you apply for Medicaid, always ask your provider if they take Medicaid. After you apply for Medicaid, costs will not be covered from a non-Medicaid provider.

Other rules:

  • Costs are only covered for Medicaid services. These are services Medicaid is allowed to pay for. They include doctors, dentists, home care, hospitals, prescription drugs, and other services.
  • Medicaid may only cover the set rate for services. This may be less than the bill you paid.
  • Medicaid only covers costs that occur when you are eligible for Medicaid.
  • You must show your Medicaid bills. You must also show proof that you paid them.

If you have past medical costs, Medicaid can help. Please call the NY Medicaid Helpline at 1-800-541-2831.

 

 

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