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The Toybox

people for the conservation of limited amounts of indignation

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psa: medicaid, medicare cost share, and various benefits
awesome bunny
For Everyone

Food Stamps has been renamed SNAP or Supplemental Nutrition Assistance Program. If you know what SNAP was before, you will be confused. Don't worry; that's everyone. Just go with it. I'll still call it Food Stamps here because it's more identifiable.

First, in Texas

With healthcare being a big concern and everything, I thought I'd go ahead and repost a link to my outline on Medicaid in Texas for women, children, pregnant women, et al.

Medicaid and You, a very unofficial outline of how Medicaid works in Texas. If you are pregnant and lost your job, or have kids and lost your job, or you know, you need help, please check it out.

Public Service Announcment, written prior to the above, with a short explanation of other programs available through the state.

Texas Works Handbook, for anyone who likes to do research. It is--confusing and it seems contradictory. But that is the manual of Texas Works, services covering food stamps, women and children's Medicaid, and TANF. It does not cover SSI (that's federal) or nursing home care.

The Medicaid Eligibility for the Elderly and People with Disabilities Handbook, for anyone with elderly/disabled relatives, friends, who needs more information.

Neither are easy to read or understand--I will say they are counterintuitive--but they do have all of state policy in them, updated reguarly. Both are googleable; go to google, advanced, enter the web address to limit the search, and enter keywords. It won't necessarily make it less confusing, but it may get you to your information quicker.

I cannot emphasize enough that I am not a caseworker anymore, so consider this an unofficial guide. You cannot wave anything (excpet maybe the handbooks) at an eligibility specialist. However, if you have questions and would be more comfortable asking me rather than going into an office, I'll do my best to answer them or say flat out I don't know or can't find that information. Unofficially.

Special Remarks Regarding Elderly

This will cover Medicaid and SNAP-CAP (a differnet kind of SNAP than the SNAP formerly known as Food Stamps, see why I'm still calling it Food Stamps?), which is a food program.

The programs covering nursing home care are very--complex. I was trained for the entitlements, not the medicaid for elderly/disabled, so my knowledge is very basic, or enough that when I had elderly clients, I could direct them to go to ME to apply. Hell, when I knew someone had someone elderly, I'd refer them over there. Nursing home care is fucking complicated and works on a grant basis. There is a waiting list. There is a limited amount of money per year (depending on program).

I'm going to say this again: if you have an elderly relative/friend/neighbor that may need nursing home care, in-home care, any kind of assistance, this is one of those times that early is best. Earlier the better. Not like, ten years from now, no, but it's as much the waiting list thing as getting familiar with what is available and being ready. A lot of people wait until the day they need nursing home care--do not do that. That is a special hell. A good caseworker can guide you through the process and get you help, and a great caseworker can probably get all this done fast, but fast is very relative.

I know how much it sucks to think about this--I've had a great grandmother and a grandmother both entered into nursing homes, and the stress is horrendous, and me and my mom are professionals with welfare programs and knowing who to ask, what to ask, and how it works. My personal timeline is three to five years before you think this circumstance is going to occur, so you have time to research the ratings on nursing homes that are covered by Medicaid--yes, those are out there and public information--and to get familiar with the programs available. There are a lot of options, and I know it's not something anyone wants to deal with, but having your information ready and talking to professionals ahead of time will reduce stress for your loved one as well.


This program is separate from SNAP that was formerly known as Food Stamps. It's SNAP-CAP, formerly known as only SNAP. Please just pretend that makes sense.

I'm cutting and pasting from the handbook:
The Supplemental Nutrition Assistance Program Combined Application Project (SNAP-CAP) is a six-year demonstration project to outreach elderly Supplemental Security Income (SSI) recipients not currently certified for SNAP. Single SNAP-CAP households are certified for either a $58 or $73 standard SNAP-CAP allotment based on their reported monthly shelter expense.

If the household reports the monthly shelter expense is less than $289 per month, the monthly SNAP-CAP allotment is $58. If the household reports the monthly shelter expense is more than or equal to $289 per month, the monthly SNAP-CAP allotment is $73.

To be eligible for SNAP-CAP, an individual must:

* be an SSI recipient;
* be age 50 or older;
* reside in Texas;
* not reside in an institution that causes ineligibility; and
* not receive regular SNAP benefits.

No other regular SNAP eligibility criteria apply to SNAP-CAP. Note: Individuals may switch from SNAP to SNAP-CAP as described in B-476.2.1, Switching from the Regular SNAP Program to SNAP-CAP.

Outside of Texas

This is by necessity more general, but some very specific links.

211 Information and Referral - I'll quote, "2-1-1 provides free and confidential information and referral. Call 2-1-1 for help with food, housing, employment, health care, counseling and more. Learn more about your local 2-1-1 by looking it up here."

It's active in a lot of states, but I don't have the latest maps. At my job before this one, I sat in on a presentation by 211 on their life, times, and function. They are trained specialists--there's like an accreditation for what they do, and everyone there has to get it before they are allowed to touch a phone. No, I'm not kidding. They are professional information and referral specialists with a database that scares me in its hugeness that is constantly updated with different programs to help individuals and families. And we are not talking like, one. We are talking like, thousands and thousands and thousands, and that is outside government-sponsored assistance. I mean, there is also that, but besides that? A freaking lot.

I cannot emphasize enough that it does not hurt to call when help is needed. No one knows what they qualify for or everything that's out there, and they have programs listed in my city that I didn't know existed, and I kept up with that kind of thing when I was a caseworker and when I did the complaint line.

There was a lot of welfare wank/welfare things going around, so that reminded me of this.


For entertainment value, here's my rant on welfare from a couple of years ago: Welfare - A Rant, because every so often I lose my shit on the subject in a really dramatic way.


And there you go. Questions, thoughts, more info needed? Ask. If I know, I'll answer, and if I don't, I'll find out or direct you to where there are people who do know. If anything needs expanding, or ooh, you have links to places with more information, hit reply and I'll add it to this entry.

More may be added if I think of things I missed or someone notices something I should add.


First Step - I'm going to quote the incredibly awesome seikaitsukimizu:
Here's a helpful site that, with your information (financial, geographical) it'll show you what help/state programs you're eligible for. We use it to check for Medicaid eligibility. Hope it helps someone!

She also states this is not just for the homeless.

Also, this post is linkable if anyone wants to direct people here. I forgot to mention that.

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There was a lot of welfare wank/welfare things going around

I... what. do I even want to know? I. ugh, people are fucking gross. I don't need an explanation to know that'll be my conclusion on the matter, but. people are fucking gross.

that said? this is a great post.

I was in elder law before shifting focus earlier this year, so really I have nothing but thumbs up for you encouraging people to plan ahead, plan ahead, and plan ahead. the fact is, we never ever know under what circumstances a loved one or ourselves is going to need long term care. getting your shit in order and educating yourself so to help your loved ones get their shit in order is so important.

also? thank you for mentioning friends and neighbors.

let's talk about Mrs. A, and her daughter B. Mrs. A and B don't get along well, and despite the mother and daughter living just five miles apart, B is only concerned with her own life. Mrs. A, in declining health and with only her late husband's military survivor benefit to support herself, fears that she will be placed in a home and lose her house to pay for it. but! the lady across the street, Mrs. C, checks in on Mrs. A one day and discovers her situation. Mrs. C helps her understand how she can qualify for home care, meals on wheels and other things that help her live out her last days with dignity. after Mrs. A passes, B says that Mrs. C was interfering where she had no right, and when confronted about her own callousness, B says that her mother was a terrible person and didn't deserve any help.

wrong. everyone deserves help. it is our obligation as human beings to care for one another. no, we can't know all the things that happen between family members which result in their turning their backs on each other, but basic human comfort and dignity must be preserved. and without those "interfering" friends and neighbors, so many people, man, I have seen it again and again, so many people are de facto denied their basic human rights, they end up losing what they have worked for, they end up dying of preventable causes, they end up just another number in the county home where the overworked underpaid staff has either given up caring, never did, or just doesn't have time.

I don't think there are many people whose days are so full of vitally important things that they can't say hello to an elderly neighbor and ask 'is everything okay?' I don't think our own shit is so riveting that we can't pay attention to those around us and notice and offer a hand when someone seems to be struggling. the way that our society seems to be fracturing along generational and familial lines makes it more important than ever for us to help each other.

somewhat tangential, but it's a raw nerve - I spent an hour on the phone with my brother tonight going over our parents' medicaid planning/estate planning for the nth time - and it's just a thing I have, so.

anyway. what Jenn said, people. *hands*

You are amazingly awesome with this. Beyond words. Thank you for posting this.

Just to say, I think you're kind of a superhero. :)

...I don't feel like, at this point, I'd probably be eligable for anything anywhere ever, but I should probably just call the 211 people, because omfg have you seen my panic attacks lately about my lack of insurance? Meep.

Oh, no, wait. Have checked, and it looks like they serve every county in Maryland but mine. Well, ok then. *blink*

(ok, to be fair, they don't serve ALL of them. Just many. Apparently we have a lot, and also apparently I live in the 8th wealthiest (per capita income?) county in the nation? No wonder it's so bleeding impossible to live here.)

Now that I work with insurances (including Medicare/Medicaid), I run across all kinds of useful information that I'm more than happy to share with people down on their luck, the elderly, and everyone in-between.

Here's a helpful site that, with your information (financial, geographical) it'll show you what help/state programs you're eligible for. We use it to check for Medicaid eligibility. Hope it helps someone!


PS: By the by, ignore the "homeless" part in the subtitle. Anyone can use this, despite what it says its target audience is.

Added a link and thank you. I'm sending this to our local office Monday for sending out through our offices.

This is a really damn awesome post.

you are a very awesome person for posting this. i am fortunate enough that i doubt my family will need any of this info, particularly not in the near future, but omg. it is still so incredible having a resources post like this, which introduces lots of information in a helpful, easily comprehensible, and not-scary way.

you = the AWESOMEST. seriously.

I actually have a question that is somewhat related -- I am thinking that being a caseworker might be right for me, but I am unsure how I would get into a position. Every time I look online it seems like you have to have masters to get in the door but I feel like I am not looking in the right places. Any suggestion or advice? I live in Kansas, if that is necessary to know. :)

Okay, this might get you where you want to go. The Civil Service page doesn't have SRS listed, which--I don't even know.

Here is one of them, which is, I think from teh description, analogous to food stamp/tanf/medicaid eligibility and it looks like also some CPS.


There's an email address at the bottom; I'd email them directly and see if they can direct you. It's possible that they moved that department's employment, because Civil Service isn't showing it in the drop down.


Different states use different names for the same functions, but from what I can tell reading SRS, they'd be your contact for social service jobs. Tell me if this works for you. If it doesn't, I can call some friends who are still caseworkers and see what kind of relationship our agency has with SRS or the Kansas equivalent.

*crosses fingers*

Wow you got back to me quick! I sent off an email, hopefully they will have some useful info. *crosses fingers*

The second link was a bust, the only thing even close was a job working with inmates soon to be released to form a reentry plan. IDK I guess the entire state could just not be hiring in that area but it seems to me that more help than ever would be needed right now, you know?

The other day at my office, Medicaid benefits helped a 19 year old girl see clearly for the first time in years. Without glasses, she is legally blind. With the glasses Medicaid paid for, she corrects to 20/20 vision. People that bitch to me about Medicaid are going to be hit in the head with something large and blunt.

Also, if my best friend had been made aware of Breast/Cervical Cancer assistance, she might have been able to avoid the hundreds of thousands of dollars of crushing medical debt she's been under for the last 5 years. So I don't give a shit about the people who "abuse the system." I care about the people who need the system and are discouraged from using it (because her parents berated her so much that she was completely ashamed to even ask about assistance that might be available, and neither of her parents helped her with her medical bills).

My mother finally dropped her fixation on getting my sister married off to her boyfriend before Aidyn was born (or at least ASAP afterwards) when the point sank in that being a single mother qualifies Lauren and Aidyn for Medicaid and Daniel's sketchy employment history means he keeps changing jobs before he qualifies for health insurance he could get them onto.

Thanks for the information and the link to the 211 site. I work with the disabled and elderly every workday. It's hard to keep up with the changes in and new programs available. Since the 211 people seem to be available ONLY for referrals, I'm sure I'll be contacting them directly or letting people know about it on a regular basis. I'm also going to let my elderly brother and his wife know about their local programs - they live in another state that me and I've been wishing i could help them more when i go up to visit.
My claimants and I than you.

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