Medicaid Buyout (Medicaid will pay for part of your Insurance Premiums)

Let me make sure you understand 2 terms before I start.  Medicaid is a Federal and State funded Health insurance program.  Private Insurance means insurance you get through work or through a third party that you typically pay premiums and copays and have deductibles.

Medicaid (at least in Utah...I don't know about other states) has a program called a Medicaid Buyout.

It means if you have private insurance for your child with disabilities AND medicaid, then medicaid will reimburse you for part of your monthly private insurance premiums if you qualify.

Medicaid has figured out that they often save money if they become the secondary insurance instead of the primary.  It means they are paying your copays instead of paying your insurance benefits.  If it is cost effective for them, they will help pay your premiums.

We have a Private Insurance "family plan" through my husband's employer.  We pay a regular family premium.  Then the Medicaid Buyout reimburses us about almost half of our monthly premiums.

On our part we are required to send in proof of payment of premiums (for us it is our paystubs).  We just scan them in and email them.

We also have to send in our EOB (Explanation of Benefits) about twice a year. These are the statements you get from your private insurance saying this is how much the Dr. billed and this is how much we paid.  With our insurance we can log onto our insurance online and download all of our EOB's for a certain time period into 1 document which we can just send onto the buyout manager.

Here is a link to the program online. https://medicaid.utah.gov/buyout-program

The link says to contact the department of workforce services to ask about qualifying.  I have had multiple problems with their workers not being fully informed of all programs they offer and/or telling people they don't qualify when they actually do.  So don't give up if your first answer is no.

Have you had success with the buyout program?  What advice do you have for others?

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