Boyfriend has lung disease and is trying for transplant. He is on SSDI and has Medicaid insurance that covers everything. We are planning to get married so I can get family leave to care for him after transplant and can only get that if we are married. I don't want him to lose his excellent coverage, but I can't lose my job either.
For the income part - managed by SSA - when you marry, your income will be tested to see if he is eligible to continue getting his SSI check. A portion of your money is 'deemed' to be counted as income for him.
They will also look at your 'resources'. Example: Single, he can't have over $2000 in the bank. I think for a couple, it's $3000. And that means at any time during the month. You deposit $4000 in the bank from your pay - it would make him over the limit.
For the Medicaid part - it is managed by both Federal and State - so rules can vary from state to state. But remember - Medicaid is a program for people with limited or no income. Very likely that your income is going to put him over the limit to keep the Medicaid. Really low income limits for adults to be eligible for Medicaid.
You should really talk to the dr. If he has this surgery, wouldn't he go to a rehab afterwards? Taking time off using the FMLA does not necessarily mean you will get paid leave for the maximum 12 weeks of leave. Most companies let you take off, but you have to use your own saved sick time and vacation time to get paid. If that's true of your company, do you have 12 weeks saved up? Or will you be without a check for most of that 12 weeks? Too many people assume FMLA is a paid benefit by their company and it's not.
The other thing I will point out: If you have been 'holding out' or representing yourself to others as already married (like common-law), SSI and Medicaid could make him pay back benefits he was not eligible for. In Texas, you are considered common law simply by telling others 'he is my husband'. It doesn't have anything to do with how long you have lived together (as some believe), it's about how you present yourselves in public, legal documents, etc. Your insurance company may require you to sign documents for an informal marriage to add him, but the Medicaid and SSI may just go by how you present yourselves.
Remember, Medicaid is a needs based program, which means a beneficiary must have limited financial means. Unfortunately, a marriage can push a beneficiary over the Medicaid set limits and result in Medicaid disqualification of the newly married spouse. It is very possible in your state that as a married couple, even if your income was quite low, that you would be required to add him to any other insurance available to him - such as your insurance at work. Medicaid wants you to use any other program/insurance available to you before using fed/state paid coverage.
IRS documents are another way for the Social Security Administration and Medicaid to find out if you have filed taxes together and failed to report the husb/wife relationship to them. So if you've ever done that, even though no formal marriage, you could have already created issues.
Your income & assets come into play. & he’s now on your health insurance and I bet they will decline to pay for anything. The bill that y’all will be personally libel for will be huge, like bankruptcy in your future huge. I wouldn’t be surprised that if he changes his insurance at this stage, that it resets his timing on having a transplant.
Don’t get married.
Akso please please please heed AlvaDear’s advise. You need a team to do transplant care and your team needs their own support system.
Do your research with your boyfriend's medicaid caseworker. You cannot have him lose that insurance. You may be a position of having to quit your job for the duration of this time frame.
I am so sorry you are dealing with this difficult situation. I had a friend you was unable to get transplant because she was never able to get that team for home care together for 24/7 care. I sure wish you both good luck in moving forward.
There are no guarantees with transplants. A friend of mine lasted 3 yrs after hers. I would think he is not going to be sent home right away. I would think he would need to be monitored for rejection and ongoing med adjustment.
Where your work - while you may not be able to take FLMA, would they be willing to give you a leave of absence while you care for BF? Can your duties be performed at home allowing you to work around your caregiving duties? Is there any way you could work reduced hours and be able to go in for a few hours a week when not caregiving?
I don't know how post transplant caregiving is done, so if my questions in the above paragraph sound like I don't know what I'm talking about - it because I don't know what I'm talking about. But just trying to be helpful.
Good luck and blessing to you and your BF. I hope you can find a workable solution.