many kids are on both parents' insurances. one primary, the other secondary. people can have more than one insurance, adults or children. so do you mean is it legal to have kids on two insurances or you mean public assistance like medicaid. that would be illegal but two insurances are legal. delta dental is a normal dental insurance, it is not assistance type. never heard of title 19.

title 19 of the Social Security act is Medicaid

Having other insurance in and by itself is not a reason to be ineligible for medicaid if that is the question

I used to determine eligibility for medicaid (medi-cal) and there are many programs. If a child is eligible and they also have health insurance, the medicaid card is flagged so the provider has to bill the health insurance first, then medicaid picks up the rest. It is not illegal to be on medicaid if you have health insurance. It is illegal to lie about having health insurance to use only medicaid. That is not intended to be legal advice. Lying on an application for aid is fraud.

My question is basically what Ima answered. I think BM may be using medicaid she has had on SS and not disclosing to them that SS is now covered under my dh's family plan. I believe she is doing this because she is not happy with our insurance because we have in-network and out of network doctors.

I will add also that the medicaid office gets health insurance reports (by SSN) and she'll eventually get caught & her medicaid card will be tagged as having health coverage. They rarely prosecute for medicaid fraud, at least in my experience. They usually prosecute doctors & clinics that commit medicaid fraud, rarely recipients.

This is exactly what my DH's ex did. She NEVER used her son's health insurance that my DH provided because she didn't want to have to pay the co-pays, etc. She got Medicaid for him and used that b/c everything was "free."

It did catch up with her and SS's medicaid was cut off and BM has now been court ordered to pay half of everything related to their son's medical care. BUT--I doubt the state will ever do anything in terms of suing her for fraud or whatever.

I don't think it's "legal" but I think the state usually has bigger fish to fry.

It is legal, at least in my state. Our orders require NCP to maintain insurance only if it does not cost more than a certain % of their monthly income. My ex husband covers our daughter, my 2nd ex does not cover our son, and DH is required to cover for his son (if the cost is not ore than whatever %) It was an outragous amount to over SS, over $350mo. My state offers insurane plans to purchase, its like buying medicaid. I applied expeting to pay $45 per child per month. Apparently I qualify for the no cost plan. I was 100% honest in my application, even sent a note explaining out custody of SS, and the state covers all of them at no cost. I have to verify eligibility every July and this is the third year we have qualified. It is secondary coverage to the two children who have "regular" insurance from their other parents.
It is humiliating to use this insurance, there is such a stigma of being a "welfare mom". Really, I am married, my husband and I both work full time, we own a home, its just the healthcare available through our employers cost too much.

'It is secondary coverage to the two children who have "regular" insurance from their other parents."

This is what I believe is the problem is that she is using his medicaid coverage that she got on him before my dh got insurance on him and is not disclosing to them that he now has insurance.

Healthcare is crazy expensive I agree. Luckily my dh has affordable insurance through his job it is just that bm does not like our insurance arrangement and instead of trying to work something out she just went around us and took him to the dentist even though she initially was fine with him getting dental work done in our town.

I just have to ask -- does Medicaid cover doctors that Dads policy doesnt? or treats as out of network? That seems strange to me -- I though I hear people complaining how bad Mediciad is.

My experience has been that medicaid offers basic care which is, I won't say substandard, but it's "basic" care. It isn't as good as you might get from private health insurance. I don't see why anyone would choose medicaid over private coverage, except in cases where the family doctor that's been the family doctor for years and still takes medicaid (many don't) or if they are trying to get out of paying copays, but medicaid will pick that up. The biggest problem is having doctors that take blue cross but don't take medicaid so they don't want to bill medicaid for the copay.

Yes, I didnt mean bad. People say long waits, not enough doctors, etc. So I cant understand what is going on here.

It is my understanding, for my situation, if I took my kids to the doctor and did not provide their "real insurance" for proper billing that would be considered insurance fraud. I can't see the benefit of taking that risk. More often than not, I don't provide their secondary information and just pay the copays.

I'm sorry I missed how old your SS is, is he old enough to know where she's taken him? The clinic or doctors name? If so you could call the provider and give them your insurance info. It sounds like you're speaking specifically of the Dentist? I work in a dental office (billing insurance) and in my experience....Medicaid pays so little it's difficult to find a provider who will take a "medical coupon" The office would probably really appreciate some primary insurane information. Often times if you see an "out of network provider" Delta will still pay, maybe just at a lesser percentage. Unless you are part of a capitation plan where you are limited to a certain provider. I'd try to contact the providers office directly.
Good luck,

Don't worry medicaid will find out about the other insurance and bill hubby's insurance first then medicaid ... don't worry about insurance fraud for that ... its not on you ....

Hubby has always carried insurance for the kids and now mom is on welfare so it covers the co-pays :) so no out of pocket expenses ... no chasing her down for her half no having her throw it up in court how she paid $$$$ for copays .... her welfare is covering it ...

She is even thinking about getting SS13 braces using both medicaid and our insurance ... hey go for it neither of them have the $4000 to get the kid braces.

Okay, so here is the clarification for those of you who were not sure what I am talking about.

When my dh was in school we had SS on a dental assistance program that is through deltal dental. It is assistance, but there are copays. Also, bm is on assistance as well and I believe that she may have put him on it as well.

Now my dh is out of school, employed, and has insurance on our whole family. However, we have in network and out of network and since they are in a different state the docs there are out of network. My dh had talked with her this summer about him doing routine stuff down here to save on the out of network fees. I believe if it is in network it is 80/20 and if it is out of network they pay 50/50. She was not all that happy about it, but told us to go ahead and get him into the dentist. Well, it had apparently been over a year since he had been in and he needed about 1000 bucks worth of dental work. We told her and then dh scheduled an appointment for the end of Dec for his fillings. She was initially ok with this. Then about a month ago she took him to the doctor to get his shots and check up, but one week before he came down to see us for five days. She then called after the appointment and wanted DH to submit it to the insurance. She does not have a card yet as we are waiting for them, but we have the number. DH had previously told her that on our insurance plan we each get $250 worth of free medical care before we have to pay the deductable. So, if he had come down here to get his shots it would have been free. She got all mad about it and said that it is all about money with him and on and on. Well she paid by check I believe so we got the bill and submitted it and sent her half the cost. My dh reminded her about the insurance and this is when she said she thought he should have it all done there and did not want to get rid of his docs there. My dh explained to her that of course he should have docs there, but if it is routine things he would like to do them here. Well she did not say no or anything. I sent her an email with the name and all of the info for any docs here. Well, he gets an email from her saying that his cleaning appointment came up and she just took him in. She then said that they had time so they did his fillings. She went on to say that basically all of his medical care would be taken care of by her. Fine, why she just could not say this in the beginning is beyond me. If it so important to her that she be the one to take him to the dentist that is fine. It is not worth the fight though there is a big change in cost. Well she does not have the insurance info yet and when he asked her last time if she wanted the number she said that she would get it later. So she does not have the insurance info to give the dentist. She does have dental assistance though. The appointment had to have costed at least 800 to 1000 and I really do not think that they have that kind of money just laying around and really who does. So either she paid for the whole bill by check or used her assistance. I can hardly see her paying by check as that is a lot of money. I have no idea what is going on since she wont return his call so they can talk about it. Honestly, dh does not care that she wants to do his stuff up there. It will cost us more not her since she is on assistance, but whatever it is not worth fighting with her over. I just wanted to see if we could be in trouble for her not reporting the insurance to the dentist.

No, you wouldn't be in any trouble at all :)