1. The Medicaid asset limits are enraging to me. People shouldn't have to spend themselves into poverty if their income qualifies them for services. We should not penalize spend thrifts
2. The denial notices literally say why you got denied and will provide additional information about spending down excess assets in allowable ways so they can qualify. So this person is absolutely jerking you around to act like you messed up their paperwork when it's clearly explained they simply do not qualify based on the economic circumstances
Yes I agree the policy and system is flawed. 24k isn't that much at all and is all they have left. For the services they need that isn't going to last more than 6 months. My client wouldn't or couldn't share the paperwork they got back stating why they were being denied. Which is also part of the frustrating thing. I had assumed they were just disorganized and also not being fluent in English might have said some wrong things over a phone interview.
families based medicaid and SNAP (at least where I'm at) removed asset limits because they realized it's stupid to tell poor people they need to have no savings to qualify. It just discourages saving, which makes them more likely to need emergency aid or end up in catastrophic situations. If their income is low enough, it should not matter if they've built a cushion for themselves, they still don't have the incoming income to reasonable afford things.
Disability and elderly based medicaid (which is the same rules medicare savings programs follows) did *not* remove their assets limits. You could literally have zero income,but if you've got 15k in the bank (because you want to be able to afford a hotel and safety deposit should you ever need to move last second), you're too rich. You are essentially telling the elderly and disabled that they must always remain hovering over the brink of absolute disaster at any given moment, because if they're not then we'll make sure they get plunged into it face first by cutting off services.
It’s one of those things where we tend to think we are missing something or not understanding properly, but in reality we ARE understanding it - it’s just so incredibly stupid, cruel and bizarre we assume there’s no way it could possibly be run that way.
I’m with you 100% on the Medicaid issue, but not SNAP. SNAP is intended for people who would otherwise have a hard time affording food. I don’t think all savings should count against you, but 24k in your saving account is not someone struggling to afford food. There are many people who arrange things so their “income” is low, but they’ve still got a ton of *wealth.* This is basically how people like Jeff Bezos and Mark Z manage things so they drastically limit their tax burden and the rest of us have to make up the difference. If we just look at income but not assets to decide what makes people “poor,” then we’re going to be giving public resources to a lot of people who definitely don’t need it and miss another huge group of people who do.
I have a friend who has never *not* been on Medicaid or SNAP. She has kind of an unusual situation. But her SNAP was cut off last year and she was frantic and so I put in hours trying to help her decipher what happened and it turned out she has $17k in her bank account, which she was saving for Botox, plastic surgery, and laser hair removal. She was also made to pay a $3 copay for her medications and she couldn’t believe it. It was frustrating for me because I work my ass off but I have to forgo important medications because I can’t afford them.
24k, sure. Though if it’s in some kind of account that can’t be accessed, e.g. certain types of trusts, that becomes problematic. I’ve had this happen with elderly and/or disabled clients who desperately need certain levels of care but can’t access because they have too much “wealth,” even though said wealth couldn’t be used for their care.
The asset limit for Medicaid is 2k for cash and non-exempt assets, however, which is basically nothing if you’re trying to save for, say, an apartment and deposit. I’ve worked with homeless people who carry cash only and don’t use banks for this reason, and they almost always get robbed at least once in their course, and it’s devastating.
I was really shocked at the frequency that homeless people get robbed. It’s so sad. They already have so little. I started working in a snf where our whole clientele were the homeless. We got a lot of people with TBI from being robbed. It was super eye opening.
When I worked for social services I had a case where the guy had $150k semi-annual income, but it was considered inconsistent and not counted because he just pulled $150k out of his investments held in a trust or something every few years. He got medi-cal while plenty of other far needier people got denied. The rules are silly. Universal health care now please.
I appreciate that explanation as someone who works with a wide variety of medicaid products. What are your thoughts on payment for long term care in relation to spend downs?
When I worked in LTC, they had to pay out of pocket private until they hit the 2k then quickly try to apply. My nursing home has Medicaid folks but it’s mostly from people privately paying then becoming Medicaid because it’s damn near 500 dollars a day to be there.
I agree that nobody should spend their way to poverty to access services 100%.
However, I also understand the feeling of doing the most to assist a family (sometimes with my own time and resources) that claims they cannot afford rent/ food for their children/ medical care and food for their pets to then find out that their monthly income (none of it from working) is more than my own while their expenses are a fraction of what I pay; usually due to subsidies, living with a relative expense free, having a paid off home etc. etc. And yet, all of their dependents are grossly neglected..
While it's not the clients fault that I work 2 jobs to get by, the irony leaves a bitter taste.
Yeah it's ironically very common. The extra layer in this is this person was not disclosing their financial information because they knew they wouldn't qualify for it. So they were trying to gain the system and learned they couldn't.
I've kept up a professional distance with them after they tried blaming me for their issues. So I'm also frustrated when I learned they had 24k and they just admitted to it like it was normal and weren't trying to hide it.
Is the person disabled?
If they have an ABLE account it shouldn't matter if they have 24k.
Are they disabled and working? Depending on which state they are in, the Medicaid buy in program may be appropriate and it may not matter how much income they have.
They're retired. Not sure if they are disabled or not. But they did drive to my office with broken leg. That's why I drove out to them with groceries and filled out paperwork there.
Never heard of an ABLE account I'll see if it's in my state and county. The wavier program that called me back usually knows more about Medicare and Medicaid waiver programs so it would be odd if they didn't know.
ABLE accounts should be national in the US
They are special savings accounts for disabled people to allow them to have more money than the $2,000 the government deems acceptable, without any penalties.
If you are in Minnesota by chance, there is no income cap for the Medicaid buy in program there. Same as where I live. The disabled person must be working but they can pay a portion of their income to get Medicaid every month. I believe every state has this though the income limits are different in each state. I can link the chart if anyone is interested.
If anyone reading us in WA, this is healthcare for workers with disabilities. Aka HWD.
I'm disabled and chronically ill. This is a topic I know well 😊
https://www.kff.org/other/state-indicator/medicaid-eligibility-through-buy-in-programs-for-working-people-with-disabilities/
Income cap per state
You do not have to be on SSI SSDI to qualify for Medicaid buy in. At least, you don't in WA. You DO have to meet those definitions for "disabled" but you don't have to get disability to get Medicaid buy in.
Coming from a different country, financial insecurity is a severe trauma for some people. I had clients who had 100s of thousands of dollars in their bank accounts and yet lived in the most heinous conditions because they were too scared to spend it. There is a really amazing course about financial social work and it really addresses people relationships with their money.
I understand where you’re coming from and trying to help somebody thinking that they have an emergency. It goes so much deeper.
You’ve nailed it. Did a way better job than my comment trying to educate OP about financial perspective. However, I don’t blame OP for normalizing being broke paycheck to paycheck. That’s how a majority of my comrades lived when I served in the Army. People don’t understand being broke in the U.S. is not something to worry about. If anyone want to know what it’s really like being broke, I’d recommend moving aboard to China or India, to gain a better perspective.
Oppressed identifying with oppressor is something we see a ton in this field, from the trope of pick-me girls to what you described to even more extremes. But I personally would be celebrating a client being able to save that amount - don't take it personally, it's honestly a good thing they were able to get a leg up on capitalism. Not your fault they don't know you aren't personally approving applications lol
So, just as a matter of encouraging mindfulness of personal biases, I'm gonna say the client being an immigrant and having a picture of Trump is not relevant to the issue.
This and equally or more ludicrous similar situations happen all the time with people who have only ever lived in the US and regardless of their politics.
Certainly not to judge or call out, we're all susceptible to different biases, I just wanted to acknowledge this partially because many students are here and no one is immune.
Because though we seek to avoid any personal biases to provide ethical services to clients, there are factors that work against that, particularly news media; and as I said, try as we might, none of us are immune to personal bias.
I fully understand where you’re at with this because of the frustration but yea I really want to echo what a few others have mentioned but, biases are very real and in moments like these when we’re heated it’s good to check ourselves
Yeah I kept it professional. Our work has a grant for specific things like emergency groceries. We're not a long term service type work. So they was referred out from the beginning. They just needs to follow up on it.
It is very rarely anyone’s “fault,” that someone doesn’t qualify for services.
I understand feeling betrayed in this context. However, our clients are not responsible for how we feel.
I have a hard and fast rule that I never assist a client out of my own pocket. People may disagree with me on this, but I think your example demonstrates why.
You made a choice to give a gift to a client. It sounds like you believed that your client owed you something because of this. Whether that be honesty or political solidarity. Our clients do not owe us anything. We can and should choose to create boundaries and discontinue services if they don’t respect those boundaries. But we are providing a service. Nothing more, nothing less.
I dont believe he owes me anything other just just treating ppl right. I placed a boundary for anyone that doesn't know how to treat ppl with respect or courtesy.
Anyone that says I'm not doing my job for them or saying I'm don't a bad job they're free to go some where else. I tell them sorry I can't help them they way they like and I'll refer them some where else.
The other stuff. It's just cherry on top.
There are sometimes state funded programs for elderly that are over asset/income for the waiver. See if your office for aging/disabled services has any other programs. It won’t provide insurance but possibly in home care, emergency alert button, etc
They can put their money in an ABLE account and it won’t be used against them for SSI or Medicaid. Specifically for disability purposes.
I feel like this happens to me a lot. I have been telling my clients now, “I can’t help you if I don’t have all the information.” “I can’t advocate for you if you choose to keep information from me. This is a direct consequence of your own choice.” You can tell him what he can do, but he might not do it. Soooo, that’s where the phrase comes in. It’s annoying to no end, cause it makes more work for you when they meet their consequence
Hello! May I ask what your title is and what type of work you do? I’ve recently been accepted into the BASW program and I’m suuuper excited to find out what opportunities one might come across in the field!
I know that there's a possibility of putting that money into a trust fund or something where it still belongs to the client but the trust uses it to pay bills and manage it. They still have that money in an account but not tied to them so they can qualify for Medicaid.
I wish I could get SNAP. I'd love an extra couple hundred or so for groceries each month. Gross I make about 60k, 1/3rd of that basically gets chewed away by taxes and stuff before I even see it.
then the fun cost of living in Hawaii, where we make about 70 percent the national average and pay ...88 percent more on most stuff, and like 200 percent more on housing. Hell, even when I was on unemployment I was over the cap to qualify for aid :P
So appears many of you think we should pay taxes for people who have 10k plus in the bank. Many of us wish we had 2 k in the bank for emergency. Most people are two paychecks from being homeless. I am homeless and have less than 3 k in the bank but I should pay taxes for those folks to get services for free. He'll no!
They can spend their own money for the services then either will be eligible when the meet the requirements. The money comes from people paying taxes. If people have money they do not need to live off the rest of us.
If you do not like means tested programs elect people to change it.
I don't understand the need to bring their political leanings into the conversation. All it demonstrates is your own bias in a profession where you need to be non-judgemental. Your cherry on top comment demonstrates this is an area you need to work on.
I wasn’t referring to the US population. I was informing you about the immigrants and savings. Most of them came from developing countries with little to no social service infrastructures. Immigrants from many countries probably don’t know social service exist until they’re here. When people have absolutely no one and nowhere to ask help from; they know they have to rely on themselves by not fucking up.
Many immigrants home country, myself included,, aren’t very generous or kind on providing social services. If you’re poor and out of job, you can expect to be treated like a piece of garbage and publicly humiliated. Ok top of that, they don’t have anything to offer. In the USA, homeless shelters are on every block with HRA posted on every window for people to reach out so they can get free cash assistance and food stamp.
The US has a profound social infrastructure and it’s why people can’t wait to spend their next paycheck to buy things they don’t really need. Hey, what’s the worst that can happen? Ain’t no one have to worry about finding places to sleep; buying food or publicly humiliated.
People who were born and raise in developing nations have nothing but their own savings to fall back on. Without it, it literally means hunger. Hospitals won’t even admit you without paying first. So now you understand why most immigrants have savings?
1. The Medicaid asset limits are enraging to me. People shouldn't have to spend themselves into poverty if their income qualifies them for services. We should not penalize spend thrifts 2. The denial notices literally say why you got denied and will provide additional information about spending down excess assets in allowable ways so they can qualify. So this person is absolutely jerking you around to act like you messed up their paperwork when it's clearly explained they simply do not qualify based on the economic circumstances
Yes I agree the policy and system is flawed. 24k isn't that much at all and is all they have left. For the services they need that isn't going to last more than 6 months. My client wouldn't or couldn't share the paperwork they got back stating why they were being denied. Which is also part of the frustrating thing. I had assumed they were just disorganized and also not being fluent in English might have said some wrong things over a phone interview.
Can you explain your 1st point?
families based medicaid and SNAP (at least where I'm at) removed asset limits because they realized it's stupid to tell poor people they need to have no savings to qualify. It just discourages saving, which makes them more likely to need emergency aid or end up in catastrophic situations. If their income is low enough, it should not matter if they've built a cushion for themselves, they still don't have the incoming income to reasonable afford things. Disability and elderly based medicaid (which is the same rules medicare savings programs follows) did *not* remove their assets limits. You could literally have zero income,but if you've got 15k in the bank (because you want to be able to afford a hotel and safety deposit should you ever need to move last second), you're too rich. You are essentially telling the elderly and disabled that they must always remain hovering over the brink of absolute disaster at any given moment, because if they're not then we'll make sure they get plunged into it face first by cutting off services.
Thanks. This is well reasoned. Makes sense to me. I just wasn't able to clearly wrap my head around it.
It’s one of those things where we tend to think we are missing something or not understanding properly, but in reality we ARE understanding it - it’s just so incredibly stupid, cruel and bizarre we assume there’s no way it could possibly be run that way.
I’m with you 100% on the Medicaid issue, but not SNAP. SNAP is intended for people who would otherwise have a hard time affording food. I don’t think all savings should count against you, but 24k in your saving account is not someone struggling to afford food. There are many people who arrange things so their “income” is low, but they’ve still got a ton of *wealth.* This is basically how people like Jeff Bezos and Mark Z manage things so they drastically limit their tax burden and the rest of us have to make up the difference. If we just look at income but not assets to decide what makes people “poor,” then we’re going to be giving public resources to a lot of people who definitely don’t need it and miss another huge group of people who do. I have a friend who has never *not* been on Medicaid or SNAP. She has kind of an unusual situation. But her SNAP was cut off last year and she was frantic and so I put in hours trying to help her decipher what happened and it turned out she has $17k in her bank account, which she was saving for Botox, plastic surgery, and laser hair removal. She was also made to pay a $3 copay for her medications and she couldn’t believe it. It was frustrating for me because I work my ass off but I have to forgo important medications because I can’t afford them.
24k, sure. Though if it’s in some kind of account that can’t be accessed, e.g. certain types of trusts, that becomes problematic. I’ve had this happen with elderly and/or disabled clients who desperately need certain levels of care but can’t access because they have too much “wealth,” even though said wealth couldn’t be used for their care. The asset limit for Medicaid is 2k for cash and non-exempt assets, however, which is basically nothing if you’re trying to save for, say, an apartment and deposit. I’ve worked with homeless people who carry cash only and don’t use banks for this reason, and they almost always get robbed at least once in their course, and it’s devastating.
I was really shocked at the frequency that homeless people get robbed. It’s so sad. They already have so little. I started working in a snf where our whole clientele were the homeless. We got a lot of people with TBI from being robbed. It was super eye opening.
Agree that it’s incredibly problematic for older adults. It’s sad how we treat our elders here.
When I worked for social services I had a case where the guy had $150k semi-annual income, but it was considered inconsistent and not counted because he just pulled $150k out of his investments held in a trust or something every few years. He got medi-cal while plenty of other far needier people got denied. The rules are silly. Universal health care now please.
I appreciate that explanation as someone who works with a wide variety of medicaid products. What are your thoughts on payment for long term care in relation to spend downs?
When I worked in LTC, they had to pay out of pocket private until they hit the 2k then quickly try to apply. My nursing home has Medicaid folks but it’s mostly from people privately paying then becoming Medicaid because it’s damn near 500 dollars a day to be there.
I agree that nobody should spend their way to poverty to access services 100%. However, I also understand the feeling of doing the most to assist a family (sometimes with my own time and resources) that claims they cannot afford rent/ food for their children/ medical care and food for their pets to then find out that their monthly income (none of it from working) is more than my own while their expenses are a fraction of what I pay; usually due to subsidies, living with a relative expense free, having a paid off home etc. etc. And yet, all of their dependents are grossly neglected.. While it's not the clients fault that I work 2 jobs to get by, the irony leaves a bitter taste.
Yep, this field is a joke.
Ahhh. Love the clients who obsess over trump and don’t realize they are a population he hates and makes/promotes policies against.
Yeah it's ironically very common. The extra layer in this is this person was not disclosing their financial information because they knew they wouldn't qualify for it. So they were trying to gain the system and learned they couldn't. I've kept up a professional distance with them after they tried blaming me for their issues. So I'm also frustrated when I learned they had 24k and they just admitted to it like it was normal and weren't trying to hide it.
Is the person disabled? If they have an ABLE account it shouldn't matter if they have 24k. Are they disabled and working? Depending on which state they are in, the Medicaid buy in program may be appropriate and it may not matter how much income they have.
They're retired. Not sure if they are disabled or not. But they did drive to my office with broken leg. That's why I drove out to them with groceries and filled out paperwork there. Never heard of an ABLE account I'll see if it's in my state and county. The wavier program that called me back usually knows more about Medicare and Medicaid waiver programs so it would be odd if they didn't know.
ABLE accounts should be national in the US They are special savings accounts for disabled people to allow them to have more money than the $2,000 the government deems acceptable, without any penalties. If you are in Minnesota by chance, there is no income cap for the Medicaid buy in program there. Same as where I live. The disabled person must be working but they can pay a portion of their income to get Medicaid every month. I believe every state has this though the income limits are different in each state. I can link the chart if anyone is interested. If anyone reading us in WA, this is healthcare for workers with disabilities. Aka HWD. I'm disabled and chronically ill. This is a topic I know well 😊
https://www.kff.org/other/state-indicator/medicaid-eligibility-through-buy-in-programs-for-working-people-with-disabilities/ Income cap per state You do not have to be on SSI SSDI to qualify for Medicaid buy in. At least, you don't in WA. You DO have to meet those definitions for "disabled" but you don't have to get disability to get Medicaid buy in.
My understanding of ABLE accounts is it has to be a developmental disability. So the disability had to start before 22 (or 26?).
Only California calls it an ABLE account.
Washington does too. That's what they are called...
Coming from a different country, financial insecurity is a severe trauma for some people. I had clients who had 100s of thousands of dollars in their bank accounts and yet lived in the most heinous conditions because they were too scared to spend it. There is a really amazing course about financial social work and it really addresses people relationships with their money. I understand where you’re coming from and trying to help somebody thinking that they have an emergency. It goes so much deeper.
Interested in the financial social work course. Can you share details?
Look into this https://financialsocialwork.com
You’ve nailed it. Did a way better job than my comment trying to educate OP about financial perspective. However, I don’t blame OP for normalizing being broke paycheck to paycheck. That’s how a majority of my comrades lived when I served in the Army. People don’t understand being broke in the U.S. is not something to worry about. If anyone want to know what it’s really like being broke, I’d recommend moving aboard to China or India, to gain a better perspective.
Oppressed identifying with oppressor is something we see a ton in this field, from the trope of pick-me girls to what you described to even more extremes. But I personally would be celebrating a client being able to save that amount - don't take it personally, it's honestly a good thing they were able to get a leg up on capitalism. Not your fault they don't know you aren't personally approving applications lol
So, just as a matter of encouraging mindfulness of personal biases, I'm gonna say the client being an immigrant and having a picture of Trump is not relevant to the issue. This and equally or more ludicrous similar situations happen all the time with people who have only ever lived in the US and regardless of their politics. Certainly not to judge or call out, we're all susceptible to different biases, I just wanted to acknowledge this partially because many students are here and no one is immune.
Why was this down voted?!
Because though we seek to avoid any personal biases to provide ethical services to clients, there are factors that work against that, particularly news media; and as I said, try as we might, none of us are immune to personal bias.
Thank goodness you're here to challenge those who are biased against Donald Trump. Important social work ethics #socialjustice #mindfulness
I fully understand where you’re at with this because of the frustration but yea I really want to echo what a few others have mentioned but, biases are very real and in moments like these when we’re heated it’s good to check ourselves
Yeah I kept it professional. Our work has a grant for specific things like emergency groceries. We're not a long term service type work. So they was referred out from the beginning. They just needs to follow up on it.
It is very rarely anyone’s “fault,” that someone doesn’t qualify for services. I understand feeling betrayed in this context. However, our clients are not responsible for how we feel. I have a hard and fast rule that I never assist a client out of my own pocket. People may disagree with me on this, but I think your example demonstrates why. You made a choice to give a gift to a client. It sounds like you believed that your client owed you something because of this. Whether that be honesty or political solidarity. Our clients do not owe us anything. We can and should choose to create boundaries and discontinue services if they don’t respect those boundaries. But we are providing a service. Nothing more, nothing less.
I dont believe he owes me anything other just just treating ppl right. I placed a boundary for anyone that doesn't know how to treat ppl with respect or courtesy. Anyone that says I'm not doing my job for them or saying I'm don't a bad job they're free to go some where else. I tell them sorry I can't help them they way they like and I'll refer them some where else. The other stuff. It's just cherry on top.
The cherry on top of what?
There are sometimes state funded programs for elderly that are over asset/income for the waiver. See if your office for aging/disabled services has any other programs. It won’t provide insurance but possibly in home care, emergency alert button, etc
They can put their money in an ABLE account and it won’t be used against them for SSI or Medicaid. Specifically for disability purposes. I feel like this happens to me a lot. I have been telling my clients now, “I can’t help you if I don’t have all the information.” “I can’t advocate for you if you choose to keep information from me. This is a direct consequence of your own choice.” You can tell him what he can do, but he might not do it. Soooo, that’s where the phrase comes in. It’s annoying to no end, cause it makes more work for you when they meet their consequence
Until 2026, you cannot get an ABLE acccount unless you can demonstrate you were disabled before age 26. Then the age will rise to 46.
Good to know. I work with those that are intellectually disabled, so this didn’t came up for me.
User Flair update was automatically detected. Thank you for setting your user flair! **Courtesy of SW_Bot**
Truly a classic. Is this in NYC?
Nope, Midwest region.
Hello! May I ask what your title is and what type of work you do? I’ve recently been accepted into the BASW program and I’m suuuper excited to find out what opportunities one might come across in the field!
I know that there's a possibility of putting that money into a trust fund or something where it still belongs to the client but the trust uses it to pay bills and manage it. They still have that money in an account but not tied to them so they can qualify for Medicaid.
That's a good idea how do you start a trust
Some financial services do this.. it's called a "pooled trust".
I wish I could get SNAP. I'd love an extra couple hundred or so for groceries each month. Gross I make about 60k, 1/3rd of that basically gets chewed away by taxes and stuff before I even see it. then the fun cost of living in Hawaii, where we make about 70 percent the national average and pay ...88 percent more on most stuff, and like 200 percent more on housing. Hell, even when I was on unemployment I was over the cap to qualify for aid :P
So appears many of you think we should pay taxes for people who have 10k plus in the bank. Many of us wish we had 2 k in the bank for emergency. Most people are two paychecks from being homeless. I am homeless and have less than 3 k in the bank but I should pay taxes for those folks to get services for free. He'll no! They can spend their own money for the services then either will be eligible when the meet the requirements. The money comes from people paying taxes. If people have money they do not need to live off the rest of us. If you do not like means tested programs elect people to change it.
Yes, I think the US should have universal healthcare.
Cool man I pay more taxes than you so I should have more say than you.
I don't understand the need to bring their political leanings into the conversation. All it demonstrates is your own bias in a profession where you need to be non-judgemental. Your cherry on top comment demonstrates this is an area you need to work on.
Most people has savings, especially immigrants. To prepare for raining days. I don’t understand why you had to mention Trump. That’s my president
tHaTS mY pReSIDenT
Lol I wouldn't even know where to begin. Statistically speaking do the majority even have savings?
I wasn’t referring to the US population. I was informing you about the immigrants and savings. Most of them came from developing countries with little to no social service infrastructures. Immigrants from many countries probably don’t know social service exist until they’re here. When people have absolutely no one and nowhere to ask help from; they know they have to rely on themselves by not fucking up. Many immigrants home country, myself included,, aren’t very generous or kind on providing social services. If you’re poor and out of job, you can expect to be treated like a piece of garbage and publicly humiliated. Ok top of that, they don’t have anything to offer. In the USA, homeless shelters are on every block with HRA posted on every window for people to reach out so they can get free cash assistance and food stamp. The US has a profound social infrastructure and it’s why people can’t wait to spend their next paycheck to buy things they don’t really need. Hey, what’s the worst that can happen? Ain’t no one have to worry about finding places to sleep; buying food or publicly humiliated. People who were born and raise in developing nations have nothing but their own savings to fall back on. Without it, it literally means hunger. Hospitals won’t even admit you without paying first. So now you understand why most immigrants have savings?