 [ Symptoms ] i have been on social security disability since 2009 i get medicare a b and d  i am also on the qualified medicare beneficiary and a medicaid spend down which i do not need with my being on disability and medicare i would not need the new marketplace health insurance is that correct would you need to be on medicaid in order to qualify [ Disease ] hi yes cortisone injection can be taken without ultrasound guidance once the xray is done and the exact location of the spur is noted doctor can give it without any ultrasound guidance the doctor needs to be skillful or else if he has no confidence then it would be better to take ultrasound guidance its a doctor is call thanks