Re: Medicare--Shauna!!!!!!

[Guest guest]

I have gotten my medicare card and it has helped a great deal. I was told that my SSI may be reduced if I was to get SSDI or vice versa. I was also told that if I was approved for SSI I would get medicaid automatically. Is this not true? I am almost to the three month period. I guess I am just a little impatient as I need medicine and dental care urgently. But I am sure it will come. My teeth and bones are very brittle these days so I am taking supplements that hopefully with help.

Shauna,

I'm confused. You say you have your Medicare Card. This is a red, white and blue card that has your social security # which is followed by an "xxx-xx-xxxxA or B".

The A or B just signifies whether you are getting thru all the years you worked, (A) or your spouse (.

Then it has Medicare Part A and Medicare Part B on it. The Medicare Part A is hospitalization, the Part B is Medical (your MD's, lab, xray coverage.)

I don't know if the new cards have a Part D line - which would be your drug coverage.

You state that you thought you'd AUTOMATICALLY GET MEDICAID. Are you talking about the State Low Income assistance that would pick up what Medicare does not cover?

If not-- you need to either apply for MediCaid or MediCal--if you have a low enough income. Or you need to designate and enroll in a Medicare Supplement Plan that will cover the 20% copays that Medicare Part B doesn't pay-- as well as designate a Drug Plan.

If you do qualify for Medicare/MediCaid, because of low income, then you don't have to pay your monthly Medicare premium ($93.70 a month this year for Part . You also wouldn't have to pay the $131.00 annual Part B deductible, and the 20% copay that Medicare doesn't cover on office visits and xrays. Lab is paid at 100% with no deductible.

Hospitalization Part A does not have a annual premium, but it does have a deductible, $760.00 per admit if more than 60 days has passed since the last admit in cases of hospitalization.

The Part D monthly premium can range from a few dollars a month, to $150.00 a month. Depending on what coverage you want. This is for prescription drugs.

Again, if you are low income, then you pick a drug plan, and MediCaid pays the monthly charge. BE CAREFUL-- THERE ARE ONLY CERTAIN PLANS IN EACH STATE THAT QUALIFY FOR THIS WHEN MEDI-CAID IS INVOLVED.

If I were you, I'd be calling a HICAP, or Senior Advisory Group for suggestions-- a social worker thru your local hospital may be able to advise you.

You have to take the action-- it won't happen automatically--at least it doesn't in California. If more than 90 days go by,

you are not "guaranteed enrollment"! So do it tomorrow!!!!!!!!

I hope this helps, do get on it immediately. I wasn't aware of the 90 day thing-- and blew it on my choices by not taking action when i should have.

Take care,

Tracie

NS Co-owner/moderator************************************** See what's free at http://www.aol.com.

[Guest guest]

Shauna That's great! Just make sure you get names from people in the gov that give you info. I'm over $20,000 in debt because I got faulty information. Oh well, they can take $5 a month for how many hundred years????? grannylunatic@...

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[Guest guest]

Shauna That's great! Just make sure you get names from people in the gov that give you info. I'm over $20,000 in debt because I got faulty information. Oh well, they can take $5 a month for how many hundred years????? grannylunatic@...

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[Guest guest]

I have the medicare card with part A & B . I pay for it monthly which is the $93.50 and in this state you must first be approved for SSI to get medicaid is what I was told so I should be getting in this month. I don't have to apply because it was done with my SSI application.

This still concerns me. MediCaid (Medi-cal in California)-- is the secondary coverage that happens when you are very low income.

SSI is to replace a small (25%) of what you made while working-- so if you made $4000 a month, you basically get $1000 in SSI money.

If you make a few hundred dollars on SSI, and it is so low that you need the additional assistance of State MediCaid Coverage-- then you would have what is referred to as Medi-Medi coverage. The MediCaid portion picks up (actually it pays zero-- but the MD's have to write off the portion of charges not paid by Medicare.) It also should pick up your MediCare Part B premium of $93.50, the annual deductible of $131.00, and the Hospital deductibles of $760+ dollars.

Prior to being qualified for SSI-- all the States have a MediCaid program for financially stressed families. This is one that you would have applied for thru your local County Welfare Offices.

some people do qualify-- and maybe they did have you file for the continued MediCaid-- I do hope so.

What are you doing for the Part D drug coverage. This also has a monthly premium, an annual deductible and copays. There is a booklet that Medicare should have sent you that lists all the choices for Part D coverage and the premiums and copays listed.

I truly don't want to see you end up like several of us that went thru this over the last couple of years-- because we were given (and unable to understand) the complexity of the system.

Did you have an attorney help you with your SSI application? Is this someone you can call and make sure that you know what is happening.

As you said, you're getting close to that 90 day time limit-- and you don't want to blow it-- or the next opportunity to get private secondary insurance isn't until you turn 65-- then you have a guaranteed enrollment again-- and for many of us- that would mean 20 yrs without a secondary insurance.

When you say MediCaid-- are you talking about the state aid for low-income assistance?

Just making sure--

Tracie

NS Co-owner/moderator ************************************** See what's free at http://www.aol.com.

[Guest guest]

This Medicaid is for medically needy persons. I was unable to apply

for Medicaid for low income so I was told that once approved for

SSDI I would receive medicaid. I haven't tried to get the premuims

for Medicare paid for yet. I only have the SSI income for now. I

check with the state and they said it is being handle thru the SSA.

But it is on record that I should be receiving it. I thought

medicaid paid for medicines, dental visits and other things,

eyeglasses, etc.

Shauna

>

> In a message dated 6/14/07 2:57:17 PM Pacific Daylight Time,

> sglaspie2000@... writes:

>

>

> > I have the medicare card with part A & B . I pay for it monthly

which is

> > the $93.50 and in this state you must first be approved for SSI

to get

> > medicaid is what I was told so I should be getting in this

month. I don't have to

> > apply because it was done with my SSI application.

> >

>

> This still concerns me. MediCaid (Medi-cal in California)-- is the

secondary

> coverage that happens when you are very low income.

> SSI is to replace a small (25%) of what you made while working--

so if you

> made $4000 a month, you basically get $1000 in SSI money.

> If you make a few hundred dollars on SSI, and it is so low that you

need the

> additional assistance of State MediCaid Coverage-- then you would

have what is

> referred to as Medi-Medi coverage. The MediCaid portion picks up

(actually it

> pays zero-- but the MD's have to write off the portion of charges

not paid by

> Medicare.) It also should pick up your MediCare Part B premium of

$93.50,

> the annual deductible of $131.00, and the Hospital deductibles of

$760+

> dollars.

> Prior to being qualified for SSI-- all the States have a MediCaid

program for

> financially stressed families. This is one that you would have

applied for

> thru your local County Welfare Offices.

> some people do qualify-- and maybe they did have you file for the

continued

> MediCaid-- I do hope so.

> What are you doing for the Part D drug coverage. This also has a

monthly

> premium, an annual deductible and copays. There is a booklet that

Medicare

> should have sent you that lists all the choices for Part D coverage

and the

> premiums and copays listed.

> I truly don't want to see you end up like several of us that went

thru this

> over the last couple of years-- because we were given (and unable

to

> understand) the complexity of the system.

> Did you have an attorney help you with your SSI application? Is

this someone

> you can call and make sure that you know what is happening.

> As you said, you're getting close to that 90 day time limit-- and

you don't

> want to blow it-- or the next opportunity to get private secondary

insurance

> isn't until you turn 65-- then you have a guaranteed enrollment

again-- and for

> many of us- that would mean 20 yrs without a secondary insurance.

>

> When you say MediCaid-- are you talking about the state aid for low-

income

> assistance?

>

> Just making sure--

> Tracie

> NS Co-owner/moderator

>

>

> **************************************

> See what's free

> at http://www.aol.com.

>

[Guest guest]

This Medicaid is for medically needy persons. I was unable to apply

for Medicaid for low income so I was told that once approved for

SSDI I would receive medicaid. I haven't tried to get the premuims

for Medicare paid for yet. I only have the SSI income for now. I

check with the state and they said it is being handle thru the SSA.

But it is on record that I should be receiving it. I thought

medicaid paid for medicines, dental visits and other things,

eyeglasses, etc.

I know that Medicare is automatic with SSDI approval, if you've had 2 full years off work. I know that there is a medically indigent program for those whose medical needs go past what Medicare can provide. Generally it's the advanced MS, the ALS (Lou Gehrig Syndrome, the mentally retarded and handicapped.)

As far as what your state does in the way of Medicare/MediCaid coverage-- that is what I'm questioning.

I'd be asking questions of your Social Worker thru the SSDI process so that you don't find yourself without some form of secondary coverage.

IT is time sensitive for guaranteed enrollment, I believe it is 90 days from the time you were granted your MEDICARE. If you miss this time frame, you can't get guaranteed enrollment in a secondary plan.

Medicare Part D has now taken over the prescription drug coverage-- IT IS NO LONGER AVAILABLE THRU YOUR MEDICAID IN ANY STATE!!!!!!!

You must choose and enroll in a Part D plan, to get your drug coverage. If you have qualified for MEDICAID then they should have had you designate a Part D choice. Talk to your pharmacist about the kinds of meds you are on-- so that what you choose will cover those meds. Many of the plans only cover generic, or have NO coverage of the "Gap"-- that $2500 hole to hell where you have out of pocket entirely, so it is best to really sit and talk with Senior Advocacy Advisors (I know, we're not that old, but we fall into their league for medical care.)

As far as dental and vision-- for us- since we have sarcoidosis, our appointments to the OPHTHALMOLOGIST--eye MD; should be covered if they use the diagnosis of sarcoidosis, cataracts, glaucoma, iritis, uveitis, glaucoma or glaucoma suspect- or any retinal or macular health issues. Plaquenil exams to make sure that hte Plaquenil we're on isn't causing retinal damage are also covered. The part of the exam where they refine your eyeglass lense prescription is never covered (unless you have Medicaid due to low income). Generally the refractive portion of the exam runs about $30.00 out of pocket.

Dental is not covered except by MediCaid-- so far Medicare thinks we can gum our food to death.

Here is the site address for Medicare.

http://www.medicare.gov/

It is easy to navigate, and you can put in your state and it will give you the programs available to you. It also explains the different coverages and programs available to you. You can also look at the different Part D coverages and see what the premiums, copays and gap coverage is about--and how it effects you.

Take care,

Tracie

NS Co-owner/moderator************************************** See what's free at http://www.aol.com.