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Does It Make Sense ?

Schmidty started this conversation

I've been disabled since 2006 because of Lung Cancer, they took half of a lung out, and so far with all the blood work, there is no sign of a reoccurance. Thank God! I filled out all the papers and did all the test to see if I qualify. One of the test was to sqwat to walk like a duck while I was still healing, approximately a month after surgery, and I could use my cane  IF I wanted to. They care so much for us.

I was eligible for Medicaid but not food stamps. With Medicaid I was eligible for a spindown program, because of SSA payments that were more than SSI payments. I would have to pay approximately $400.00 a month for (free) medical with co-pay. There are programs out there that are cheaper, about $198.00 a month, but I didn't have anyone to ask what or who should I talk to on whether it would effect my SSA disability. I was assigned a social worker to handle my case. Luckly, with what I am paying to the hospital for the surgery and subsequent visits, is deductable, along with the cost of medications when Medicaid isn't covering me, thus it's almost a month by month basis.

When I first signed up for Disability, I asked, ""Why in God's name am I on a spindown program when I'm disabiled and I'm not able to work?" It was explained to me that because my SSA payments were higher than the alloted amount(SSI, I imagine) that I would have to pay the excess. "So, I'm being penalized because I worked all my life and didn'lt make it to retirement before needing help?" I was assured that was not the case, it's just the way it is set up????? Boy, now that really assured me.

Now that it's been over two years,  I qualify for Medicare. I get this notice telling me that I qualify, and I need to send information for them to make a determination on whether I get extra help with my prescriptions. I sent a letter that explained that nothing had changed to use  what was on my application when I applied for Medicaid.

In the mean time I started receiving statements from the main office in Springfield telling me that my spindown was $278.00 a month and which months do I want to pay for. I try to contact my case worker, like a few times before, no reply, either out sick or on vacation, asking which do I pay the $400.00 amount or the $278.00 amount.

Which really made me wonder , if I've been paying to much all this time? But, I knew that if I asked some one would take it as they had been cheating me, and I would never know whether I had rights to reclaim that money or not.

I asked my caseworker the above question and I didn't get any reply. I received another statement with the same amount. I just send in my receipts, knowing it will not help to ask again.

I'll go back to tha part about Medicare and the reply of mine about going off the application I signed when applying for Medicaid. It was denied! I called up, couldn't talk to anyone because the lines were busy, try again tomorrow. I do, the same thing. So , I go on line using ' contact us' and ask them to call. They do. I send in my bank statement andI get qualified for the extra help with medications. The reason for denial, they didn't get the information they asked for?

I receive another statement from Springfield, THIS time the amount is $382.00.I call up the caseworker, I make contact the first time, I ask her why the big jump in cost, there was a small, very small increase in February. She says that it shouldn't have raised that much. Let's hope not!! I mention that I got help with prescriptions, that wouldn't effect it that much would it? She said no, that she had to make adjustments for a few others and she'll get it changed. I thought and have been led to believe that Obama's plan was to help those in need of the health care system, nothing was said that the Government will give and then the states shall take. It still leaves open the question on whether I paid too much all that time or not, would I be intitled to a refund?

You tell me, Does It Make Sense to treat people who are disabled, or people who need help, this way????   Yet, we are.

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Pat McMann

What a confusing mess!

So sorry you are caught up in all of this.

You might give a call to the MEDICARE RIGHTS CENTER's consumer hotline at 800-333-4114.

They are available between 9 am and 6 pm Eastern time, Monday through Friday.

A Medicare counselor can answer your questions about health insurance choices, Medicare rights and protections, dealing with payment denials or appeals, and complaints about care or treatment.

 

The criteria for extra assistance with Mediare Part D (prescription coverage) is totally based on income. If you are on Medicaid (some people are on both) you may automatically be eligible.

 

Hope this helps.

 

God Bless,

Pat McMann

www.FindHelpToPayBills.com

reply to Pat McMann
luv2bamom

No... this don't make sense at all. I think that they should be more help out there for diabled people and people in need. My fiance is disabled and he has had a time getting what he deserves already. He also has worked his whole life. He is a veteran of the first gulf war and just know got into the local VA. for his medical care. I just wanted to tell you that I hope things work out for you, and I will put you in my prayers! God bless! Amber

reply to luv2bamom