My mom receives a little over $1,500 a month from Social Security disability. Her medical bills and prescription drug costs are roughly $800 right now doing the bare minimum. Her heart doctor needs to run more tests to figure out why her blood pressure is staying in such a dangerous range but we can not afford to pay what Medicare won't cover. She has a Medicare replacement plan through United Healthcare and they cover only about 50% of her drug costs and have high co pays for doctors visits. She has thousands of dollars in unpaid medical bills and her doctors are threatening to stop treatment if we can not afford to pay. If she received about $200 less in Social Security she would qualify for supplemental Medicaid. I do not know what to do to help her. She is severely depressed and wants to just give up since she is suffering with no medical relief and it's breaking my heart. Is there a way to reduce Social Security payments so that she can qualify for extra assistance? Should she stop receiving Social Security altogether and go completely on Medicaid, Food Stamps, utility assistance, etc...? She just moved in with us since she has no ability to afford rent and medical care together but we can not financially support her. Any guidance would be greatly appreciated.
Is she receiving social security disability or regular social security?
I also think you may benefit from seeing an elder care lawyer.
Also, some counties have prescription drug cards, available for free. Ours does; I've never used them so I don't know how much help they are though..
Her most expensive medications are her ADD meds and her heart meds. I have contacted the pharmaceutical companies that sell these medications and they sent me a discount card but my pharmacist informed me that they could not be used in conjunction with Medicare. Her doctor took her off of the expensive blood pressure medication that was actually working for her and put her on a cheaper substitute that barely does any good.
She sees her therapist twice a week. She was originally told by the office that she had no co pay but after 5 months of billing insurance they realized that she has a $50 co pay for each visit and now has a bill over $1,500 with them. She desperately needs to be able to see her therapist but can not afford $400 a month for therapy alone on top of her other medical costs. I'm at a loss.
My nephew only gets $400 in SSD and $600 in an annuity. He has Medicare as primary and Horizon BC/BS for Medicaid. His prescriptions are with UH. He was having problems with an ADD med being covered. We were told to go to Office of Aging and have them go over what he gets. We found that for an extra $16 a month he could go up a tier and that med would be covered. You may want to try that. While talking to them, ask if there is a state prescription plan she maybe able to get. Also, were I live we have a place that has Pychiatrists and counselors. They work on scale and except insurances and Medicaid. Set up payment plans with her doctors.
Have you called the county office of aging to see if she qualifies for other help? Many areas have food pantries for non perishable items. Saving that expense can help her pay other bills. Also, some agencies offer sliding scale counseling. Can you look into that? If the medical bills are from hospitalization, has she applied for charity care? I had to do that for my son-in-law. Once he was approved, I sent copies of the approval to each doctor and they wrote off his balance. If you can share what county you live in, others may have more specific ideas.
The plan she is on was the best plan at the time for her prescriptions but it's not great for doctors visits. The therapist office told me that if she has original Medicare instead of the UHC replacement plan, her visits would only be $18 instead of $50. We plan to look for a new policy during open enrollment but I'm trying to figure out something in the meanwhile so she doesn't have to stop most of her medical care.
Unfortunately, the doctors offices will not accept a payment plan that she can afford ($5-10 a month) After all her bills come out each month she is usually in the negative and I usually cover the overdraft amounts. She has $300 spending allowance each month for gas, groceries, toiletries, clothes, and all other necessities. The rest goes entirely to bills.
We live in Faulkner county, Arkansas.
I think you need to go with mom to your local Medicaid office and talk to a caseworker.
Also, look into a qualified income trust if she is truly over the income limit .
Would original Medicare be a better option, or a different Medicare Advantage plan?
I hope the Carelink folks can give you some guidance.
She is 62.
Regular Medicare would be a better option but if we discontinue the UHC plan right now, she will lose drug coverage and we were told that she would have a penalty for not having part D. I spoke with her pharmacist about how much her out of pocket drug costs would be if we dropped UHC and they would go up by around $400 so it doesn't help solve the situation.
Carelink was no help what so ever. They said that recieved too much money to qualify for anything. I can not believe $18,000 a year with nearly $10,000 a year out of pocket medical costs does not qualify for any assistance. I'm at my wits end.
Have you looked into the Extra Help thru The Medicare Prescription Drug Program?
I should have been auto-enrolled, was not, applied right on the SS website. They approved me over a weekend. It covers the Part D monthly premium, drives the price of Generics down to $3.35 each at the pharmacy, some have mail order.
Please apply for her if you have not. I had never in my life heard of this, found it doing research, and surprise. Applied and now most of my script issues are gone.
"You should complete this application for Extra Help on the Internet if:
You have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance); and
You live in one of the 50 States or the District of Columbia; and
Your combined savings, investments, and real estate are not worth more than $28,150, if you are married and living with your spouse, or $14,100 if you are not currently married or not living with your spouse. (Do NOT count your home, vehicles, personal possessions, life insurance, burial plots, irrevocable burial contracts or back payments from Social Security or SSI.) If you have more than those amounts, you may not qualify for the extra help. However, you can still enroll in an approved Medicare prescription drug plan for coverage.
EXCEPTION: Even if you meet these conditions, DO NOT complete this application if you have Medicare and Supplemental Security Income (SSI) or Medicare and Medicaid because you automatically will get the extra help."
I just enrolled into Part B and Part D, 6 months after I was eligible. Because I had Medicaid, they consider this comparable health insurance coverage (tho most website and people will tell you differently!), and I got no penalty at all.
I had to take proof of my Medicaid coverage to the local SS office, they said the Fed. govt. can't see you get Medicaid (right!), show that I was covered. Local office faxed it in to Fed. level, I was approved in 1 day.
The penalties from what I have experienced are mainly if you refuse any coverage, Part A-D, when you are eligible AND have no other health coverage. Medicaid counts, so do pretty much all other health insurances. I hope this helps, I spent hours with SS figuring all of this out, but in the end, thankfully I have no penalties.