Help me pick a supplemental insurance to cover 20% after Medicare

My employer-provided insurance stayed in effect to cover the 20% - at full cost as before.

I think medicare has some optional plans that might cover some of the things you're concerned about, but at a cost.

I am on medicaid, but a Step Up Program for 2020. 2019 I had QI-1.

SNP program I will never get cause I make too much.

I have been dealing with this all month, talking to my new states agencies for myself but most importantly to help some people I met who really need help and can figure out the system like I can.

OP - depending on how much your disability income is you may qualify for state assistance to offset what you are paying as well as Medicaid. If you qualify for Medicaid based on your income and assets, that would be the best option for you as it would pick up the 20 percent that Medicare doesn't pay for.

Right now you have Medicare part A and B. With that you can go to any physician and only pay 20 percent - usually, 20.00 co-pay. If you are hospitalized you again will owe 20 percent. With Medicare/Medicaid - God forbid if something happened you will not have any copays. All of your medication and medical care is covered as well as assistance in your home, nursing home placement, and rides to medical appointments. To qualify you cannot have over a certain amt. in the bank or two cars in your name.

QI? So you're making a couple hundred bucks a month too much.

Ya, they whole thing is wacked and none the balances add up.

SSA says the pay me this but I really get this. Also I have deductions and it still is less that I actually receive.

Thank god I am good with money.

The website says one thing, I have a letter that says another and the my bank says something totally different.

My buddy asked me to help his wife out when he died, he passed over in March.
She's 41 and was 20 when she had a car accident which put her in a coma for months and came out of it with some brain damage that left her with seizure disorder and memory problems on top of that. She also suffers from a genetic problem that left her with no cartilage in her knees. She gets $800 a month and that's all. She also lost her drivers license due to seizures and lives rent free in her mother in laws vacation house which is now on the market. She has 5 grand to her name.

She only has medicare and was refused medicaid and on top of that was denied her spouses measly SS. because of her age.

This stuff is beyond me to help or fix.

Any ideas?

Last Edited by The Semi Shut In on 11/13/2019 10:53 AM

With an income of only $800/month she probably lives in a state that didn't accept Obamacare because she should qualify for Medicaid. If she has relatives in a state that expanded Obamacare have her move there. With her income she should qualify for SNAP and if she's legally disabled she should qualify for other benefits as well.

It winderful how the government can steal someone’s social security instead of letting the person will it to someone else. At least for the money the government took from them.

She lives in upstate N.Y., her parents live in N.J.

Last Edited by The Semi Shut In on 11/13/2019 11:04 AM

Yeah she needs to find a state that will help her and move.

I don't understand then. NY accepted the Obamacare expansion and Medicaid qualification should be for anyone with income under 138% of FPL and $800 a month is definitely under. There's no asset litmus test so her $5,000 is a non-issue.

New Jersey also accepted Obamacare so I would suggest you have her move in with her parents in NJ, get on Medicaid and SNAP (Food Stamps) and see if she qualifies for any other benefits.

Oh and good job keeping your promise to your friend.

whats available for a young person with Rheumatoid Arthritis

According to her she was told she had to much money over the $2000 threshold and at 41 she was too young to collect her husbands SS. I just don't have a clue about all this and told her to get a SS lawyer. Thanks for all the input. Onward and Upward.

First, let me say I'm not a professional on the subject but I have helped numerous people over the past few years with Medicaid and Medicare; if anyone knows more feel free to chime in.

Yes, she is too you to collect her deceased husband's SS but under Obamacare, states dropped any asset test for Medicaid as of 2013 or 2014. With her income, in NY or NJ, she should be on Medicaid, not Medicare regardless of her savings. This is somewhat important because Medicaid provides 100% medical coverage at no charge to the recipient.

Also, she may qualify for SNAP although her savings might be an issue. She may also qualify for other benefits provided she is legally disabled.

Good...this should be easy for you then. It's just figuring out what you need in coverage and it very likely won't cost you a dime.

I got your zip code but need to provide your info here as can't respond privately....let me do some quick research. I can ask questions here and you can give me answers privately...

I will get back here in a few.


EDIT: Dang it.....I just pulled up plans for your area but there are 47 of them! WOW. The problem, I was going to link the results here but it looks like it will show your county on that link if I post it.

Not sure if you want but I can email it to you and we can converse that way if you want the help. If you aren't comfortable doing that I understand. I promise, I'm in Texas and my only interest is in trying to help you and I can post the results link here if you are comfortable with that. We can then narrow the choices by your needs...just let me know.

Last Edited by FeedYourHead on 11/13/2019 11:51 AM

Also, if your friend's wife was disabled before the age of 22 she might be qualified to go on her parent's Social Security.

[link to www.disabilitysecrets.com (secure)]

Thank You folks for the input. I'll forward this thread to her to read. GLP at its Finest.

You speak of the $5,000 to her name but they also look at assets such as real estate, stocks etc., even life insurance proceeds. It's tough.....but on the surface this sure sounds wrong.

Folks like here are what Medicaid was designed for.

You're welcome and I'm sorry for your loss.

WOW!

Thanks Feedyourhead and all the others who are helping!

More information from me would be helpful it would seem....

I just turned 62. I am 100% permanently disabled. Some days can barely walk.

"If I knew I would live this long I would've taken better care of myself!"

I get a small pension from the Millwright union, $480.
SSI disability paid $730 BUT deducted my pension. So it payed $313 per month.

I have been on Medicaid for Missouri for 1.5 years. Could have gotten it sooner but a heart attack and stent cost $50K so the hospital told me to apply for Medicaid which paid for that after the fact. Prescriptions cost me 50 cents each.
Heart doctor had me on about 5 meds for high blood pressure and blood thinners, that sort of thing. Had some chest pain last night and took 2 Nitroglycerin tabs over an hour.

That makes only 3 I've taken in 1.5 years. I've been weening myself off the other meds. Was supposed to be off all of them by now but the pharmacy calls the doctor to renew them....
Had a busted molar, root canal pulled last Friday, $147 total cost, My part was $4.

The Social Security I start this month, paid December, will be $740. Total income will be about $1230. No assets or savings to add to that.

What would you suggest based on those new facts?

My zip code is 65674, Humansville, Missouri.

I was on Medicare Advantage for a couple years but have switched to regular Medicare and no supplemental or drug plan after watching a lot of YouTube videos for several weeks. Feels good to be free of the HMO. I have no medical diagnoses and take no drugs. Medicare was paying the HMO for me to be a member and that’s wasted money. Now starting in 2020 i won’t be costing Medicare anything unless I actually get medical care. I like that.

I think if you are on Medicaid now, then Medicaid will make sure you get enrolled in Medicare Part A and B as soon as you are eligible, and Missouri Medicaid then becomes your Supplemental and pays the 20% automatically as the bills rollover from Medicare to Medicaid.

Would I get the $130 charge for Medicare I heard mentioned?

If you are on Medicaid, then no. Medicaid will pay your Medicare premium for you. No deductions for that from your SS check.
Missouri Medicaid Basics. Scroll down to 2. Medicare Cost Savings Program
[link to mffh.org (secure)]

I'm not sure how your disability plays into it but for a non-disabled person, and possibly you, Medicare is only for those 65 and older. From my understanding, you would stay on Medicaid until the age of 65, and then you would be put on Medicare.

Now Medicaid under the age of 65 has no asset limit, in states that expanded Obamacare, so you probably pay nothing. However once you reach the age of 65, and are placed on Medicare, the requirements to also stay on Medicaid get more stringent. There will be a lower income threshold as well as an asset limit.

When placed on Medicare there are three types of Medicaid: QMB, SLMB and QI. Whichever one you may qualify for is contingent upon your income and assets. Assuming you're single, and have no assets as you said, based on your income you would qualify for SLMB Medicaid while you are on Medicare. This would mean you will be on Medicare and your part B will be paid and possibly most of your Part D if you qualify for extra help.

[link to www.medicare.gov (secure)]

Click on Specified Low-Income Medicare Benificiary.

cont'd

You probably already know that if you are on Medicare, even with SLMB, you will have to pay deductibles for Part A (hospital) Coinsurance and Copay. A way around that is to pay for Medigap or supplementary insurance. Medigap Plan G will pay for just about everything except your yearly $185 deductible for Medicare Part B. The last person I helped with Medigap is paying $139 a month for plan G.

Again, I don't know how your disability would play into all this.

When someone is on Medicare and Medicaid, the provider does not balance-bill the patient. So no need for any other supplemental than Medicaid.

You can still get whats know as a 'cadilac' plan that pays all medical expenses or you can get an advantage plan and get optical and all the rest of it. But you will pay part of your medical expenses with the advantage plan.

PICK PLAN N

see this guy's channel

[/youtube] [link to www.youtube.com (secure)]

Last Edited by Theobromine on 11/13/2019 01:06 PM