Medicare, Medicaid, Welfare, Oh my . . .vent.
 

I am in such an odd place right now. Sorry, this is kind of a rant but . . .

I am on SSDI and have Medicare. I was dropped from Medicaid as of the 1st of the month as DD18 turned 18 in Aug; therefore, my income mix changed. (Think tax bracket change.) I miss the cut off for Medicaid by $32. Medicaid is my secondary insurance and they pay the 20% of my medical costs, my Medicare premium and Part D ($130/month), and my prescription co-pays.

Knowing that everything is going to change I did some cost analysis this morning. OMG!!! I am in a dilemma now. My total out of pockets cost in the next year will be $600 a month.:eek: This leaves me very little money leftover. Technically speaking, I wouldn't be able to afford rent, food, utilities, and other little expenses.

Then I did some checking in to the welfare programs in my state as I am trying to figure out how I am going to make it. Financially, I would be far better off telling SSDI I don't want it any more. If I did that, all my medical costs would be covered. I would get a much higher amount in food stamps AND would qualify for other assistance. This would put me ahead. In reality, I know I won't do this and will find a way to make things work.

Isn't this just the craziest thing? It really doesn't make sense. If I were a total crack head, not working, and playing the system, I'd be just fine. However, I am not that person. When I was working, I was a hard worker and always had excellent yearly reviews and received many extra bonuses because of my work ethics and being a hard worker.

Ok, vent over. . . Phew!

Oh btw - as far as welfare, there are people that truly do need the help and aren't addicts. I do feel it would be selfish and unfair of me to drop the SSDI so I can be in the welfare system. The area in which one of my local welfare offices is located (where I applied years ago) is the crystal meth/crack section of town. So, so sad and yet so irritating.

There are so many of us that fall through the cracks and those of us with disabilities and not being able to work are in that crack. We are a forgotten group. We can't go out and get a job or even a 2nd job. I think that is what irritates me so much.:mad:

I have BEGGED them to allow me to drop the SSDI because as long as I am on it, I am FORCED to take MEdicare as my primary! I have 2 count um, 2 golden policies that will cover anything, and everything, but as long as I am "disabled" the state/feds require me to accept SSDI, and as part of my retirement settlement from state service THEY applied for SSDI for me. It completely messes everything up! It keeps me on the fringe, and locked into a bracket that is limiting to say the least. It doesnt matter how much money I have in the bank, savings, or investments, I am locked into SSDI. I cant refuse it because its tied into my retirement. As long as SSDI pays me X per month, the state can reduce my retirement check by X because that allows the paycheck to match 75% of what my highest earning year average was, and saves them money. Madness! complete madness!

My sister on the other hand, is a layabout crack head who knows how to work the system. (yes, folks she is actually a crack head!) she gets free furniture (good stuff!) from social service programs. free dental free prescriptions, and no copays for anything she gets medically. Her rent is subisdized, and she doesnt have to contribute to it, she gets free oil in the winter, and different agencies drop off free food at her door. She collected welfare for children who were not living with her, and has become a master at turning it on its head. I have an old g/f that works for the county where my sister is a client, and she said that she has a masters degree in SS work, and my sister can put her to shame on knowing exactly how manipulate what is and isnt available. Dont bother turning her in, they show up at her door, and she refuses to let them in. they tack on a "will be back in two weeks" notice on her door. That gives her two weeks to prepare for a "surprise" visit.

The system is broken! My sister is an able bodied, healthy woman, who is collecting for 5 children, even though she has only one eligible and he doesnt live with her. We have elderly eating cat food! Its a huge pet peeve of mine that this system doesnt do enough to help those in real need, and does too much to help those that are simply good at the manipulation game.

I hope you are able to find a way to make it better. I hate the system.

Dej - Sorry you are having to deal with this as well. It doesn't really make sense. Also, that is too bad about your sister and that must be so hard on you. :hug: I think those that "play the system" are actually very intelligent and need to be working for the government or be lawyers or something because they are able to find loop holes and manipulate very well. I don't have it in me to do that.

It is my understanding that while on SSDI, you have to get the drs approval for you to go back to work full time or you risk losing SSDI altogether if you need it again in the future.

:hug: Trish. I don't have any advice on this but want you to know I do get it. I've lost all of my disability insurance because I quit work 6+ years ago to take care of Jim. As far as retirement, forget it, it's not enough to pay for medicare when I retire. While I am not disabled it scares the carp out of me if I was to become disabled. I worked darnit and still do but for free now!!!! Does that not count for anything??? I would gladly pay my SS and Medicare fees if they would let me. Anyway, Obama plans to reform SS starting next year and not sure if that's good or bad but you can be sure my letters will flood his mailbox.

Anyone on SS wont be getting a cost of living allowance for the next two years, yet their Medicare will increase. Maybe by early next year you'll qualify for more when SS doesn't give COLA? :hug:

Obama is going to get flooded with my letters now. I am writing one now trying to make my point clear.

I've sent many......all with no response. Not even a form letter. :(

BTW - For those that are on Medicare here are the numbers that I came up with when I did the cost analysis. Mind you, I was very conservative when I did these calculations. In otherwords, I did not include my PT or neuropsych testing. I did not include my labs that I have to get done every 6 months, yrly woman check ups, and mammograms as I didn't have the amount on my reports.

Medicare Premium - $96.40/mth
Medicare Part D Premium - $44.00/mth
Meds Deductible - $4350/yr = $362/mth
Dr. Visits = $976/yr = $81.33/mth (This is based on 4 neuro visits a year, 2
PCP visits/yr and 1 urologist visit/yr)
Total = $583.73/mth

Now should I get sick or have to go to the hospital or anything out of the ordinary I would have to meet the $3900 deductible for Medicare. Take away my conservative dr visits and add in the Medicare deductible of $3900 and the monthly total changes to $827.90!:eek:

I did take the yearly total and broke it down by month. While some months I wouldn't go to the dr but I would have to put aside money for the dr visits or my premium. The yearly total for all medical garbage on the conservative side is around $7,000 and on the full blown side it would be almost $10,000. There goes my SSDI - all to medical costs.

Dang it all! I am not allowed to have a flare that requires PT, hospitalization, and steroids. (Which by the way, the neuro said if I require steroids I would have to be hospitalized because of my bad reactions to the steroids.:o We made an agreement that the only time I will do that crap again is if I lose my eyesight completely. ) I would not be able to cover the costs.

I share this with all of you because I know some of you are in the same boat as I am and your costs are very similar to mine.

Mr. President, here I come. LOL Seriously, I am going to put these calculations in my letter. Hopefully I calculated correctly.:p

When living in another state recently, I became familiar with a couple of women who had babies before getting married because Medicaid paid for them as long as the women weren't hitched.

As soon as their family was complete, they married the guys. What a racket.

gmi

LOL My dad was telling me this morning of a couple that legally got divorced so that they can get in the system. CRAZY! She was on welfare and her "husband" continued to work. They made out like bandits.

Okay, I am going to make myself look like a complete fool here...
you're disabled, yet you have to pay for Medicare? I don't get it at all...my inlaws don't pay for it (they're in their late 80s). Why do you have to pay for it?
I really am not understanding this at all...:confused:

I will have to start paying my Medicare premium and my Part D premium. I was on Medicaid and they helped with this portion. It is my understanding that there are programs in my state that will help me pay my premiums if I "qualify". Your in-laws may be part of a program and so they don't have to pay their premiums. I did call a few of the programs here but since I am not "old" I don't qualify.:rolleyes: I don't know if it is because I am on SSDI and not SS. That may make a difference.

Everyone is charged a premium for their Medicare and Medicare Part D. How each persons pays, whether it is themselves paying or others paying for them, just depends on the programs. My parents have to pay for their premiums. If I remember correctly, they were "forced" to get Medicare. I don't remember the circumstances but it did have something to do with SS.

Does that help?

Jim's is taken out of his check as far as I know.

Trish,

You should receive a thing in the mail that tells you how to apply for extra help. I know my fiance got it and applied and it now pays his Part B, his Part D, and the copay for his prescriptions. His meds alone are 25K a year. He has a low copay on meds until he reaches catastrophic level in Feb. of each year and then the copay goes away.

I am not positive, but here in Maine I believe he applied under SCHIP or something like that. I know he went to what is called "Senior Spectrum" when they had a benefits coordinator there for elderly and disabled and they were able to put him into the running for all the programs with one application. He didn't qualify for everything, but he qualified for enough so he could afford to live.

He does have a son who is underage and that may have made a difference. He also has a daughter who is in her last year of college and somehow he was able to continue coverage for her until she turns 21, which was a big deal for her since she also has a health condition, requiring treatment and expensive prescriptions.

I believe I got this link from here, maybe from Kitty?
It may help.

http://www.benefitscheckup.org/

Please let us know how it goes for you and if you find anything that helps you so others may try it! :hug:

The link wasn't from me but thanks for posting it! It's got a wealth of information on it. It will be beneficial for many here. :hug:

OMGOSH!!!!! RW, I could just hug you.:hug::hug::hug::hug: This took a ton of bricks off my shoulders. I got more helpful information on this site than I did from my case worker and others in this state. I found that I do qualify for extra help on my medicines and premiums. It is a federal program and the income limits must be different. I am so relieved.

*tkrik wiping tears and giving a big sigh of relief*

:o sorry for my lil rant. I really do have a hot button with some of my relatives that are brilliant at working the system, while I visit, and help care for elderly that cannot afford meals on wheels or basics like shampoo because every penny goes to deductibles, co pays, and doughut holes. My lil 92 year old friend recently told me she was thinking about shoplifting for her shampoo! We gifted her a basket of goodies for her belated birthday present. I see many folks (yes, some are my family, makes ya proud dont it?) that are simply "good at the system" Case in point. my 26 y/o neice. Has asthma, and is 350lbs. I paid for a college education of 4 years for her. Because she is her momma's child, momma taught her that "you dont have to work!" she lives rent free, no utilities, has cable, phone, high speed internet, and gets free dental, free medical, free oil/heat, free furniture, free food, plus food stamps, and so much more. She is HEALTHY! She needs an inhaler because she is winded from lack of exercise, and drives her FREE CAR to and from town to hang out with her friends! it burns me up!

I cannot turn down SSDI because its tied to my retirement. I was retired due to a fractured spine, and because of the spinal instability I am unable to work as a nurse, in my field of education. There fore I was forced to retire, and as part of the settlement, the state applied for me for SSDI to offset my retirement paycheck. I am reimbursed for the Medicare premium through my state contract, but its maddening! I have a masters degree in nursing, and am unable to work in my chosen field. IF i went to work as a cashier, or other unskilled jobs I would lose my retirement. it would reopen my case. A job making $8 an hour wont even come close to my retirement that was negotiated, so I am trapped. That $8 hour job doesnt include benefits. its a circle that is a trap.

Yes! the system does work for some. Yes! the system is a God send for so many deserving folks who need a hand up, and some help. it has been a God send for many folks that I know personally. The problem is that unless you know how to work the system, you get half the benefits, and dont know which programs to ask for. They wont offer them, you must ask to initiate them. Recently word got out here that the state pays for daycare fees if you make less than x amount per year. So many found out, and asked that it bankrupted the plan, and now only those that are currently enrolled in the system will get the help. Even if they now make past the amount required to enroll. They are not bumping off those who have passed the requirements to make room for those that are in need. Its maddening!

btw, I too have written till my hands are bleeding. I get the feeling that no one is listening. I think my letters are just being dumped into some temp secretary's file to be dealt with in 2020. it will be too late then!

Thanks for letting me vent in your vent. :o

Dej - I have major issues with food stamps. It does not cover toiletries but covers chips, candy, cookies, soda, etc. With all the technology we have, I don't understand why they can't program the food stamp card to not accept junk food and accept toiletries. Not only that, they give you an incredible amount of money for food stamps.

When I 1st got food stamps the total amount for the 3 of us was a little over $700 a month.:eek: It was slightly over my income. :confused: Seriously, I was able to feed the 3 of us for around $300 a month with careful planning (buying things on sale, using coupons, etc.).

One Christmas, the youth group at my church collected items for "a family" (we were kept anonymous). I was never so excited to be given toilet paper, shampoo, soap, etc. then I was that Christmas. It was such a blessing.

What you did for that lady is wonderful.:hug: When DDs and I started receiving SSDI, I always made sure that when my church had the Christmas collections, I donated toiletries.

BTW - When we 1st got the food stamps DDs would ask for chips and stuff for their lunches. I wouldn't buy them. I explained to them that this was actually tax dollar money that people paid. I was not going to use other peoples money for junk. I asked them how they would feel if they gave someone money for food and they used all that money for junk food. They got the point and never asked for junk again.

I did buy staples though and was able to make treats.