My sister was granted Medicaid in January of this year. Has no health insurance or Medicare. She is 60 years old and she was granted Medicaid for Stage 3 breast cancer. She had 19 lymph-nodes removed and this qualified her for Medicaid. We learned from her Doctor that her Medicaid had been cancelled on May 31st. My sister has not received anything from Medicaid stating that she was cancelled and we cannot get anyone at Medicaid to tell us what the problem is. She was being paid $703.00 as a disability check and recently she got a raise to $1,131 for Social Security Disability. When she went to Social Security to apply for Medicaid no one said she would get an increase in her $703.00 disability check.
Someone told me about what you do to help people who do not know where to go or what to do. This is overwhelming because my sister cannot receive her chemo treatments any more. Can you tell me what I need to do? Thanks in advance…Gray from Bellaire
Oh My… Gray:
I do not get very many problems like this, but after talking with you this week, I wanted to inform my readers about this Medicaid issue. People need to know how vitally critical and important it is, when you qualify for Medicaid to be sure you stay in the monthly income and asset bracket that qualifies you for Medicaid. One dollar ($1) too much and you can LOSE your Medicaid benefits and will have to pay 100% out of your pocket for your medical expenses.
Gray, my heart ached when you said, “you would have helped your sister with some of her expenses because of her disability check raised from $703 to $1138, but you could not pay the $2,600 per chemo therapy treatment with 8 treatments in a cycle that totaled over $20,800.00. She lost her Medicaid for only $400.00.” And that you considered the state had given your sister a “death sentence” because her doctor is not giving her chemo since the medical facility is not getting paid.
Here is what I would advise you to do to help your sister:
1) Talk to her Congressman because Social Security is federal, her Texas state senator and also the Texas state representative for where she lives because Medicaid is provided by Texas. Explain her complete situation.
2) Ask how you can get the Social Security changed from the $1,131 to the original amount of $703, so that she can be in the correct income bracket to have Medicaid. Who knows maybe there is a loop hole somewhere?
3) Talk to the cancer facility where your sister was receiving her medical care and chemo treatments. Find out if there is a non-profit fund set up for situations like your sister’s. See what grants or philanthropic organizations help in this type of emergency.
4) Contact the American Cancer Society and the local office is at 6301 Richmond Ave., Houston, TX 77057, (713)-266-2877. Tell them about her serious situation and how time is slipping away. She needs help NOW!!
My main goal in writing this week’s column is to make the public aware to how important it is when you qualify for Medicaid, whether you are under 65 with no health insurance or you are over 65 and have Medicare, that you must stay within the financial limits…One dollar ($1) too much and you lose your Medicaid benefits and have to pay 100% out of your pocket.
I am seeing changes happening with our healthcare and the good ole’ days are gone! Medicare and Medicaid are doing everything to hold on to their dollars because as you know there are 10,000 turning 65 every day for the next 20 years and beginning January 1, 2014, the Affordable Care Act or Obamacare begins. And then the FUN really starts!!
Toni King, Medicare advocate, consultant and author of Medicare Survival Guide that is available only at www.tonisays.com and not sold in bookstores. Email questions to toni@tonisays.com or call 832/519-TONI (8664). Sign up for the new Medicare Survival newsletter available at www.tonisays.com.
