Hello Toni:
My sister, who is 60 years old, was granted Medicaid for Stage 3 breast cancer in April of this year. She had 19 lymph-nodes removed and this qualified her for Medicaid. We learned from her Doctor last week that her Medicaid had been cancelled on August 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 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…Ted from Alvin, TX
Oh My… Ted:
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.
Ted, 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 Social Security Disability check, 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.”
I have some good news for you, but you and your sister’s time is ticking. She has to act fast to enroll in a new Affordable Care Act plan (ACA) also known as Obamacare!!
Talk with the cancer facility and her oncologist as to which affordable care act health plan they accept and contact www.healthcare.gov to enroll in that health plan. Today, there are no pre-existing conditions or medical underwriting with the new health plans.
Since she has lost her Medicaid plan effective September 1st, she qualifies for a Special Enrollment Period because of a qualifying life event (QLE) and has only 60 days after a qualifying event. Losing her Medicaid coverage on September 1st is the beginning date of her qualifying life event (QLE) and the 60 days begin counting for her to enroll.
Other QLEs are:
- Lose of health coverage i.e., lose employment, exhaustion of cobra, lose eligibility of Medicaid or CHIPS
- Change in Family size i.e., get married, divorced, death in family, have child by birth or adoption.
- Change in citizenship i.e., become US citizen, naturalized or gain lawful status.
- Move to new coverage area. Toni King, author of the new Medicare Survival Guide®, which is a simple guide explaining Medicare is on sale at www.tonisays.com. Email questions to www.tonisays.com/ask-toni or call 832/519-TONI (8664).
