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Mom has kidney failure (ESRD) and is currently enrolled in Medicare, she had full Medicaid but was switched over to Medicare because from what we were told all renal failure patients are automatically qualified for Medicare no matter what the age. She is currently receiving social security disability checks every month (NOT SSI checks) around $1245. SSDI checks are her only source of income and we are wondering why she isn’t eligible for Medicaid if she stands below poverty level here in New Mexico? Some have said that it’s because she has Medicare that she does not qualify for Medicaid, but some people at her dialysis center are receiving both Medicare and Medicaid so we don’t understand. The only reason we are leaning more towards Medicaid is because it covers so much more than Medicare does in regards to services, prescriptions, transportation, etc. couldn’t she continue with her Medicare plan as primary insurance and Medicaid could be considered secondary plan? We’ve also heard about Medicaid waivers but aren’t sure how those work. Would she need to be enrolled in Medicaid to qualify for waiver or does the waiver substitute for Medicaid when one is not financially qualified for full Medicaid? I’m sorry if this is all over the place we are just very confused as we have never had to deal with anything like this. She has already tried reapplying for Medicaid, even went down to the local office and we didn’t have any luck as no one could give us definite answers as to why she doesn’t qualify. I really don’t think it’s because of her income and I refuse to believe it’s because she has Medicare because what would be the point of dual eligibility if that was the case? Anybody have any experience with this?

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If you are below the % of poverty level for your state's Medicaid plan, you may be approved for Medicaid even if you are on Medicare. Some state Medicaid programs will actually pay your Medicare premium which would increase your Social Security check. I know that is true in some states. I would suggest going to apply for Medicaid in person and checking on this option. It is a separate application from the Medicaid application. You may also qualify for Extra Help program attached to your Part D prescription coverage.
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Mac, igloo gave a comprehensive answer to Reyes about a FATHER, not MOTHER as described here with the same description of problems...Medicare covers ESRD regardless of age. You are transitioned into Medicare from Medicaid within specific timelines. The difficulty may be the TYPE of Medicare or Advantage plan that was chosen.
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The Medicare plans will only cover for ESRD if she has been on the same plan for several years. Any new plan would deny her. It looks like you list coverage by trying to add a Medicare plan
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