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I'm trying to help a woman on disability and can't afford dr visits/meds. I want to act as her advocate, as this has caused a lot of stress for her and she has numerous health issues. She has tried going to local free clinics before I tried to help, and says that the complexity of her health issues made things difficult. She was born with bone disease and other issues with her organs, and more conditions manifested later on, like glaucoma. She has been ordering what she considers the bare essential medication she needs just to get around and address her physical health issues from online pharmacies. She hasn't had a regular doctor in years, and she needs a evaluation and consistent care as well as prescription drugs that are up to date - not something she was prescribed years ago. She is on disability and has very limited resources. The last time she had an advocate was in the early 2000's, apparently her brother helped her before he passed away. She qualified for medicare part a in 2006, and that's currently all she has. I don't want to sign her up for a plan she can't afford, but i would think with all the recent changes in healthcare policies that there must be something out there can help her get her meds and visit the dr that she can afford.

I created an account for her on mymedicare.gov and entered in the medications she currently takes. I really need to know where to go from here..has anyone been in a similar situation with a friend or family member? Was it recently and are there any new programs that can help her? Thank you for looking over the situation

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I would try medicare.gov and I believe you may mean part D? I have not heard of part E it may be that I am missing something and need to take a look too. I personally do not know but she could qualify for Medical or Medicaid. I think it would be a good idea to consult with an Insurance Broker and an Elder Attorney. We all need good advice and direction sometimes it's not good to go it alone in specialized areas. Getting help is the best thing to do as we can never be to careful. God Bless and get some Elder help.
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You are not going to be able to do much without a Medical Power of Attorney or Power of Attorney, which you do not mention. Simply "advocating" for someone does not make a legal contract. First, get her to make you her MPOA, and since this is enrollment for Medicare until Dec. 7, make sure she has Part B and D (for prescriptions), get her to a doctor who accepts Medicare and she will have to pay the other 20% of costs, but at least she will not be taking the wrong medications. She might qualify for Medicaid so check that resource. Thank you for helping her! (P.S. In order for her social security checks to be put into an account that you would control, you have to provide a doctor's statement she cannot manage her finances, then a personal trip to social security where the person who will handle her claim will ask her questions. If all goes well, you will be made a "Representative Payee" for her and that is how the checking account will read. I just had to do this for my husband.)
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Maybe your state has programs like mine. Many towns in MA have a senior center or elder services office that offers appointments with a SHINE counselor who is trained to help seniors with insurance questions. (stands for "Serving the Health Information Needs of Elders"). Some towns also offer free short appointments with attorneys although you probably don't need this for your concerns. Give your town office a call if you can't find such a program. Or call Medicare directly, preferably with her available or on another phone to give approval to your speaking for her. I don't think you need POA to help her as long as she is with you when you talk.They're VERY helpful! Good luck!
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Medicare Part A (hospitalization coverage) is what you get automatically when you sign up for Medicare -- for most people, it's free, Part B (doctor visits, etc.) is very inexpensive (usually around $105/month). Part D (prescription drug coverage) is also inexpensive (can cost nothing, or up to $50/month). But even with all three, she will be paying about 20% of medical bills on her own, which can add up.

I'd recommend she consider adding Part B, and then looking at a Medicare Advantage policy (usually called Part C, or "Medigap") or a Medicare Supplement policy. These policies pick up the 20% out-of-pocket expenses not covered by Medicare. Some of them include prescription drug coverage, so she won't need a separate Part D policy. My husband has a Medicare Supplement policy through AARP and United Healthcare, and it has been very helpful. You can find out about it through the AARP website.

When you say "Part E," you're probably referring to a Medicare Supplement policy, which has 12 different options, A through L (one of them is called Plan E -- my husband has Plan F). You can see very clear descriptions of all of these through the various websites. The cost of these policies is very reasonable -- some are even free, depending on the person's financial situation.
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Thank you for all the help. I did mean part D, not part E. Fortunately this is the enrollment period for that. I had read a bit about part c - or the medigap policies and will keep looking into enrollment in these. SHe currently only has part A. Unfortunately it looks like we'll have to pay a penalty if she
HAS BEEN eligble for part b and didn't enroll. Being on disablility. Most people on disablility seem to be eligible for part b, and she's been on disablility for some time. I live in Alabama which doesn't have a lot of programs for the elderly, but I am searching. Thanks again for the helpful advice
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She has a few differnt options. I would need additional information to help you figure out the best route for her at this point.
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Your Area Agency on Aging:
http://www.fortpayne.net/agingprograms/
Ask them about applying for SSI Related Programs specifically:
http://medicaid.alabama.gov/documents/3.0_Apply/3.2_Qualifying_Medicaid/3.2_Medicare_Savings_Programs_Revised_5-23-14.pdf

If her SSDI income is under $721 per month she can apply for SSI to bring it up to that amount.

Part C "Medicare Advantage" programs might work for her once she gets Part B - depends on what is being offered in her county, but forget about Medicare supplements, she can't afford it.
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This information is from my "2015 Renewal Information" which I received from my insurance carrier, Humana. Page 15. "The Stte Health Insurance Assistance Program (SHIP) is a government program with trained counselors in every state. They are independent & not connected with any insurance co. or health plan." Also, " EXTRA HELP" from Medicare could pay up to 75% or more of drug costs including monthly prescription drug premiums, annual deductibles & coinsurance. Those who qualify will not have a coverage gap or late enrollment fee. Many people are eligible & don't even know it!" To see if she qualifies, call 1-800-MEDICARE (1-800-633-4227) 24 hours a day. Also, call Social Security Office @ 1-800-772-1213 between 7am & 7pm Mon. - Fri.
One last thing, go to "http://www.medicare.gov & click "Find Health & Drug Plans". Here you find information about costs, coverage & QUALITY RATINGS for Medicare plans! Hope this is helpful to you & others to pass on. Since many of us leave this world the same way we came into it; we elderly need all the help we can get and I pray that God will richly bless you for helping this pathetic woman in need!!!
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thank you again, what more information can I provide to you guys? I'd be happy to provide any info that will help - we have been on mymedicare.gov "find health and drug plans, and found a plan that looks to be affordable, with doctors in our are. However, Plan B is a requirement for this plan, so we're working on enrolling before the cutoff.
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I found tons of info. right her on Aging Care.com just start clicking and looking until you find some help or direction.
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yeah I've been reading a lot on this site today. I found out from the links provided earlier (thank you) that in Alabama there is a program that would help pay the $100 or so cost for her to get part B, but she recieves $30 over the limit on her disability - however, she has a substantial amount deducted from her disability check each month from old debts - including an old student loan that shes sure she paid off - so there's years of mishandled finances to deal with here, and with what she has left on her disability there's hardly anything to pay for premiums and the Part B fee. I'm trying to keep her spirits up. I can tell she's discouraged, and I'm trying to alleviate the stress and responsibility of handling finances and healthcare alone. There are some mental health issues that I'm afraid will continue to worsen, so I'm afraid if we don't get her medicare straightened out now, as well as her personal finances, it could lead to some serious financial problems i.e. getting far behind on bills, and being unable to afford medications.
Its sad to think that some of the collection agencies that are coming after her for old debt HAVE to be aware that there are mental health issues affecting her judgement. I don't think it would be difficult to get a doctor to write a letter stating she's incapable of handling her own finances/affairs. My concern is that if I did seek power of attorney it may arouse suspicion from her distant family, although they don't take any part in her care, and haven't for years. I would love to convince one of them to help, since it seems to look better to have a family member speaking for you, but have had no luck as of yet. For now I'm trying to find info on some of this past debt to see if we can free up some income to cover a plan, and/or find some program that will assist with part B fee before enrollment is over.
Thank goodness for this website and its resources, and all the people willing to help.
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If you call medicare to sign her up for a plan she will need to be on the same call. Have all her information prepared to provide on the phone call. Make a list of what she needs in the order she needs it and see what plan will provide for the most expensive of these items and services.

You and she can go on line and see what there is. Also remember that she could choose to assign her medicare to an HMO and see what kind of services they offer.
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