Follow
Share

I am on SSDI / Medicare 61 years old. My mother passed and I received life insurance $45,000.00. I put it all into paying bills off, doing home repairs and handicapping home for myself in 1 month. Six months later, now I need surgery to remove a growth in brain and I need the 20% Medicaid pays so I can have surgery. What is the "look back" on this? (If only I could have predicted the future). I am in the lower income bracket and qualify for Medicaid but, was able to make payments and pay the 20% before but, now I need it so, they will perform the surgery. Thank you.

This question has been closed for answers. Ask a New Question.
If you used the money for your own needs (not given to others) i do not believe it will impact your qualification for Medicaid, but i suggest working with the Medicaid office. I'm sorry and about your need for surgery and hope it will all work out well for you. Please update us.
Helpful Answer (7)
Report

If you'd gone on a Caribbean cruise and given the rest to homeless dogs or something it might be different, but from what I've read the look-back doesn't apply to money you've spent on normal living costs or reasonable adaptations to your home and I certainly don't see how it could apply to clearing legitimate existing debts. So I *hope* Medicaid will be able to set your mind at rest - have you spoken to them yet?
Helpful Answer (4)
Report

I am not sure they can refuse to do the surgery because you are unable to pay. A brain tumor needs immediate attention so i would go ahead and scedule the surgery.
Definitely talk to Medicaid and see what their requirements are. it will take a while for Medicaid to kick in but benefits are backdated to the application date.
Collect proof of what you spent the money on as Medicaid will require proof.
Many hospitals also have funds that help pay for people with no assets.
Helpful Answer (1)
Report

You should have reported the money to Medicaid. It effects your income for the year.
Helpful Answer (1)
Report

I didn’t know inheriting money could affect medicare disability income. Maybe seek legal advice before contacting medicare. All those commercials they do on the tele must be worth something. Take care of yourself and stay strong through your surgery and to a quick recovery. (((hugs)))
Helpful Answer (1)
Report

You say you are on Medicare-not Medicaid- and your surgeon is asking for proof as to how you will pay the 20% Medicare does not cover? I don’t think that should effect them scheduling surgery for you now as Medicare will cover 80% or so, but you will be responsible to pay the 20% Medicare doesn’t cover. That’s just the way it is.

I am not familiar with the laws re SSDI but you might have had to count that $45K as income which may decrease your disability payments. Maybe someone with more experience will answer that question.

If I were you I would consider purchasing/enrolling in a MediGap policy in the near future if you suspect your treatment will be ongoing. The Medigap policy will cover some of not all of the 20% you are responsible for. Medicare won’t pay 100% of cost most of the time.

If you are on Medicare & Medicaid, I am pretty sure that $45k needed to be reported to them as income, and you will probably be required to present receipts for what you used the money for.

They (Medicaid) will determine whether the spending was appropriate (updating your home to make it handicapped friendly) vs paying your individual bills (they don’t like frivolous spending).

I am also not sure if the inheritance money should have been reported to SSDI either.
I would speak with a disability attorney sooner rather than later, as however long it may take, Medicare & Medicaid will find out. With federal & state budgets being cut these days, they will seek repayment. 

Also, your surgeon’s office may have its own policy re payment and require a plan for the 20% to be paid back prior to surgery. If that’s the case you may need to find another surgeon & fast.
Helpful Answer (0)
Report

This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter