Medicaid and Medicare dual eligibility and other concerns? - AgingCare.com

Medicaid and Medicare dual eligibility and other concerns?

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Please help us in our situation. We are both on Medicaid. Our income is at the level where we can both qualify for financial assistance for schedule B of Medicare but not schedule A (they are not qualified for financial assistance schedule A of Medicare).
We both do not have 40 credits at this time. The earliest that one of us will get 40 credits is going to be next year when one of us will turn 66.
We obviously do not have enough income to pay for schedule A premium of Medicare.
We also want to collect our social security benefits when one of us will turn 66 (next year).
(1) First Colorado Medicaid office us that once we turn 65, our Medicaid will be terminated even though our income will still qualify us for Medicaid. We argued that this response is incorrect but they said that its Colorado state regulation. How can we find out more about this
(2) Our major concern is that is if we don’t enroll in Medicare part A (while not collecting social security benefits) will result in some penalties and higher premiums for schedule A of Medicare in the future. Could you please clarify.

(3) Also, we are not sure to get financial assistance with premiums for schedule B of Medicare (i.e. where to start etc.
(4) Assuming their situation, we believe that there is option to get enrolled into schedule B and not into schedule A of Medicare until one of us get 40 credits (next year) while NOT collecting social security benefits. Is this correct?
Thank you very much for your help!!!

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You have some excellent advice here from all the commenters and you should be able to get the info you need from reading their posts. It's always easier to accomplish something when you have all the facts and information to choose from. Make all the appointments you need to make to make sure you understand exactly what help you can get and how much it costs, etc. I know it's complicated and irritating to have to do all this but you'll be glad you did. Also the Elder attorney can help with some of this info for you if you run into a blank wall as so many do when dealing with the government. I had a social security problem a few years back and went from one department to another for help to deal with it and hit a brick wall each and every time, countless hangups on the phone, leaving me on hold, etc. and I finally went to my state senator's office and their logo said they will help citizens in his district with any problem so I made an appointment and took all my letters and correspondence from and to SSA and one of the assistants who worked there sat down with me and listened while I explained what was happening. After she went thru all the letters, she said she needed to make copies of all and she would go over it with the senator to see what they could do. She contacted me within a few days and set up an appointment with someone within the SSA who knew what to do and my problem was solved within a short time. I tried to handle this myself and found that it was better to get help from someone who had some pull with SSA officials. Amazing how they were so helpful after they knew the senator was involved and wanted answers as to why I wasn't getting the help I needed. I had tried for MONTHS to get thru to someone who could help and he accomplished it within a matter of days! So, what I'm saying, is find the right person who can help. If you don't get any answers, go over their head and ask to speak to their supervisor, if no answer there, see their supervisor until someone gives you the help you need. Good luck and I hope you get what you need.
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You need to go personally to your local SS office and your Medicaid. I find its easier to sit with someone to help me understand. Do you work? When u retire, will ur employer continue to pay for your health insurance as a supplimemtal. If so, they will probably expect you tohave part B. Part B will come out of your SS checks. I pay about $105. You will never miss it because you never had it. My nephew is 25 on SSD. He gets Medicare and Medicaid is his suppliental.
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I am in Colorado too and DHS has not been very helpful with my transition to Medicare/Medicaid from Medicaid since I turned 65. Contact your local Area Council of Governments on Aging and set up an appointment with a SHIP counselor. Sorry I don't have the number, but it depends on which county you live in. In Colorado Springs/El Paso County it is the Pikes Peak Area Council of Governments. A SHIP counselor should be able to sit down with you and help you figure out your specific situation and there is no charge.
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One other comment. Part B is only charged separately until you start to collect SS, and then that monthly amount is automatically deducted from that so you never even see it.
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Agree with Terry512 that an elder attorney would be a very good idea given the complexities of your situation, or at least a trip to the state Dept. on Aging to speak with qualified informed people who can help guide you. I am a bit confused when you speak of Medicare Part A costs as Part A is free to all but Part B is around $100+ additional per month depending on your income. Part C is the supplement that ramiller spoke about and Part D is another separate policy for prescription drug coverage. But, all of this is associated with Medicare coverage and not Medicaid to the best of my knowledge. If you do qualify for Medicaid, then your medical and drug plans are more comprehensive (i.e., even cover things like hearing aids, full dental, etc.) and the drug plan can have zero premiums and zero copays, again dependent upon your income. For example, my 93 year old mother in AL in NJ is on the United Healthcare Community Solutions medical plan, and the network of doctors that takes this is fairly limited but still adequate. She just had to have a full lower denture replaced and it was fully covered under this plan with zero $ outlay. Again, the best suggestion would be to discuss all of your options with the Dept. on Aging, but make sure you have income documentation, etc. for at least a year back before you make the initial appointment. Good luck and I hope all comes together for you.
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In Florida..... all Medicaid and other state assistance is applied for online. I went online and just check marked everything that the state offers, and help paying Medicare premium was one of them.( My MIL is 81, and back in 1999, she took Part A, but refused Part B. She has never paid for Part A.) Florida Medicaid automatically enrolled her in Part B, and we didn't find out until over a month later. I highly recommend making sure that you have an online SSA.GOV account set up as well as a Medicare.gov account. Definitely sign up for ALL MEDICARE PARTS A,B, and D when eligible, it is very irritating and a lot of run around and higher fees to do so after your initial eligibility.

In my MIL situation, Medicaid is paying her Part B and the penalty. I chose to get her a supplement that costs, versus one that has no monthly fee, mainly because of her doctors. Because she has assistance paying for the Part B, she gets a reduced monthly fee of about 25% off. You also have to make sure you get the Part D, or a supplement that has drug coverage, or there are more penalties.

Good luck, and I hope my MIL story helps you or someone else.
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I think you have more of a complicated problem than anyone here can answer so I would advise you to consult an elder attorney and see if they can help you. Most of them will give you the first visit either free or a small fee to see if you can be helped. Also, you can visit the local Medicaid office and tell them you don't understand why, what, where, etc. and you need someone to help you. Write down all your questions beforehand so you can hopefully, get an answer to all. You may also call the state office that handles the Medicaid/medicare policies and see if they can give you a list of policies that deal with your situation. If you can read the Colorado state regulations, you may get your answers from that, otherwise, an attorney will have to help you.
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I do not know anything about what sounds like a cimplicated situation, however I would like to suggest to you that you call the health care market place in your state. I have had several occations to talk to them and they were always very helpful. They may be able to help you find supplement policies that cost little to nothing based in your income while u wait for medicare to kick in. Also remember once you get medicare you will still need a supplement policy to go along with it. My friend found out the hard way last month that just straight medicare isnt enough.
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