My mom makes barely too much to qualify for Medicaid to supplement her Medicare, but can not afford her co pays and prescription drugs. Any advice?

She's on SSD not SSI. If she gets regular SS disability of $18,000 ($1500 mo) she is over the income limit. Is she on a UH Medicare Advantage plan? That would also include her Part D drug plan which UH has very restricted formularies for advantage plans. Also UH advantage plans have high co-pays. Advantage plans are not a good option for someone with extensive health problems.

Your Mom has SSD and Medicare but not Medicaid? I think her United Health is her Medicaid part. Does she pay a small premium? Your Mom may be on Medicaid but because of her income she has to "share" in her care.

My nephew only gets $400 in SSD and $600 in an annuity. He has Medicare as primary and Horizon BC/BS for Medicaid. His prescriptions are with UH. He was having problems with an ADD med being covered. We were told to go to Office of Aging and have them go over what he gets. We found that for an extra $16 a month he could go up a tier and that med would be covered. You may want to try that. While talking to them, ask if there is a state prescription plan she maybe able to get. Also, were I live we have a place that has Pychiatrists and counselors. They work on scale and except insurances and Medicaid. Set up payment plans with her doctors.

I'm confused. The Arkansas Medicaid website states that if you qualify for SSI, you can get Medicaid.

I think you need to go with mom to your local Medicaid office and talk to a caseworker.

Also, look into a qualified income trust if she is truly over the income limit .

Barb, UH is notorious for luring people into their advantage plans. Most have very low or no premium. But the drug plan is not the best and the co-pays for specialists are high. Blankstm needs to calculate the costs very carefully. If she goes to regular Medicare her premium will go up to $134.00 per month and she will have to select a part D drug plan and Medicare supplement plan. The part D may have a premium of $40.00 or so. The supplement may be difficult as well because of all of her health conditions. Most people don't realize that Medicare supplemental programs have the right to deny coverage for pre-existing so conditions if changing plans. That was one of the negotiation giveaways to the insurance companies in Obamacare. That would need to be shopped for very carefully. She could check online during open enrollment to use one of the drug plan selectors based on the medications she takes to see which program would be best. also, shop very carefully for the pharmacy. Prices can vary widely.

Are you planning on placing her in a nursing home with medicaid pending? If so, then medicaid would deduct most of her social security income to pay part of the nursing home bill and then pay the rest themselves.

Is she receiving social security disability or regular social security?

I also think you may benefit from seeing an elder care lawyer.

Some pharmaceutical companies offer assistance. Contact the manufacturers of the drugs she takes and ask if they offer assistance to people in need.

Also, some counties have prescription drug cards, available for free. Ours does; I've never used them so I don't know how much help they are though..

She does not currently need nursing home care. While she has quite a few health issues she is still able to take care of most most of her basic needs and she is adamant that she never be placed into a nursing home. I have medical and financial power of attorney though since she is not quite able to take care of those aspects of her life. She is severely ADD and has numerous other emotional issues along with her physical disabilities. She receives Social Security disability with Medicare tied into that.

Her most expensive medications are her ADD meds and her heart meds. I have contacted the pharmaceutical companies that sell these medications and they sent me a discount card but my pharmacist informed me that they could not be used in conjunction with Medicare. Her doctor took her off of the expensive blood pressure medication that was actually working for her and put her on a cheaper substitute that barely does any good.

She sees her therapist twice a week. She was originally told by the office that she had no co pay but after 5 months of billing insurance they realized that she has a $50 co pay for each visit and now has a bill over $1,500 with them. She desperately needs to be able to see her therapist but can not afford $400 a month for therapy alone on top of her other medical costs. I'm at a loss.

She is on the UH Medicare Advantage plan. When we enrolled two years ago it provided the best coverage for her Vyvanse and Adderall which were her highest expense. Now she needs a lot more care. We plan to pick a new plan during open enrollment but we're trying to figure out something in the meanwhile.

She is 62.

Regular Medicare would be a better option but if we discontinue the UHC plan right now, she will lose drug coverage and we were told that she would have a penalty for not having part D. I spoke with her pharmacist about how much her out of pocket drug costs would be if we dropped UHC and they would go up by around $400 so it doesn't help solve the situation.

Carelink was no help what so ever. They said that recieved too much money to qualify for anything. I can not believe $18,000 a year with nearly $10,000 a year out of pocket medical costs does not qualify for any assistance. I'm at my wits end.

Have you looked into your state's Prescription assistance plan? It sounds like she has Medicare D for prescriptions, yes? Can you look at other company's plans that would have different drugs on their formulary?
Have you called the county office of aging to see if she qualifies for other help? Many areas have food pantries for non perishable items. Saving that expense can help her pay other bills. Also, some agencies offer sliding scale counseling. Can you look into that? If the medical bills are from hospitalization, has she applied for charity care? I had to do that for my son-in-law. Once he was approved, I sent copies of the approval to each doctor and they wrote off his balance. If you can share what county you live in, others may have more specific ideas.

Becky, thank you for the correction.

Would original Medicare be a better option, or a different Medicare Advantage plan?

I hope the Carelink folks can give you some guidance.