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Thread: Medicare and perscription coverage

  1. #1
    Senior Member jessie.gray's Avatar
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    Medicare and perscription coverage

    Ever since Friday, when my urologist told me that I most likely won't be able to get Medicare to cover the Botox injections for my bladder (I'd rather have the shots than augmentation surgery), I have been wondering if its possible to have Social Security just put me back on full Medicaid like I was on when I was getting SSI (I am on SSDI now, drawing from my Dad's social security since he's dead).

    Ever since I started getting both Medicare and Medicaid (a red/white/blue card and a medical coupon), I've had a lot of trouble with perscription items my doctors deem necessary being covered (like the Botox injections for my bladder). Heck, I still haven't got my catheters yet for June or July, because CCS Medical is having trouble getting authorization from Medicare for them.
    Has anyone on SSDI ever asked social security if they can just be on Medicaid for their primary insurance to cover everything (perscription, DME, and appointments)?

    Jessie

  2. #2
    Are your resources over $2,000?
    Aerodynamically, the bumble bee shouldn't be able to fly, but the bumble bee doesn't know that, so it goes on flying anyways--Mary Kay Ash

  3. #3
    Senior Member jessie.gray's Avatar
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    Quote Originally Posted by november
    Are your resources over $2,000?
    Not sure exactly what you mean, but if its how much I get a month, I get $805.00 every month from SSDI.

    Jessie

  4. #4
    I don't think you can be on Medicaid if you have assets of more than 2,000. More than 2,000 in the bank and/or savings at a time.
    Aerodynamically, the bumble bee shouldn't be able to fly, but the bumble bee doesn't know that, so it goes on flying anyways--Mary Kay Ash

  5. #5
    Medicaid has different requirements in each state. Once you have Medicare Medicaid will back it up and pay the 20% for you. This is only if you meet qualifications in your state. You will have to call your Dept of human services to find out.
    If you can't handle me at my worst, then you sure as hell don't deserve me at my best.


    Sometimes it is easier to widen doors than it is to open minds.

  6. #6
    Most states use the federal guidelines for Medicaid eligibility which includes no assets (bank accounts, savings accounts, stocks, bonds, CDs, etc., etc.) worth more than $2000 and ownership of no more than one home and one vehicle. There are also monthly income limits. Many people in SSDI do not qualify, although many on only SSI do. Your spouse's income is included in qualifications.

    (KLD)

  7. #7
    Senior Member jessie.gray's Avatar
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    SCI Nurse,

    I only have a savings account and it only contains $805.00 every month on thr 3rd., and nothing more (I use the majority of that money for bills, bus passes for 2 transit lines, and groceries). I don't own a car or my own house and rent an apartment.
    I plan on going to the social security office tomorrow to see what I can do.

    All I know is that my gastroenterology surgeon and my urologist are ticked off at Medicare right now, because they won't cover certain medicines that would work for my neurogenic bladder and diversion colitis. Instead, they'd rather pay for a rectal/anus removal surgery and a bladder augmentation using my stomach, which are risky and way more expensive.

    Jessie

  8. #8
    This may sound nuts to you but this is what happened to me. I am the same situation as you so I decided to take out the Medicare part D insurance. Now here you go there are multiple loops to go through and it may cost you but after there searching my resources I became eligible for federally funded premium payment. I do have to pay $2.00 per prescription and there are medication not allowed mostly because there is a generic substitute.

    This is just an idea and you will have to check it out on your own because of local restrictions.
    T6 complete

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