SSI, Medicare and Medicaid question

[sammie8450]

Hi everyone,
I haven't posted in a while. My daughter,23 and handicapped is on SSI and Gateway, medicaid. Do we need to sign her up for Medicare? I asked the transplant social worker and she said no need to but I am scared something is going to happen if we don't. Any help would be great and TYVMIA.

[KarenInWA]

Sammie, I would sign up for Medicare. I signed up for it, and I don't really need it at this point. But, I signed up for it as a safety precaution. Also, if your daughter is handicapped/disabled other than ESRD, she will qualify to have Medicare based on that, and won't need to worry about losing it 3 years post-transplant.

KarenInWA

[sullidog]

I'm not 100 percent sure but I've heard you can't have medicade and medicare both.

[KarenInWA]

sullidog, there are *plenty* of IHD members who are on both Medicare and Medicaid.  Just take a look at some of the posts in this category.

KarenInWA

[Meinuk]

People with Medicare and Medicaid are called "dual beneficiaries" and there are so many that States are trying to manage their care better and more efficiently (this is a hot news topic in the health care industry).

There is a very large population of people on dialysis that are dual beneficiaries (because dialysis even with Medicare is so expensive)

Sammie, I don't know what state you live in, but please do check out all of your daughters options. I am sure that the Transplant Social Worker is just one of her social workers, you may want to ask others.

The main barrier that I see to Medicaid is that she is only covered in the State that you live in.  Should you want to go on vacation or move, she would have to go through the Medicaid enrollment process in any state that she is cared for in.  Medicare is National, and there is some freedom to travel (less the 20% co pay).

Also, many states require that if a patient is eligible for Medicare, but only have Medicaid, they must sign up for prescription drug benefits through Medicare. This is the NY State Policy:  http://www.health.ny.gov/health_care/medicaid/program/medicaid_transition/

If her dialysis social worker is unsure, ask her to check in with your state SHIP http://www.medicare.gov/contacts/staticpages/sids.aspx

[sammie8450]

Thanks for the replies. I called SS today and they told me she does not qualify for medicare. She has been disabled from birth so she has no credits towards it. I just wanted to make sure I am contacting the right people with all this going on and don't want to get a huge bill in case she did qualify and i did not sign her up. Thanks again everyone.

[hubbyhatesdialysis]

Thanks for the replies. I called SS today and they told me she does not qualify for medicare. She has been disabled from birth so she has no credits towards it. I just wanted to make sure I am contacting the right people with all this going on and don't want to get a huge bill in case she did qualify and i did not sign her up. Thanks again everyone.

Does your daughter have ESRD? I'm guessing she does if she is looking to get a transplant. From my understanding I thought that ANYONE who had ESRD no matter what age, job, credits, ect. qualified for Medicare. I may be wrong but I am almost certain that my hubby's transplant hospital explained that to us.

[msrosefromms]

I am no expert, but it was my understanding if you were not e;ligible for medicare when you first started diaylsis, that you automatically qualify for medicare after 3 years. Ask SS about that.