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Author Topic: Medicare and SSI?  (Read 2817 times)
wvgirl
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« on: June 06, 2012, 06:13:19 PM »

I am getting SSI and started dialysis May 1st. My social worker told me I need to apply for Medicare. Right now I get Medicaid. I called the SS office and she said the only way I can get Medicare is if I pay a $456 monthly premium with a $1500 deductible. My Medicaid pays for dialysis and I get $698 a month ssi. Do I have to take the Medicare? I am thinking that makes no sense for me to have it but the Social Worker seemed to think I do need the Medicare. I am confused.
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Jeanne
1988- Chronic Kidney Disease
2005- Biopsy showed IGM Nephropathy
10/2011- Fistula surgery, transplant evaluation-gfr 13
02/2012- On transplant list
05/2012- Started in center dialysis with gfr 9
2 calls for a transplant but still waiting...
smcd23
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The patient, the baby and the donor - October 2010

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« Reply #1 on: June 06, 2012, 06:21:30 PM »

It depends on what state you live in. Some states will pay for what they call 'uninsured Medicare" if you are on Medicaid, because it saves them money in the end. It sounds like that's what you would be qualified for - which is basically Medicare for folks who haven't worked enough to be insured on their own (generally 10 years), and have to pay the full premium amounts and deductibles for Part A and B. I know the State I currently work in does not automatically pick up Medicare for those who are uninsured while MA does.

But if you're married (and I have no idea if you are or how old you are) and your spouse is at least 62, you can file using his credits.

I would call the social worker back and tell her that you do not have enough credits for Medicare and would have to pay the full cost for A and B. Then ask her since you are on Medicaid will the state pay for that? I'd say just ask the Medicaid office, but sometimes they have no idea themselves, and I think the Social Worker may know because she probably encountered it before. Send me a PM if you want more help or have more specific questions. (I work for SSA).
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Caregiver to Husband with ESRD.

1995 - Diagnosed with vesicoureteral reflux and had surgery to repair at age 11. Post surgery left side still had Stage I VUR, right side was okay. Both sides were underdeveloped.
2005 - Discovered renal function was declining, causing HBP. Regular monitoring began.

March 2008 - Started transplant evaluation for preemptive transplant due to declining function.

September 16, 2008 - Transplanted with my kidney.
September 18, 2008 - Kidney was removed due to thrombosis in the vessels in and leading to the kidney.

October 2008 - Listed in Region I

May 2009 - Started in Center Hemo
January 2010 - Started CCPD on Liberty Cycler

June 15, 2012 - Kidney transplant from a 43 year old deceased donor
June 22, 2012 - Major acute rejection episode and hospitalization began
June 27, 2012 - Nephrectomy to remove kidney after complete HLA antibody rejection. Possibly not eligible for another transplant, ever again.

Now what?
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