topic Re: Medicare and Medicaid conumdrum in Medicare & Insurance

Medicare and Medicaid conumdrum

k10493m — Wed, 05 Feb 2025 21:34:47 GMT

Here is the situation:

1. I know someone whose sole income is just about $1200 per month from Social Security

2. Her health is bad: she only has (had) Medicare

3, She was recently approved for Medicaid. She was told that she would no longer have Medicare, and that she would no longer be billed monthly for Medicare, because she was now entitled to receive care under Medicaid.

4. She was receiving about $90 a month in SNAP benefits, but those benefits have been cancelled because she is now on Medicaid.

5. Finally, will her change in status affect her ability to receive reduced heating billing because of her low income?

My big question: who is qualified to explain these things in a manner which is understandable? I want to advise her about who she can talk to about her situation. It is often impossible to find someone who is knowledgeable in these matters.

Re: Medicare and Medicaid conumdrum

GailL1 — Sun, 09 Feb 2025 00:20:56 GMT

@k10493m

The state where your friend lives are the ones that issue both Medicaid and SNAP benefits.

Since she gets SS and has a Medicare number, she would be getting both Medicare and Medicaid. She doesn’t lose her Medicare, Medicaid is just added but it is the payer of last resort so Medicare pays 1st and then Medicaid. They work together in getting her health care coverage.

Medicare is primary and then the remainder is from Medicaid. That’s a simple explanation. She should let her health providers know that she has both of these Insurance plans - she should have id cards for both.

Medicare.gov - Medicaid

She most likely is getting her Medicare premiums paid by one of her state’s Medicaid program - those are called Medicare Savings Programs and the link below will take you to Medicare’s description of them - any question about her having one of these programs would be answered by her state’s Medicaid office and there is a link to this on this page also.

Medicare.gov - Medicare Savings Programs

Now under some or these programs, she will get EXTRA HELP - which is a program that will cover her prescription drugs - also thru the state. If she is getting one of the Medicare Savings Programs Extra Help is included, if not she applies for it under the SSA.

SSA.gov Extra Help publication for 2025

So she needs to check with her state on exactly which program she is on and what is covered and how - Medicaid also sends out id cards which should state the coverage. like QMB or SLMB shown on the Medicare Savings Program linked page.

SNAP is give out from the states and each has a different eligibility and amount - so she will have to check with them on that coverage. The LIHEAP (LOW INCOME HOME ENERGY ASSISTANCE PROGRAM) comes from the federal government but I am pretty sure that the state dishes out the funds based on eligibility and need.

Sorry I do not know too much about LIHEAP -

USA.gov - Get Help with Energy Bills

IF your friend’s state has a Dept of Aging - they can hopefully get her signed up for anything that she is eligible for -

Re: Medicare and Medicaid conumdrum

javmd — Sun, 09 Feb 2025 21:11:05 GMT

Check on the SHIP program in your state, the State Health Insurance Assistance Program. Each state should have a program administered by the state department of insurance. In North Carolina, where the program is known as SHIIP (Senior's Heath Insurance Information Program), there is a dedicated phone line with trained counselors who can answer questions, assist with Medicare enrollments. In addition, throughout the state there are trained volunteers certified by the NC Department of Insurance who can meet with clients in person to provide assistance.

The assistance is free of charge and free of any bias or promotions to individual insurance companies.