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MediGap or ??

So I am going on Medicare in Oct, I will be 62 and on Social Security Disability. Currently, I have Medi-Cal (IEHP) in California. My benefits are going to be $1872 a month, and State of California, says I no longer qualify. They believe $1872 is plenty to live on (Rent $1000, which is cheap, leaving $871). Well Plan A is no charge, but I will not be able to play the $142 for plan B and to add Plan C/D. I can get CoveredCa cheaper than Medicare, but if I go with a Private, I lose my SS Benefits? So right now, my options are Homeless with Insurance or Homeless with No income.

I was told that Gap thru UnitedHealthCare is not available for Social Security Disability. Can anyone verify, that or have options?

 

Also, when I went on Disability, it was for permanent Hip and Back conditions, as of Nov 2023, I was diagnosed with Prostate Cancer, and in May 2025 I have Chronic Kidney Disease and getting worst.

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Community Concierge

Hi, here to help! Although AARP isn't an insurance company, we work with insurance carriers to make carefully researched and evaluated products available to you. Please contact United Healthcare at 800-506-7651 for more information. -Carla S.

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I'm sorry to hear about your situation. Navigating Medicare and disability can be challenging, especially with your health conditions. Here's a summary of your options and some potential solutions:

Understanding Medicare Plans:

  1. Medicare Part A: Hospital Insurance, typically no cost if youโ€™ve worked and paid Medicare taxes for at least 10 years.
  2. Medicare Part B: Medical Insurance, which has a monthly premium (around $142).
  3. Medicare Part C (Medicare Advantage): Includes Parts A and B and often Part D. Costs vary by plan.
  4. Medicare Part D: Prescription drug coverage, with an additional premium.

Medi-Cal and Medicare:

  • Once you qualify for Medicare, you can no longer receive traditional Medi-Cal benefits, but you may qualify for a Medicare Savings Program (MSP) which can help pay for Medicare premiums, deductibles and coinsurance.

Medicare Savings Programs (MSPs):

  • Qualified Medicare Beneficiary (QMB): Covers Part A and B premiums, deductibles, co-insurance, and co-payments.
  • Specified Low-Income Medicare Beneficiary (SLMB): Covers Part B premiums.
  • Qualifying Individual (QI): Covers Part B premiums on a first-come, first-served basis.

Dual Eligibility:

  • If you qualify for both Medicare and Medi-Cal, you are considered "dual eligible." Medi-Cal can help cover some costs not covered by Medicare, including long-term care.

Prescription Drug Assistance:

  • Extra Help (Low-Income Subsidy): Assists with Part D premiums and drug costs. You automatically qualify if you have Medi-Cal.

UnitedHealthcare and Medigap:

  • Medigap policies are standardized supplemental insurance plans that help cover out-of-pocket costs for services under Original Medicare.
  • People under 65 on SSDI may have limited access to Medigap plans, as availability varies by state and insurer. California has specific protections for those under 65 with disabilities, so itโ€™s worth confirming with UnitedHealthcare or exploring other insurers.

Covered California:

  • If you opt for a plan through Covered California instead of Medicare, verify how this impacts your Social Security Disability Insurance (SSDI) benefits. Typically, going with Covered California shouldn't affect your SSDI, but it's best to confirm with a benefits advisor or Social Security.

Actionable Steps:

  1. Contact Medicare: Confirm your eligibility and enroll in Parts A and B. Call 1-800-MEDICARE or visit their website.
  2. Apply for MSP: Through your local Medi-Cal office to see if you qualify for help with premiums.
  3. Seek Assistance from Social Services: Contact a local social services office or nonprofit for assistance navigating these programs.
  4. Explore Additional Benefits: Look into Extra Help for prescription drugs and any state-specific programs for those on SSDI.

Resources:

  • Medicare.gov: Official site for detailed information on Medicare plans.
  • SSA.gov: For Social Security Disability Insurance information.
  • California Department of Health Care Services: For Medi-Cal and MSP information.
  • Local SHIP (State Health Insurance Assistance Program): Offers free, personalized counseling for Medicare beneficiaries.

Given your specific needs and the complexity of the situation, consulting a benefits advisor or a local SHIP counselor can provide tailored guidance and ensure youโ€™re making the most of available resources.

Contributor

So I am getting the Run Around from both SS and Medicare. I called Medicare to talk about Medicare Advantage, they told me to Sign-Up for Medicare Extra Help, and that I would have to talk to SS about it. I called SS, and they told me, they do not offer coverages/policies, that I would have to talk to Medicare???? I was told once, that if I decline Medicare, I lose Social Security Disability, I asked if this was true, he said I must take Plan A, but can decline B, and collect. I am wondering (living in California) if I can do Plan A, and get CoveredCa, there are policies that I can get for $20 a month, with my income, but I do not know if they will co-inside with Plan A. July 3rd I am attending a SCAN Healthcare seminar, and July 8th I have a phone appointment with IEHP. This is so frustrating.

 

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