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I need to enroll in Plan B

Well, to make a long story as short as possible, for the past eight years I've been living overseas while collecting SSDI, and next year I'll be sixty years old.  Recently, a general practitioner in the country where I was living informed me that I might be suffering from colon cancer.  This was about a month ago, and about two weeks ago I returned to California in search of medical care. 

 

I tried going to an emergency room, but they told me that complaint was not an emergency, and that I should go to medical clinic.  I went to a clinic in SF bay area, but they told me that my income was too high ($1635 a month on SSDI) and that I did not qualify for aid from the county. The staff at the clinic told me that I should apply for Medi Cal, and come back to their clinic after my Medi Cal was approved. 

 

So, this morning I called Medi Cal, and was told that I could not get Medi Cal, because I'm already enrolled in Medicare Part A.  However, Part A only covers overnight hospital stays, and the medical clinic won't accept it.  I've been told by the staff at the clinic that I must get on Part B before they can see me, but the soonest I can get on Part B is sometime next week.

 

In the meanwhile I'm suffering from bloody stool, I'm feeling weak, and no one will see me.  I need advice on where to go for help???

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Honored Social Butterfly

I am really sorry, @EricW236758  - you have an unusual problem and just the way things went along, it has left you in a problem area.  

Seems to me, you should have not been put on Medicare at all - not even Part A - because you were outside the country. It was useless for you to have outside the country and IF you didn't have Medicare Part A (because you only qualify it because you are on SSDI - and you are less than 65) - you would have been able to sign up for a ACA insurance plan pronto when you got back into the country and it would have been active immediately.  You probably would have gotten a real nice tax credit subsidy to pay your premiums - in fact, you may have had NO premiums at all.

 

OR since SS never gave you the chance to decline Part B - they only signed you up for Medicare Part A - then it also seems to me that you should be able to apply for Medicare Part B under the Special Enrollment (Special Circumstances) rule - usually for people who have some type of credible coverage (like they are still working and have credible employment coverage) - they sign up for Part A but then hold off on Part B until they loose whatever credible coverage and then sign up for Part B.  That is why I said - that the country coverage and your proof of it, depending upon the country, could give you a similar coverage - but here again, fighting this out with them would take time and knowing how to do it - 

 

I hope the Sacramento HHS Dept can help you but I'm still not too sure based on your income but who knows -

California Dept. of Health Care Services (DHCS) - Medi-Cal Income Eligibility 

California has a lot of rules the rest of the country doesn't have - like insuring some illegal aliens -  (UNdocumented - my bad 🤐) so who knows - maybe you found someone that can make it happen.

 

Yes, SS does hold all the cards and do make the rules - but not all rules & cards meet all the circumstances of people.  Find out who your House of Representative Rep is and contact his office - local one if you can find it and run it all by this "expert" staff.  What is happening to you can be disputed - but disputes take a lot of time - time you do not have but Yes, government can change their tune on matters which create problems for their citizens but it take a lot of work and time to get to that point.  

 

I do hope you get the help you need - let us know how it all turns out  - sorry I could not help more but I am located clear across the country.

 

 

It's Always Something . . . . Roseanna Roseannadanna

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Well, when I look at all of the items I've posted here on this forum, my eyes go crossed, and I'm not sure where I left off last time.  Is it just me, or does the layout of this forum seem a bit confusing?  - Anyway, I was finally able to be seen by doctor today, and I feel that I was finally listened to and treated with respect.  Looks like I'm going to have to go back early next week for some lab work, but at least things have finally started to move forward on my medical front.  

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Just a quick update to everyone who helped me out in this forum.  I now have full scope Medi-Cal, and  have a doctor's appointment scheduled for Sept. 30 regarding my medical issues.  However, now my big problem is finding a place to live which I can afford with the money I'm receiving from SSDI.  I've found one or two assisted living centers in my area which are charging a monthly rent which is almost exactly equal to my Social Security benefits, so if i moved into one of those places, I wouldn't be able to buy a roll of toilet paper if I had to.  So, how can I find a place in an assisted living center on the amount I'm getting from Social Security?  Will Medicare help pay for this?  

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So glad you were able to get Medi-Cal and a doc and an appointment.

How much "care" - daily living care, med taking, etc. do you need everyday?  You don't have to be specific - a type measurement will - small, medium, high?  Small would be that you can do most daily living things all by yourself with maybe just staff checking on you.  Medium would be that you need help with daily living care.  High would mean that the staff pretty much has to do everything for you.  If small or low - those personal care homes would be the place to check out - if financially workable.  Where I am - Medicaid does help pay for some of the cost in personal care home.  Not every personal care home here takes Medicaid.  

 

Housing for most people who are looking for something subsidized is hard to come by right now - Sect. 8, subsidized housing for the independent senior/disabled is hard to find right now because it is all full and nobody is moving out.  When something does become available, there is a long, long waiting list.

 

What might be available is area specific.  Local government / city / county might have some suggestions for you - hound the ones that support housing in social services.  Some NGO (non-government organization) might be able to help - United Way, specific support groups connected to your type of disability.  

 

Take a shot and post something on this forum under the "Housing" board, mention general area - maybe somebody might have other suggestions.

 

What about a roommate situation?  Not the greatest, I know - but you do have an income you just don't want housing to use it all.  

So Sorry I can't help more 

EDITED TO ADD:  if you do need some "care" - post also on the "CAREGIVING" Board here - again at least mention the general area - cause it all based on geographical location.

 

 

 

 

It's Always Something . . . . Roseanna Roseannadanna
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I will try posting something in Housing tomorrow, after I have a chance to put my thoughts together. 

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How much "care" - daily living care, med taking, etc. do you need everyday?

 

Well, I really don't know, but I have noticed a significant decline in the past few years, but I also haven't been seen by a doctor in many years, so it is hard to say.  Well, I've noticed that I've developed a problem with navigation within the past few years. If I go into a large building or a dept. store I'm not familiar with, I can sometimes lose my own bearing, and forget where I am, or how to get out.  Also, the other day I heated something on the stove, and a few hours later the people I'm living with got upset with me because I forgot to turn off the stove.  I felt very ashamed because I know this would not happened just a few years ago.  I don't know how much support I need, but it seems doubtful I can live on my own. 

 

Where I am - Medicaid does help pay for some of the cost in personal care home.

 

Well at this point I hate to admit it, but I'm not even really familiar with what Medicaid is, or who pays for it?  I guess I will have to look into what the qualifications are in California? 

 

Housing for most people who are looking for something subsidized is hard to come by right now.

 

You know, the other day I stumbled across a website which promotes itself as being sort of a broker between seniors and assisted living facilities.  (I don't know if I can mention the name of the site here, but someone needs to investigate it.)  Anyway, I sent a general inquiry indicating that I'm disabled, and that I'm looking for a place to stay.  A few hours later I got a phone call from someone representing themselves as a manager at an assisted living center.  This person quoted me a price which was just a little bit below what I'm getting on SSDI, and they even offered to come pick me up and drive me to their facility, so that I could sign the paper work and move in that day.  I'm not the sharpest tool in the shed, but even I could see that something didn't smell right with this.  (I was worried about being robbed, or worse) So after a few days they stopped communicating with me, but for a while, they were really using high pressure sales tactics to get me to go with them.  

 

So, not only is there a real shortage of housing for the disabled, but on top of that, there appears to be a real problem with scammers trying to take advantage of people like me who are in a vulnerable spot.  I probably won't even waste my time trying to report them to the authorities, because it seem that these days, the authorities simply don't care.  

 

The bad thing is, there is still a very good chance I could end up in the street, and winter is just around the corner. 

 

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Thank you to everyone who has helped me here in this forum. However, I think that I need to ask one more follow up question in order to gain a better understanding of what I'm facing. 

 

Where can I find someone to help me navigate all of these different agencies, as I feel a little overwhelmed trying to do this on my own?  I have a full scale IQ of 82, and a lot of times when I try and call these different social service agencies, I get the feeling that the person whom I'm speaking with on the phone is more interested in finding reasons to not help me, than they are in actually trying to help me.  

 

So, the other day, I was sitting on the curb in the parking lot at the 99 Cent store trying to call the telephone number for a county clinic I had gotten from the Department of Human Assistance, when the receptionist at the clinic told me that I couldn't be seen there unless I was a member.  (A member of what?)  To make a long story short, I was at the end of my rope, and I just started to cry like a baby as I was sitting there in the parking lot.  

 

So, eventually I called back and got an appointment to see a medical doctor on Sept 2nd, but I'm really feeling that I'm not doing all of this correctly, I'm not able to understand everything people tell me, and maybe, in the long run, I won't be able to obtain the services I'm entitled to if I don't find someone to help me.

 

So, in addition to my other problems, (high functioning schizophrenic) I also have a below average IQ, and I'm not always able to function on my own very well.  The problem seems to have gotten worse starting in my late forties, and usually my wife is there to help me, but right now she is stuck in the Philippines while I'm in Sacramento, California trying to reestablish us here.  

 

There must be someone who helps people with mental disabilities, but whom?

 

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@EricW236758 

If it is any consolation, the frustrations you are experiencing do not have anything to do with you or any disabilities - it is just trying to work within a government framework and its massive tentacles of "help" programs.  You just have to find the niche where you fit given your specifics of need and income.  Believe me, when trying to find help in any government program it is difficult and now with so many of these employees working remotely - anybody would be frustrated.  I am frustrated right there with you and I'm not even involved  😣!!

 

So, maybe get outside of government - to a NGO (NON government organization) - UNITED WAY of California  

Maybe just go to them directly:  CALIFORNIA 2-1-1 Get Connecte

Search by California location and specific services on this page OR you can just call 2-1-1 for the referral - don't know which might be best to do - maybe the webpage just to see what they can do in those help offered categories of FOOD - MENTAL HEALTH - HEALTHCARE - HOUSING, ETC.  They may know of NGOs or where more specifically to go in government to find the help that you are seeking.

 

Wish we could just point to one spot for your problem(s) solving - it is just not that easy when dealing with specific individual problem and their unique characteristics - and yours's are rather unique.  You have made some headway - keep trying.

 

It's Always Something . . . . Roseanna Roseannadanna
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Well, it doesn't look like I'm going to be able to make any progress in regards to getting onto Part B, until next year, and the Social Security people I've spoken with on the phone are adamant about that. They hold all of the cards, they make the rules, and they simply do not care about my health problems.  

 

In the meanwhile, I discovered a county agency in Sacramento called the Department of Human Services.  I went in there and they told me that I can qualify for Medi Cal, even though I'm already getting Medicare Part A.  So, one of the county workers helped me reapply for Medi Cal all over again, and I have a telephone interview scheduled next week.  In the meanwhile, they gave me the name of a clinic across town, but I haven't figured out how to get there

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I am really sorry, @EricW236758  - you have an unusual problem and just the way things went along, it has left you in a problem area.  

Seems to me, you should have not been put on Medicare at all - not even Part A - because you were outside the country. It was useless for you to have outside the country and IF you didn't have Medicare Part A (because you only qualify it because you are on SSDI - and you are less than 65) - you would have been able to sign up for a ACA insurance plan pronto when you got back into the country and it would have been active immediately.  You probably would have gotten a real nice tax credit subsidy to pay your premiums - in fact, you may have had NO premiums at all.

 

OR since SS never gave you the chance to decline Part B - they only signed you up for Medicare Part A - then it also seems to me that you should be able to apply for Medicare Part B under the Special Enrollment (Special Circumstances) rule - usually for people who have some type of credible coverage (like they are still working and have credible employment coverage) - they sign up for Part A but then hold off on Part B until they loose whatever credible coverage and then sign up for Part B.  That is why I said - that the country coverage and your proof of it, depending upon the country, could give you a similar coverage - but here again, fighting this out with them would take time and knowing how to do it - 

 

I hope the Sacramento HHS Dept can help you but I'm still not too sure based on your income but who knows -

California Dept. of Health Care Services (DHCS) - Medi-Cal Income Eligibility 

California has a lot of rules the rest of the country doesn't have - like insuring some illegal aliens -  (UNdocumented - my bad 🤐) so who knows - maybe you found someone that can make it happen.

 

Yes, SS does hold all the cards and do make the rules - but not all rules & cards meet all the circumstances of people.  Find out who your House of Representative Rep is and contact his office - local one if you can find it and run it all by this "expert" staff.  What is happening to you can be disputed - but disputes take a lot of time - time you do not have but Yes, government can change their tune on matters which create problems for their citizens but it take a lot of work and time to get to that point.  

 

I do hope you get the help you need - let us know how it all turns out  - sorry I could not help more but I am located clear across the country.

 

 

It's Always Something . . . . Roseanna Roseannadanna

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Find out who your House of Representative Rep is and contact his office - local one if you can find it and run it all by this "expert" staff.  -

Well, I found out that the US Rep for the district where I used to live is, Congressmen,Ro Khanna, (I used to live in southern Alameda County before moving to the Philippines) so I sent an email to him through is website.  If I don't hear from someone by early next week then I'll try calling them on the phone.  - In the meanwhile, I was finally able to schedule a doctor visit at a county hospital here where I'm staying in Sacramento.  It isn't until Sept 2nd, but at least I finally have an appointment. 

Regular Contributor

I hope the Sacramento HHS Dept can help you but I'm still not too sure based on your income but who knows -

Gee, I didn't think of that, but maybe the county workers were just going through the motions of helping me apply for MediCal, even though they know full well that I won't qualify for it anyway?  -  One of the painful things I've learned during all of this, is that many of the people working at social service agencies actually seem to have a lot of contempt for the people they are supposed to be helping, and it is really a terrible situation, because there doesn't seem to be any oversight.  Also, don't know if it matters or not, but I was a legal resident in the Philippines between 2013 - 2021, while I collected SSDI.  The reason why my wife and I moved to the Philippines, was because we could not find any affordable housing, anywhere, and if we hadn't moved overseas, then we would have become homeless in the US.  

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Thanks for supplying the country where you lived - that helps A LITTLE.

1st, both you and SS did things wrong in this whole mess.  SS because they did not set you up for Part B at the same time you got Part A.  It is true that your access would have been limited in the Philippines but at least your problems would have been nil at this point back in the states - 

This is kind of old but I think this question is still applicable today: (read the 1st Q&A)

PBS 01/28/2015 Q&A - Can expats take their Medicare abroad? 

I am also wondering if a non-profit can help you work out some of your current Medicare problems.  This one does have counseling & advocacy -

Medicare Rights Center.org - About Us 

I can understand how you feel about SS helping you with this problem - but understand, they are just workers - there is only so much they can do - they just read the rules and go by them.  You have to go further up the hierarchy and that takes documenting and writing down what has happened to youand asking for a variance in getting Part B NOW and with NO premium penalty because if they access you a Part B premium penalty, it is going to be large and it is forever.  Contact your House Representative office- by phone 1st and then perhaps in writing.  

 

Like I said in my other post - you have different problems of differing hierarchy:

  1. Get care ASAP - this maybe cost out of pocket depending upon what the CA Dept of Health Care Services can do for you in accessing care without a Part B.  Once you know where you stand physically, you will know the expediency of what has to be done.  
  2. Start working on securing Part B NOW by working your way UP to somebody that can make a decision for you, hopefully without a Part B premium penalty.  I know, that is gonna take a while - government moves slowly.

I hope you are understanding what  and I are telling you about the actual system of signing up for Part B.  Your objective is to sign up for it ASAP with a Special Enrollment Period (special circumstance) even if that has to be by order from somebody above because of your particular situation.  Complete that CMS-40B - with lots of REMARKS and documentation of your situation - how it happened.  A copy to Reps office when you know who to address it to at that office.

 

As I stated before - California is a state that wants everybody covered with some type of health care - but you have to fit into one of the many types of health care coverage by eligibility (different eligibility for different types) and that is clearly your problem - you are stranded in limbo because you don't seem to meet any of them in total:

  • by having that (24 month SSDI reason) Medicare Part A prevents you from some types of coverage at least with a premium tax credit - an ACA plan (Obamacare).  Explain to them that you are less than 65 years old.  So would they allow you to drop Medicare Part A without affecting your SSDI benefit status and sign up for an ACA plan NOW???
  • OR Will they let you sign up for Medicare Part B as an exception to the General Enrollment Period and use the Special Enrollment rule since I assume you were covered by some sort of Philippine coverage???  What type did you have/use there?   Public or Private insurance?

The reason why you moved to the Philippines is not relative to this problem.

The type of coverage you had there - maybe.  

 

Hopefully, you will hear about the current actions real soon - CA DHCS  determining about Medi-Cal and the clinic that you are going to see.

I am no expert - just somebody that has knowledge of the Medicare system so maybe  or somebody with expertise can suggest some other things.  Especially if they are in CA. - California is a breed of its own in health care coverage thus I will assume they will go above and beyond in helping you.  But who knows . . . . still government - 

 

It's Always Something . . . . Roseanna Roseannadanna
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@EricW236758 you have a mess

 

After 24 months on SSDI you would have been automatically enrolled in Parts A AND B. Did you opt out of Part B?

 

Living outside the country, (you did not say WHICH country), MIGHT introduce a different option.

 

Medicare coverage essentially useless outside of the USA.

 

CMS 40-B is applicable for those who are "late" in enrolling in Part B.

https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS40B-E.pdf

 

The form does not ask for your DOB. It is normally used by those who are 65 or older and qualify for an SEP or want to enroll during the GEP (Jan - Mar) and Part B will be effective July 1 of that year

 

The GEP does not specify that you must be 65 or older, only that you are enrolling in Part B for the first time.

 

Applying during the next GEP may be your only option for Part B at this time.

https://www.medicare.gov/blog/medicare-enrollment-period-2020

 

Since you have been denied MediCal you may try Covered California, although it appears having Medicare Part A knocks you out of that plan as well. Even if you do qualify for Covered California you will not be eligible for a taxpayer funded premium subsidy.

https://www.coveredca.com/support/before-you-buy/people-with-medicare/

 

As @GailL1 suggested, if your condition worsens you may be admitted to a hospital under EMTALA rules. However keep in mind the hospital is only obligated to treat you until your condition is stabilized.

https://www.acep.org/life-as-a-physician/ethics--legal/emtala/emtala-fact-sheet

 

Is there a reason why you are seeking treatment in the USA? Does the country where you were living have government provided health care?

 

 


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@EricW236758 said

In the meanwhile I'm suffering from bloody stool, I'm feeling weak, . . . 

 

1st, if this keeps up or gets worse, you need to return to the ER - perhaps one at a public hospital if one is close by - because it could turn into an emergency if you are loosing a lot of blood.  

 

Yep, you need Medicare Part B - you have to have Part B to even decide how you want to get your Medicare benefits - Traditional plan or a Medicare Advantage plan.  You might also need a Medicare Part D plan too - although some Medicare Advantage plans have them built in.  Don't forget Part D coverage somehow - that the Prescription Drug Medicare Program.

 

After you were on SSDI for 24 months - you became eligible for Medicare.  SSA usually goes ahead and signs you up for Medicare automatically because you are already getting SS benefits - Part A and Part B. 

 

So did you cancel Part B?  Are you sure that the premiums for Part B (currently, for most people $148.50 / month) are not being taken from your SSDI benefit automatically?  What does your red, white and blue Medicare card say?  If it's not listed and the premiums are not being taken out, I guess you did cancel it and it is gonna take awhile to begin even if you can possibly get a Special Enrollment.  

 

Medicare.gov - Getting Medicare if you have a disability  

 

Medicare.gov - Part A & Part B sign up periods 

If you really don't have Part B - you got some hoops to jump through and I don't know how fast this can be done.

You need to contact Social Security to sign up for Part B - that will hopefully be the fastest way - but with the Pandemic going on even that is difficult (many of them are working remotely).  

There are 3 ways you can sign up:

  1. Fill out a short form, and send it to your local Social Security office.
  2. Call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778.
  3. Contact your local Social Security office.

Note:

If you don’t enroll when you’re first eligible, you may have to pay a Part B late enrollment penalty, and you may have a gap in coverage if you decide you want Part B later.  Plus they may put a waiting date on when the Part B will start.

 

So what you will be hoping for is a "Special Enrollment or Special Circumstance" enrollment but you may have to prove that your coverage in the other country was credible - maybe it was and maybe you have some documentation to the plan you had in the other country -

 

Read about the Special Enrollment ( Special Circumstances) sign up on this page:

https://www.medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b/part-a-part-b-sign-up-periods 

 

One other thing you might check out is contacting a State Health Insurance Program (SHIP) representative to see if they can help you - California is a breed of its own in health insurance rules so maybe they have something else to help you.

Medicare.gov - Talk To Someone 

You can also CHAT with a Medicare rep at this site too 24/7 - but this type of situation may not be within their area of expertise.

 

Just as an aside - Why did you decide not get treatment in the other country?  Depending on their health care system - might have been simplier - at least long enough for you to get Part B started.

I am very sorry for your health problems but it is our government system (Medicare) - difficult to sign up for it when you need it.

Good Luck.

 

 

 

 

 

 

 

 

It's Always Something . . . . Roseanna Roseannadanna
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1st, if this keeps up or gets worse, you need to return to the ER - perhaps one at a public hospital if one is close by - because it could turn into an emergency if you are loosing a lot of blood.  -

Well, that's the thing, I went to the emergency room at a public hospital known as Alameda Hospital, and they told me that I would have to got to a clinic.  After arguing with the staff there, they eventually admitted me as a psychiatric patient, and put me under observation. But when I asked the nurse to take a look at my stool after I had a movement, he simply said he would take a look at it, but he never did.   

 

After you were on SSDI for 24 months - you became eligible for Medicare.  SSA usually goes ahead and signs you up for Medicare automatically because you are already getting SS benefits - Part A and Part B. -

Well, I did get a card in the mail after I had been on SSDI for about two years, but it only had Part A listed on the front of the card.  At the time I was living outside the US, and when I contacted the US Social Security office within the US Embassy to ask about it, they said not too worry about it, because I wouldn't be able to use Medicare over there anyway.  No, I never canceled Part B, and as far as I know, I was never signed up for it anyway. 

 

Just as an aside - Why did you decide not get treatment in the other country?  Depending on their health care system - might have been simplier 

Well, the healthcare system isn't really that great over there, a lot of places only accept cash, and the perception is that all Americans are rich.  I watched both of my wife's parents die from cancer over there, and they both suffered terribly.  

 

Also, I did try calling Social Security this afternoon about getting on Plan B, but they said I should try calling Medi Cal again, but Medi Cal says that the cannot help me, due to the fact that I'm already getting Part A Medicare.  So, doesn't look good right now.

 

 

 

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@EricW236758 said

Well, I did get a card in the mail after I had been on SSDI for about two years, but it only had Part A listed on the front of the card.  At the time I was living outside the US, and when I contacted the US Social Security office within the US Embassy to ask about it, they said not too worry about it, because I wouldn't be able to use Medicare over there anyway.  No, I never canceled Part B, and as far as I know, I was never signed up for it anyway. 

 

That should help you get a Special Enrollment period into Part B and penalty free premiums, I hope,  since the reason you are wanting to sign up for Part B now is that you have returned to this country.

 

Try filling out this form:  This would be the regular way - I don't think there is gonna be a fast way to gain access to Part B - most people have time to plan for this because they are leaving their employer plan because they are stopping work and picking up Part B - so for them it is just a step by step process - they end employer coverage on a date and then flow into Medicare.  

CMS 40B - Application for Enrollment in Medicare - Part B (Medical Insurance)

 

Sorry I cannot help more - in the meantime, you could start looking for a doctor / oncologist that accepts Medicare assignment - these would be within the traditional program.  Maybe just see a general practitioner for current problem - explain the situation and he could begin to work on some referrals for you from the Medicare list.

Medicare.gov - Find and Compare Medical Providers 

 

OR if you are gonna go with a Medicare Advantage plan perhaps an independent medicare insurance broker in CA could offer you some other suggestions.  MA plans work with a network of doctors - 

 

If you go with traditional Medicare - once you get Part B, you may need a Medigap plan that picks up some of the amounts Medicare does not cover.  An independent local Medicare insurance broker could help you with a Medigap plan too.

 

 

 

 

 

It's Always Something . . . . Roseanna Roseannadanna
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Music and Brain Health

From soft jazz to hard rock - discover music's mental, social and physical benefits. Learn more.

Music and Brain Health