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OK well he has a Humana PPO. I don't remember what his Dr co-pays are but that isn't the problem. It's the co-insurance for procedures and nursing homes.
well that complicates things for sure. He might find an advantage plan that covers more for the procedures but I don't think he can dodge the co-pay on nursing home care, but if he is in one for over 100 days he will go on medicaid and his SS check - $60 will be sent to the nursing home to partially pay for his care.
well that complicates things for sure. He might find an advantage plan that covers more for the procedures but I don't think he can dodge the co-pay on nursing home care, but if he is in one for over 100 days he will go on medicaid and his SS check - $60 will be sent to the nursing home to partially pay for his care.
Yeah we are too aware of the eventuality. It's the in the meantime we'd like some assistance. I find it odd that people can make literally $10 too much to qualify for many thousands of dollars of care. Even food stamps has a sliding thing. My mother might have actually been better off making $200 less. Things shouldn't be structured that way, imo. People who pay in more, get higher SS checks, but when it's close like that, the people who put in more get less when medical is taken into account.
Yeah we are too aware of the eventuality. It's the in the meantime we'd like some assistance. I find it odd that people can make literally $10 too much to qualify for many thousands of dollars of care. Even food stamps has a sliding thing. My mother might have actually been better off making $200 less. Things shouldn't be structured that way, imo. People who pay in more, get higher SS checks, but when it's close like that, the people who put in more get less when medical is taken into account.
You're right it's a screwed up system, when they expanded medicaid they should have had the same income qualifications for dual eligibles, I think it's about 4k more a year.
He is probably a dual eligible and instead of using the higher AGI as they do for expanded medicaid they use a lower agi limit of $1177 for one person. Why does he have all these out of pocket expenses, isn't he getting medicaid along with his medicare? Are they paying for his part B?
He just told me $1134. Now, that is after whatever Humana, his Medicare Provider takes, and someone told me they use the higher amount, but maybe, maybe ........ do you know? Medicaid would be areal blessing. Huge. He'd even get more at home care.
Hm. So at one time he worked enough to earn credits to get SSDI instead of SSI?
Like I said, I don't know the differences between the two and to be honest, I don't need to. It's enough for me to know that his mental health care team wants him to work part time and told us specifically that he would not lose any benefits unless he made over a certain amount (either $800 or $1000 a month - can't recall the exact figure but it was in that ball park).
But yes, he did "work" for quite a while - for my dad's company. That is to say, my dad paid him and he sat down at the marina bar all day drinking for over ten years till my dad finally fired him after he ran the business completely into the ground. Then he got a job as a land man but got fired from that job too.
That doesn't compute. SSDI gets Medicare. SSI gets Medicaid. SSDI is the one you can work on up to $1K and not lose any benefits from doing so.
Sigh. I'm sorry that I don't know the exact terms for each government program but he is 100 percent disabled, and the government pays him. He also lives in subsidized housing. And his medical bills are also paid by the government, though he has a small copay of some sort apparently.
And he could work part time and not lose any of these benefits but he chooses not to work part time.
That's what I know. What I don't know is the exact terms for each program.
My youngest daughter has been on SSDI for quite awhile due to a neurological disorder. She has been working P/T for a few years now. Brings home maybe $700-$800/ mo. I do know that she lost quite a bit of her SSDI when she started working and now gets roughly $100/month. I think she used to get right around $800/mo. I can see where someone might see no incentive to work and lose that government check.
One of the plusses for us and her working P/T is that she has really good health insurance on top of the Medicaid which has been invaluable.
All I know is that his team of counselors have told us repeatedly that he can make somewhere around $800 to $1000 a month before any portion of his benefits is lost.
.... Lots of discussion about how many people will need long term care.
Does EVERYONE who needs long term care need the government to provide it?
It seems so, by this discussion.
And that's pretty sad.
This hasn't been the case in most of my family, thank goodness. Hopefully won't be for me, either. We are trying to plan financially so that we are not at the mercy of the government alone.
My youngest brother though - who knows?
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