UNITED STATES—My 60-year-old sister who had no health insurance or Medicare was granted Medicaid in January last year. She was granted Medicaid because she had stage 3 breast cancer with lymph-nodes that were removed. She just learned from her Doctor that her Medicaid had been cancelled effective May 1st.  My sister has not received anything from Medicaid stating that she was cancelled, and we cannot get anyone at Medicaid to tell us what the problem is.

She was being paid $703.00 as a disability check and recently she got a raise to $1,431 for Social Security Disability which she has recently qualified to receive effective April 1st.  When she went to Social Security to apply for Social Security Disability no one said she would get an increase in her $703 monthly Medicaid check.

Someone told me about what you do to help people who do not know where to go or what to do. This is overwhelming because my sister cannot receive her chemo treatments any more due to not qualified for Medicaid.  Can you tell me what I need to do? Thanks, Gray from Jackson, MS.

Oh My… Gray: I do not get very many problems like this, but after talking with you this week, I wanted to inform my readers about this Medicaid issue. People need to know how vitally critical and important it is, when you qualify for Medicaid to be sure you stay in the monthly income and asset bracket that qualifies you for Medicaid.  One dollar ($1) too much and you can LOSE your Medicaid benefits and will have to pay 100 percent out of your pocket for your medical expenses.

Gray, my heart ached when you said, “you would have helped your sister with some of her expenses because of her disability check raised from $703 to $1,431, but you could not pay the $2,600 per chemotherapy treatment with 8 treatments in a cycle that totaled over $20,800. She lost her Medicaid for only $400.00.”  And that you considered the state had given your sister a “death sentence” because her doctor is not giving her chemo since the medical facility is not getting paid.

Here is what I would advise you to do to help your sister:

  • Ask how you can have her Social Security discontinued from the $1,431 to the original amount of $703 for Medicaid, so that she can be in the correct income bracket to qualify for Medicaid. Who knows maybe there is a loophole somewhere?
  • Talk to the cancer facility where your sister was receiving her medical care and chemo treatments. Find out if there is a non-profit fund set up for situations like your sister’s.  See what grants or philanthropic organizations help in this type of emergency.
  • Contact the American Cancer Society area office and explain about her serious situation and how time is slipping away with her not receiving her chemo treatments. She needs help NOW!!

My main goal in writing this week’s column is to make the public aware to how important it is when you qualify for Medicaid, whether you are under 65 with no health insurance or are over 65 and have Medicare, that you must stay within the financial limits…  One dollar ($1) too much and you lose your Medicaid benefits and must pay 100% out of your pocket for medical expenses.

The 2021 Confused about Medicare Zoom webinar is Thursday, April 29 at 4 p.m. Visit www.tonisays.com to sign up for Toni’s new webinar event.

Toni King, Medicare author/advocate is giving a $5 discount to the Toni Says® readers on the new 2021Medicare Survival Guide® Advanced book at www.tonisays.com. Have a Medicare question? Call 832/519-8664 or email info@tonisays.com.