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Old Nov 08, 2014, 02:30 PM
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ThisWayOut ThisWayOut is offline
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Member Since: Jan 2013
Location: in my own little world
Posts: 4,227
I have "share of cost" medicaid through the state (very high deductible each month), which almost no one takes except for a horrific community organization. I refuse to utilize them for services ever again.
I have called around to DCF, SSA, the mental health alliance, and 211 trying to find out if there is anything I can do to access competant services. The only thing I was told was to find doctors that would bill the first of the month, and also be willing to prescribe expensive meds that could be billed the first of the month so that I could be approved for "regular" medicaid for the second half of the month. I find this super-shady and am really hesitant to try... however, I'm also really in need of additional services that only seem to accept "regular" medicaid.
In one state-issued pamphlet, I noticed that insurance co-pays could be used to meet the share of cost threshold, but then I don't think I'd necessarily need the medicaid (except to pay for the insurance premiums). When I called to double-check this info, I was told that insurance premiums are NOT allowed to meet the share of cost.
I'm on disability for mental health reasons, yet I can't access the care I need. I'm still another 10 months out from being elligable for medicare, so at this point, it's looking like I can't get the services I need to keep me out of crisis unless I'm in crisis at least on the first of every month (I know meds are expensive, but my share of cost is really high, and I doubt they could prescribe enough to meet that monthly).
Does anyone know how to make this one work? I'm really frustrated with all this, and I don't like the thought of having to utilize unecessary services just to get what I actually do need.
Thanks in advance.
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Anonymous37781

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  #2  
Old Nov 08, 2014, 02:46 PM
Anonymous37781
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I don't know anything about it. You might check with NAMI
Good luck
Thanks for this!
ThisWayOut
  #3  
Old Nov 08, 2014, 03:46 PM
Anonymous37781
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The systems are very complex aren't they? State and Federal. I had two premium payments taken out of my first monthly stipend for SSDI. I was actually eligible in some crazy postdated way... i.e. I could have had Medicare backdated approximately one year if I had opted to take it and paid what would have been, in effect... 12 past due premiums
I could think of any possible benefit that would have been to me so I passed
I think the second thing that should happen when you are approved for SSDI or even SSI (or Medicaid even, which I don't have) is to have access to an advocate who is familiar with the system.
Thanks for this!
ThisWayOut
  #4  
Old Nov 08, 2014, 07:59 PM
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ThisWayOut ThisWayOut is offline
Grand Magnate
 
Member Since: Jan 2013
Location: in my own little world
Posts: 4,227
I'm not sure what the point is in making people wait 2 years for Medicare, or why they need to take premiums from an already poverty-level (or below!) income...
an advocate would be amazing! Our at least someone who understood the system.
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