Showing posts with label Social Security Administration. Show all posts
Showing posts with label Social Security Administration. Show all posts

Tuesday, December 11, 2012

Update on Things---Dealing with TEXAS HEALTH AND HUMAN SERVICES



Back in late November I wrote about how I had finally gotten approved for assistance for Medicare Part D by the Social Security Administration.  It took a while longer, but, I now know in general terms what kind of basic help I will receive on my medication costs. Anything helps and this will help me. Late last week I applied online for the program I wanted for drug coverage after overriding in the system (I think) the program that they had automatically put me into.

No surprise that the program they were automatically putting me into--something offered through AARP---had restrictive drug quantity limits and would not cover one of the drugs I am on for my high blood pressure and congestive heart failure. Having played drug roulette before where my blood pressure meds were changed due to insurance nonsense with the result I wound up in the hospital, I have no interest in doing that again.  

Back when I was working I used to scare folks because sometimes I would be beet red in the face and other times I would be as pale as a ghost. People I worked with tended to notice that sort of thing. It isn’t something you can hide like trying not to limp even when your leg and back are hurting big time. I have weird blood pressure issues where I can easily soar sky high (over two hundred) and then drop to below a hundred twenty minutes later. Basically, it is a roller-coaster effect and I have to be on meds that handle that sort of thing. Therefore, I went with a program that appears to not only be cheaper than the program they picked for me but also--at least for now--covers my drugs. It is going to be another ten days or so before I know if I got in and when coverage starts.

Like I said, anything helps. If things go the way I want, this will help.

Dealing with TEXAS HEALTH AND HUMAN SERVICES remains far more difficult than it should be or is necessary. Appeal letters went out today trying again to get us back on food stamps and Medicaid for Sandi and Scott. Somehow, and probably because of the original foul-up with Social Security, they have Sandi making a very nice income. I have provided proof again that the figure is/was wrong. I have also provided again documented proof that she is out on UNPAID medical leave and, in addition to other issues, is facing some sort of cardiac surgery to remove the thing from her chest wall slightly behind her heart. I have sent proof to the various people at the various levels who have handled the case incorrectly in the hopes that one of them can fix his or her error and thus restore our much needed food stamps and their Medicaid coverage.

I also included the latest bill from the cancer doctor as Texas Medicaid has not paid that. Now the bill has risen to 847 dollars and with more cancer treatment most likely needed in the upcoming weeks it needs to be paid by them ASAP.

What really took the cake with Texas HHSC was the deal we got yesterday. As I explained back in late November, I had been denied by Texas HHSC for help with Medicare Part B because I had failed to fill out an application. Being certified by the feds wasn’t good enough for the state folks. Also, the family being on food stamps with the same agency having financial records and every other thing on us going back two years plus was not good enough. I had to fill out another application for that and I hadn’t done so. Of course, one can’t fill out an application if one does not get one. So, I appealed the decision--pointed out the obvious problem that NO APPLICATION ever arrived--and requested an application.

I continued to request an application from each person in a different office in the state as the case was assigned a hearing officer, a date and time, etc. I kept pointing out there was no need for a hearing at this point as all I really needed was an application. I finally got my application yesterday.

In SPANISH.

After repeatedly requesting it and never once using anything other than ENGLISH, they sent me a multi-page horrendously long form all in SPANISH.  I can’t read Spanish. I can’t write Spanish. I do not understand anything sent to me in Spanish. My Spanish understanding consists of two obscenities. Two obscenities that I will not repeat here and are not found on any government forms to the best of my knowledge.

I have requested this morning an application in my native language of English.

Next time you see Texas Governor Perry on television talking about waste of tax dollars and how the state of Texas will not participate in the expansion of Medicaid because the state can set up things so much better than federal folks, think about us. Think about what we went through and have been going through to get the very little bit of assistance this state provides to their neediest residents. Residents, who, through no fault of their own, got sick, can’t continue to work, and need help.

Think about how Texas ranks number one in the number of people without insurance. Think about how Texas ranks at near the bottom on education and a number of other things. Think about us and what we have gone through and are still going through.

It just isn’t right. It is bad enough to be sick, disabled, etc. but those in charge make things much worse and much harder than they have to be.


Kevin

Saturday, November 24, 2012

Medicare Appeal Deal


Medicare is seriously confusing. I wrote a couple of weeks ago about how I had applied for assistance with Medicare Part B and assistance with Part D.  Right now I have no part D (the drug part) and pay $100 a month for Part B. I talked about how I had filed out paperwork to get assistance. I had thought I was applying for help with Part B ---so that I didn’t pay $100 a month. Instead, I was applying for help with Part D and that was what had been denied.

Apparently help with Part B is up to the state of Texas which recently denied me saying I hadn’t filed out an application. Of course, one can’t fill out an application if one does not get one. But, that is a separate issue. Our food stamps have been cutoff due to another error by them so it isn’t surprising this is messed up as well.

After appealing the recent Social Security decision against me and providing Sandi’s paystubs again as well as her copies of her unpaid medical leave paperwork as requested by an office of Social Security up in Baltimore, I got the decision today. They have thankfully reversed course and finally approved me.

This means I am now approved for some sort of financial help to purchase the MEDICARE PART D deal. How much a month I have no idea at all, but anything will be a huge help.

So, now I have to spend some time working through government websites and trying to figure out which plan will work for me. Hopefully, I will be notified how much in assistance I am eligible for before the signup cutoff date of December 7.

I am also going to photocopy the Social Security approval letter and send it to the same state government people who denied me because I supposedly failed to fill out their application (one I never got) and see if anything can be done.

Kevin

Thursday, November 15, 2012

"Say, have you read my book yet?"

and variations of this where in five separate e-mails this morning. In each case i had to explain that I hadn't as I am way behind.

One of the reasons is because I have to spend a lot of time each week writing appeal letters on insurance stuff, food stamp stuff, and Social Security stuff. Case in point is today I am having to write several letters on different things. One of which is to Social Security.

Back a couple of months ago Social Security sends me an application to fill out to see if we qualify for assistance paying my Medicare Part B. Currently they deduct $100 from my small disability payment each month to pay for Medicare Part B. So, having that $100 bucks back would be huge to us.

We fill out all their paperwork. Spend another hour on the phone talking to a very nice guy from Social Security in an office in Arizona going over all sorts of things. Had to also get Karl to not only dig out a bunch of boxes so that I could find what they needed, but to also fax tax records from 2010 for us over to this same office to correct old information they had.

All together spent about five hours on this project up until today.

Today they deny us saying Sandi earned over 19k in wages at Wal-Mart this year. I wish!!!

Actual figure--from January 1, 2012 to this date-- is $7,549.89.

I have no idea how they came up with 19k. This happened despite the fact they verified again and again that she had been out on unpaid medial leave since May 5, 2011 all the way to July 5, 2012 due to her knee surgery and then cancer.

So, the real figure ---that they missed by over 11k and change ---is $7,549.89. Figure won't change much --if at all--as she is out on UNPAID medical leave now and not getting better.

Writing appeal letter to SS office in McKinney, Texas and providing proof via pay stubs of her actual income and medical status via doctor orders. Hopefully, somebody up there can fix this screw up and finally get us the help we need.


Kevin