Medicaid but No Part A?

[Tom Highway]

I met with a lady and her daughter a week or so ago who really really want for the lady to be in an MAPD plan. They want the "extras/extra protection", and were very interested. They didn't have her HIC number/medicare card, so there was nothing I could do.

They finally found her card, and the lady has no Part A but is on Medicaid. She is obviously not eligible for MA, but what are some things that might could help this lady? She is pretty low income, but her children could help with premiums (not a lot though) on something if it could really help her. I haven't talked to them again at length to see exactly what they're afraid of to see if there's something that could help, but I was wondering what you all thought - are there any options as far as a cancer policy, FE, or dare I even say, supplement? Is a supplement even possible with no part A?

I know HOW this lady got into this predicament (never worked and somehow didn't get to file under her husband), but what does having everything BUT Part A leave her exposed to? Could she be denied a hospital stay?

This is just one of those weird cases you don't see very often.

 

[Winter_123]

Bro, you got a pantload of themes going there and have to break it down into pieces and see what's what.

Sounds like you tried to confirm her medicare enrollment by looking at a medicaid card. Find her medicare card or make the right calls to see what her status is and then go to the next steps from there. How did you confirm that she had medicare?

Next. Getting an FE and coverage for medical expenses are apples and oranges and have nothing to do with each other from an eligibility and coverage point of view. Arguably the FE could help if she dies with medical expenses but that is another matter. What does this client want to accomplish?

 

[Tom Highway]

Bro, you got a pantload of themes going there and have to break it down into pieces and see what's what.

Sounds like you tried to confirm her medicare enrollment by looking at a medicaid card. Find her medicare card or make the right calls to see what her status is and then go to the next steps from there. How did you confirm that she had medicare?

Next. Getting an FE and coverage for medical expenses are apples and oranges and have nothing to do with each other from an eligibility and coverage point of view. Arguably the FE could help if she dies with medical expenses but that is another matter. What does this client want to accomplish?

I realize there are several issues, but I DID go through the steps you said. I'm not new to this. I physically saw here Medicaid card on the appt, and called to verify medicaid while I was there, but they did not have her medicare card. That's why the appt was cut a bit short.

A week or so later, the daughter called me with the HIC number, and said the card had Part B effective date listed, but No Part A. Of course I verified this through MARX check and got the daughter to call 1-800-772-1213 to do some digging on her mother's behalf.

My question was, where could the pain be here specifically through having Medicaid but no Part A? Are there things that leave holes like no hospital coverage even though she has medicaid, or is this something that's better off left alone, even if, like you said, something like FE would pay some costs when this lady dies.

Would something like a cancer indemnity product be appropriate if it would bridge the holes they may have through no Part A?

I want to present SOLUTIONS to this lady and her daughter, not just try and sell them a product.

 

[jdeasy]

I realize there are several issues, but I DID go through the steps you said. I'm not new to this. I physically saw here Medicaid card on the appt, and called to verify medicaid while I was there, but they did not have her medicare card. That's why the appt was cut a bit short.

A week or so later, the daughter called me with the HIC number, and said the card had Part B effective date listed, but No Part A. Of course I verified this through MARX check and got the daughter to call 1-800-772-1213 to do some digging on her mother's behalf.

My question was, where could the pain be here specifically through having Medicaid but no Part A? Are there things that leave holes like no hospital coverage even though she has medicaid, or is this something that's better off left alone, even if, like you said, something like FE would pay some costs when this lady dies.

Would something like a cancer indemnity product be appropriate if it would bridge the holes they may have through no Part A?

I want to present SOLUTIONS to this lady and her daughter, not just try and sell them a product.

It is possible for a person to be on Medicaid and not have Part A or Part B. She cannot get an MA plan of any kind without part A. She must be one the rare folks that did not qualify for part A without having to pay the part A premium. She could get part A by paying the premium. It's around $250/mo.

She is not without hospital coverage since she has Medicaid. There are hundreds of thousands of people on Medicaid that do not have Medicare at all.

I had this situation with a lady in In. last year. After discussing with In. Medicaid, they decided it was more cost efficient for them to pay her part A premium than it was to pay the whole cost of hospitalization. It took several months to get it handled, but, we finally got her enrolled in part A and In. pays both her part A and her part B premium. Whatever state you are in may not take the same approach or the lady might not patient enough to let you work through it.

I also had the situation with a lady in Ky, but, Ky Medicaid did not want to take time to try and resolve it any other way.

Without part A, you cannot enroll her in an MA, an MAPD or a med sup. As far as selling her a cancer policy or FE, those have nothing to do with her Medicare status.

I really don't what help you could give her even if she had part A and B and with Medicaid unless you were putting her in an SNP. If she qualifies for an SNP, she probably wouldn't qualify for a stand alone cancer policy or maybe even life insurance.

The only PFFS that gives extra benefits to Medicare/Medicaid eligibles is Wellcare and that can't be written now.

 

[Joe Moore]

She could get part A by paying the premium. It's around $250/mo.[/quote]

JD,

We had one of our agents run into the very same problem last week.
I got sticker shock when I went looking at what the cost would be. Here is the 2009 premium info for those having to purchase Part-A:

Approximately 99 percent of Medicare beneficiaries do not have to pay a premium for Part A services because they have at least 40 quarters of Medicare-covered employment (or are the spouse or widow[er] of such a person). However, other seniors and certain people under age 65 with disabilities who have fewer than 30 quarters of coverage may obtain Part A coverage by paying a monthly premium set according to a statutory formula. This premium will be $443 per month for 2009, an increase of $20 from 2008. In addition, seniors with 30 to 39 quarters of coverage, and certain disabled persons with 30 or more quarters of coverage, will pay a premium of $244 in 2009, compared to $233 in 2008.

This came from CMS info:

CMS ANNOUNCES MEDICARE PREMIUMS, DEDUCTIBLES FOR 2009

Our lady was on Medicaid and Part-B only and had a Part-D Drug Plan, but there was no way she was going to be able to pay $443/month to qualify to enroll in a MAPD plan, even though she wanted it. For her to do anything, it would have made no sense to even suggest it to her.
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I want to present SOLUTIONS to this lady and her daughter, not just try and sell them a product.

Tom,
I am not sure there are any practical solutions, other than what she already has.

 

[Tom Highway]

Tom,
I am not sure there are any practical solutions, other than what she already has.

I think based on your post and the previous one, this may be right. What I'll do is call her daughter and give her the number to AL medicaid or get her to call her caseworker, and see if they can go that route to get medicaid to pay her part A premium (I doubt that'll happen). If she does get part A I have a great dual eligible SNP that she'd love. If AL Medicaid won't help, I'll ask them for some referrals and move on.

Thanks y'all!

 

[ronmelton3]

- are there any options as far as a cancer policy, FE, or dare I even say, supplement? Is a supplement even possible with no part A?

Medicaid is a supplement. It pays 100% of what Medicare doesn't.
Since she has no Part A, Medicaid would pay all the hospital.
You can't write a supplement on top of Medicaid. Why would you?
As long as she has a Part D plan she is fine.