Medicare Miscommunication Leaves Senior Unaware of Financial Options
For Pennsylvania’s senior residents, agency miscommunications can further confuse the healthcare process. Such was the case for Elsie Rose, a 92-year-old, low income resident receiving home and community-based waiver services to avoid admission to a nursing home. A social worker from the senior high rise where Miss Elsie lives contacted PHLP’s Helpline in May 2016 on her behalf. Miss Elsie’s daughter had recently applied for the Medicare Part B premium and was denied. Confused, they turned to PHLP.
When the County Assistance Office reviewed Miss Elsie for financial eligibility for the waiver program in 2010, they appropriately reviewed her for other possible benefits as well. During the review, she was also found eligible for the state to pay her monthly Medicare Part B premium of $104.90; however, there was a breakdown in communications between the state and the Social Security Administration, so Miss Elsie continued to pay the Part B premium from her Social Security for the next 6 years!
After six months of relentless advocacy by PHLP with top officials at the Department of Human Services and the Social Security Administration to unravel this case, we were successful in getting Miss Elsie a check for $8,025 that she was owed. Her social worker called it “a bureaucratic miracle”! Miss Elsie and her family were deeply appreciative of PHLP’s persistence in resolving her case.