Client Spotlight: Restoring Health Insurance Coverage for a Senior Seeking Treatment for Cancer and Cardiac Arrest
At 70 years old, in poor health, and losing his insurance, Michael Belford admitted he was scared. He contacted PHLP in July after he learned his Medicaid was being stopped. He had had a heart attack three days earlier. Doctors at the hospital put three stints in his heart. He also had lymphoma, a cancer in his blood cells, for which his doctors wanted to start treatment as soon as possible.
Despite his age, Mr. Belford could not enroll in Medicare Part B for another year, until July of 2016. He had been released from prison in May, and because he had not paid his Medicare Part B premium during the four years that he was incarcerated and had no income, Social Security had stopped his Medicare benefit. He now had to wait over a year to be allowed to re-enroll in Medicare Part B.
Losing Medicaid would mean his lymphoma would go untreated, at least for the next year. It would also mean any cardiac rehab or other follow-up care for his heart attack would have to be paid out of pocket. Mr. Belford’s only income was his Social Security of $1,400 a month, but that amount put him over the income limit for Medicaid.
PHLP contacted Mr. Belford’s welfare office and argued that, when he first applied, the welfare office should have put him in a category of Medicaid – the Medicare “Buy-In” category – that would have triggered immediate Medicare Part B coverage, bypassing the one year wait period he was otherwise facing. Though it would still stop his Medicaid coverage going forward, a welfare administrator agreed that the office made a mistake and should retroactively turn on the Medicare “Buy-In” category. By virtue of the welfare office authorizing the “Buy-In” category, even for a short retroactive period, his Medicare Part B was turned on.
He would have to pay the normal monthly premium of $105 for it, but three weeks after contacting PHLP, Mr. Belford had Medicare Part B coverage. He’d be able to get treatment for his lymphoma without worry about his coverage stopping. For that he was immensely grateful.
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