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How To Reduce or
Eliminate Drug Cost

 March 16, 2011

By  Brian

This contribution from Adrianne Johnston could save your thousands on Medicare for just working a little.

The 250 working disabled program provides full scope Medi-Cal benefits to working disabled individuals with countable income below 250% of the federal poverty level. Eligible people pay a premium based on their income.

What does this all mean? It means that in the state of California, you may qualify for full-scope Medi-Cal while you are working if you (as an individual) make less than $2,167 a month. AND, your SSDI earnings don’t count towards your monthly income.

*** if you are not in California than check to see if there is a local program that is similar. The first place to check is your local center for independent living. To learn about and contact your local office click here.

Go To:  http://thedisabilitydigest.com/Housingcil.htm

Back to the 250 working disabled program…

The premiums you pay are minimal after all the countable income deductions are calculated and/or if your countable earnings per month are in the low to moderate range. Example: If your countable income is determined to be $1-600/mo you will pay $20/mo premium for full Medi-Cal benefits. The most it will be is $250/mo if your countable earnings are $2101-2603 per month.

Here are 2 links with further information on how to qualify:
http://www.disabilitybenefits101.org/ca/programs/health_coverage/medi_cal/250/

And
http://www.cahealthadvocates.org/low-income/medi-cal.html

If you qualify for the 250% Working Disabled Program Medi-Cal will also pay your Medicare Part A and B deductibles and copays and pay your monthly Medicare part B premium ($115.40/mo in 2011) once your Medicare benefits begin.

Here is a link with more information on this:
http://www.cahealthadvocates.org/low-income/medi-cal.html

So, if you live in California and can work even a few hours a month the savings on medical expenses under the 250 WDP can be tremendous.

In a nutshell, the easiest explanation of the potential savings is this: add up what you are spending per month in medical (including medications) expenses and minus $20.00/mo from that amount. That would be an estimate of a persons monthly savings.

To break it down further:

If a person qualifies for the 250 DWP and before their Medicare begins their savings would be whatever cost they have been incurring in medical expenses, including medications and minus the monthly premium they will now be paying for Medi-Cal under this program. In my case I now pay $20.00 month premium and am saving approximately $250 a month. It would have been much higher, but I couldn’t afford to pay for tests, etc. that my doctors wanted to do.

If a person qualifies for the 250 DWP and has Medicare part A & B they will be paying the monthly premium (in my case $20.00/mo) and saving on most of the other medical expenses, including the Medicare part B premium, doctor co pays, hospital expenses, etc.

I would believe any state has similar programs where a person would qualify for both Medicaid and Medicare. But, I don’t know if any other state has a program where a disabled person becomes eligible for Medicaid just by working.

What makes this California plan unique and quite puzzling to be honest, is before I started working I did qualify for a Medi-Cal program by being on disability. This program is called a Share Of Cost program. You pay a certain percent of your medical expenses and then Medi-Cal kicks in and pays the rest.

Sounds fair, right? Here’s the interesting part (or whatever other word you think is appropriate): In MY case, being single, no children at home and earning between $1,200-1,500/mo in SSDI payments I was responsible for paying the 1st $850/mo in expenses before Medi-Cal paid a dime.

Tell me…..who in the world could afford that? Does it even make sense?

But, that’s the way it was for me. AND, that is one of the reasons why I am so grateful to be able to work from my home.

I hope this tip saves you some money,


Understanding Continuing Disability Reviews: Key Updates and Guidance


Welcome to our latest blog post where we delve into the critical topic of Continuing Disability Reviews (CDRs), which are essential for individuals receiving disability benefits. The focus today is on recent statistics and personal anecdotes that highlight the ongoing importance of staying informed about CDRs.

What is a Continuing Disability Review?
A Continuing Disability Review is a routine process for individuals who have been approved for disability benefits. The Social Security Administration (SSA) conducts these reviews to determine if the health of a beneficiary has improved to the point where they can return to work, and thus no longer qualify for benefits.

Recent Case and Discussion
Recently, a case surfaced involving a person who had been receiving Social Security Disability Insurance (SSDI) for end-stage kidney failure since they were 20. Despite their condition remaining unchanged, they received a notification of health improvement at age 50 and were at risk of losing their benefits. This situation underscores the unpredictability and significance of understanding the CDR process.

How CDRs Work
During a CDR, beneficiaries might be asked to complete a short or long form detailing their current health status. The forms are then reviewed, and if further information is needed, a full medical review may be initiated. It's crucial for recipients to respond promptly to any communications from the SSA to avoid complications or cessation of benefits.

Statistics and Trends
In 2022, approximately 1.5 million of the estimated 9 million disability recipients underwent CDRs. Of these, about 125,000 had their benefits terminated. These statistics reflect a consistent review rate, with an apparent annual increase in the number of reviews conducted, emphasizing the necessity for beneficiaries to stay vigilant.

Key Takeaways
Stay Informed: Always keep your contact information up to date and pay close attention to all correspondence from the SSA. Missing a notification or failing to respond can lead to benefit termination.
Understand the Review Frequency: Depending on the expectation of medical improvement, reviews may occur more frequently. Typically, conditions considered likely to improve are reviewed sooner and more often.

Prepare Adequately: If a review is scheduled, ensure all medical documentation is current and complete. Understanding the review process and preparing accordingly can significantly affect the outcome.

Seek Expert Advice: Engaging with professionals who specialize in disability rights and CDRs can provide crucial support and guidance. For instance, next week, we will feature an in-depth discussion with Attorney James Mitchell Brown, a veteran in the field of social security disability.

Conclusion
Continuing Disability Reviews are a standard part of the disability benefits process, but they can be daunting. By staying informed, prepared, and proactive, beneficiaries can navigate these reviews successfully. Remember, the goal is not only to retain benefits but also to ensure that the support aligns correctly with the individual’s current health needs.

Stay tuned for more updates and expert insights in our upcoming posts, and don't hesitate to reach out with your questions or for further information.

Brian


My name is Brian Therrien, and I'm a professional researcher. So when a number of my friends went through unexpected downturns in their life and required disability assistance, I left no stone unturned to try and help them.

At first, I was concerned with how to qualify for disability, ... but as I learned more about the system, I realized that people also really needed help with getting approved, maximizing their benefits, and most importantly, supplementing their income without losing their benefits when they were ready to transition back to the work force.

That's why when you subscribe to my FREE disability newsletter you'll get concrete help with ALL the issues you'll encounter in the disability system

Brian Therrien

related posts:


The Spoon Theory: A Real-Life Guide to Managing Energy with Chronic Illness


What To Do If SSA Surveillance Leads to a Mistake — And You’re Blamed for It


 Documenting Every Condition, Head to Toe

Questions? Comments? Get in touch... we're happy to help!