Success Stories

Client names have been changed to protect their identities.

Marianne and Bob - Medi-Cal, Food Stamps, SSI and Veterans Benefits

Marianne was referred by a representative at the local Social Security office. Marianne and Bob (a Korean War POW) received some temporary financial assistance from their daughter to help pay their rent. When they reported it to Social Security, they were cut off of SSI and told they had to repay $4000 to SSI. Because they lost their SSI, they lost their SSI linked Medi-Cal. They were living on a combined $1252 per month in Social Security. Social Security starting deducting $99.90 a month for their Medicare Part B premiums leaving them just a little over $1000 a month to live on. Then, Social Security started deducting a $125 penalty from their combined Social Security payments to pay back the SSI overpayment. We helped Marianne and Bob apply for and receive Food Stamps and Medi-Cal. Once on Medi-Cal, their Medicare Part B premium payments were waived and they were each reimbursed three (3) months' worth of Medicare Part B premiums. We also helped them negotiate a reduction of their $125 SSI repayment penalty to $40 per month. In addition, we helped them apply for Veterans Aid & Attendance benefits and they were approved for a total of $898 per month. Lastly, because Bob travelled to the Veterans hospital in Loma Linda several times a month, we told them about the mileage reimbursement program through the VA and they are now reimbursed about $50 per trip.

Maria and Jose – Medi-Cal and IHSS Protective Supervision

Maria cares for her 83 year-old grandfather Jose, who suffers from Alzheimer’s. Because Jose needs 24-hour care and supervision, Maria gave up outside employment to live with and take care of Jose. Together, they scraped by on his Social Security Retirement and United Farmworker Pension of $1500 per month. We assisted Jose in applying for Medi-Cal and IHSS Protective Supervision and he was approved for 272 hours of IHSS help per month with Maria as his paid caregiver. With the support they are now receiving, they are financially secure and Maria can keep her promise to Jose to keep him at home.

Harry – Share of Cost Medi-Cal and In Home Supportive Services (IHSS)

Harry, age 91, lives all alone in a 2nd story apartment with no elevator. He can’t go up and down the stairs on his own. He walks with a walker. Harry wants to live on his own for as long as possible, but it was becoming too difficult. He applied for Medi-Cal and IHSS, but his monthly share of cost for Medi-Cal and IHSS was $750 leaving him with just $600 per month to live on so he couldn’t avail of the either program. We assisted Harry with applying for and obtaining a dental insurance policy to use as an offset to his income so that his countable income ended up being under the cut off for Medi-Cal. After paying for his dental insurance, Harry has $1200 per month to live on, he has full Medi-Cal benefits and he receives 104 hours of IHSS per month. In addition, because he has full Medi-Cal, he no longer has to pay his Medicare Part B premium, and his medication copays dropped for his Medicare Part D drugs and he is now saving approximately $100 per month on copays for medications.

Marge and Fred – Veterans Aid & Attendance

Marge, age 78, takes care of her husband Fred, age 88 and a WWII veteran, who suffers from Alzheimer’s and needs full time caregiving. We assisted Marge and Fred in applying for Veterans Aid & Attendance benefits and they were approved for $1900 per month in benefits and retroactive benefits of over $20,000. With this support, Marge will be able to access more help to assist her in caring for Fred.

Eileen - Medicare Part B and Medi-Cal

Eileen, age 67, was referred to us when she was turned down by a Medicare HMO because she only had Medicare Part A (Hospital) insurance. Eileen turned down Medicare Part B when she was 65 because she could not afford the $96 monthly premium. She had no money left over each month based on her $350 in Social Security Retirement and her part-time earnings working in retail. No one told her that because of her low income, she was eligible for a waiver of the Medicare Part B premium. Eileen developed a painful hernia but she could not go to a doctor because she only had Medicare Part A hospital insurance. We helped Eileen apply for and receive Medi-Cal. Once on Medi-Cal, she was able to get free Medicare Part B right away, instead of having to wait a one-year penalty period. She now has Medicare Parts A and B, Medi-Cal and she signed up with a Medicare HMO and is receiving medical care for the first time in years.

Jose - 250% Working Disabled Medi-Cal

Jose, age 60, suffered a major stroke which left him wheelchair bound. Soon after the stroke, Jose qualified for SSI and SSI linked Medi-Cal and he received excellent healthcare by his doctors through Medi-Cal. However when Jose's Social Security Disability Insurance of $1400 per month kicked in he lost SSI and his SSI linked full Medi-Cal. Instead, he was switched to Medi-Cal with a share of cost of $800 per month leaving him with just $600 per month to live on. Because of the $800 a month share of cost, Jose could no longer afford to go to the doctor or fill his prescriptions. We helped Jose qualify for 250% Working Disabled Federal Poverty Level Medi-Cal. He now has full Medi-Cal for a monthly premium of $20 per month and he is able to see his doctor and fill his prescriptions.

Steve – Medi-Cal

Steve, age 67, a Vietnam War veteran, missed out on signing up for Medicare Part B when he was 65 years old because he planned on retiring later. Steve became legally blind from cataracts and could no longer drive or work. Because he only had Medicare Part A (Hospital) insurance he could not get treatment for his cataracts. Because he didn’t sign up for Medicare Part B when he turned 65, he was penalized and found out that Medicare Part B would not start for another year for him. We helped Steve apply for and receive Medi-Cal, which started right away. Soon after, Steve had successful cataract surgery restoring his vision.

Brad and Tom – Medi-Cal, Veterans Aid & Attendance, IHSS

Brad, age 55, called seeking help. His partner Tom, age 68, a Vietnam War veteran, was suffering from Alzheimer’s and Brad, asked if there were any programs which could help them. We helped Tom apply for Medi-Cal, In Home Supportive Services and Veterans Aid & Attendance. Tom was approved for full Medi-Cal, $536 in monthly Veterans Aid & Attendance benefits, and 40 hours of In Home Supportive Services per month with Brad as his paid caregiver. With the support of these programs, Brad and Tom can remain in their home and Tom will be well cared for.

David and Tom– Social Security Retirement and Supplemental Security Income (SSI)

David, age 77, called saying he was unsuccessful in getting his Social Security Retirement benefits. He had applied when he was 65 years old, but was turned down because he had changed his name and Social Security number when he became an actor and then once again when he went into business. He was not able to prove who he was to the satisfaction of the Social Security Administration, so he gave up on Social Security and lived on his savings. He had no health insurance and became blind due to untreated glaucoma. We assisted David in gathering all of the documentation required by Social Security. David had a very patient and diligent Social Security worker who consolidated all three of his Social Security work records into one account. David was then approved for almost $1000 in monthly Social Security benefits, Medicare and Medi-Cal. Tom, David’s 80 year old partner, was living on $600 a month in Social Security benefits and paying his $96 Medicare Part B premium, and was unaware he was eligible for SSI and Medi-Cal. He wasn’t going to the doctor with his traditional Medicare plan because he couldn’t afford the copayments. Tom now has SSI to boost his income to $874 and with his Medicare and Medi-Cal he now has a Medicare HMO which provides medical care with no copayment.

Bill – Improper Medi-Cal Share of Cost

Bill, a disabled Korean War veteran, was maintaining his independence on his Social Security, Medicare, Medi-Cal, IHSS and Veterans Aid & Attendance benefits. Then, he received a notice from Medi-Cal saying that he had to pay an approximate $900 share of cost each month which would leave him $600 a month to live on. His Medi-Cal worker never answered his phone calls and never returned his multiple messages informing her that his Aid & Attendance benefit was not countable income for purposes of Medi-Cal. We immediately filed a Request for a Hearing with Medi-Cal which stayed the proposed change in his Medi-Cal status. The Medi-Cal hearing officer agreed with our position and reinstated Bill’s benefits to their prior status with no share of cost.

Marie – Supplemental Security Income (SSI), Medi-Cal and Medicare

Marie, age 68, called because she had no income and no health insurance and was worried about what would happen to her when she ran out of her savings. Marie had two short term marriages and had not worked enough quarters on her own (i.e., 40) to qualify for Social Security Retirement and Medicare benefits. We explained the eligibility criteria for SSI to Marie and accompanied her to the Social Security office for her to hear it directly from the SSI representative. Marie was told that once she spent down her remaining assets to below $2000 she would be eligible for SSI. She did so, and we accompanied her back to the Social Security office where she was approved for the full SSI payment (i.e., $854), Medi-Cal, Medicare Part B and the Medicare Premium Payment Program to pay her Medicare Part A premium. She now has a monthly source of income and health insurance and is no longer worried about what will happen to her.

Robert – Social Security Retirement, Medicare and Medi-Cal

Robert, age 75, called from a homeless shelter after being released from a California state prison earlier that month. Robert said that he had no income and no health insurance. He said he ran into problems with the Social Security Administration previously when he applied for benefits because he could not produce a birth certificate. He was abandoned at birth and raised in an orphanage until he was 14 months old and had never seen a copy of his birth certificate. This time we accompanied Robert to the Social Security office to apply for benefits and the SSA rep said the rules had changed since Robert previously had applied in 2003 and 2007, and he no longer needed to provide a birth certificate. Robert was approved for $994 in Social Security retirement benefits along with Medicare and Medi-Cal.