SSI, Medi-Cal, Veterans Service Connected Disability Compensation, Section 8 Housing Voucher
Rodney, a 72-year-old Vietnam Veteran, widower, and father to a 16-year-old daughter, called during the pandemic saying he needed to find work. He was no longer able to do handyman work due to his progressive macular degeneration. He and his daughter were living on $1300 in Social Security benefits and food stamps and his rent was $1100. He said he “would scrape gum off the sidewalk” if he had to.
We provided emergency rental assistance and then we helped Rodney apply for and receive Supplemental Security Income of approximately $300 per month, Medi-Cal, and a Section 8 housing voucher which reduced his rent to 30% of his income. In addition, we referred Rodney to a VA specialist and Rodney was approved for 70% Service Connected Disability Compensation in the amount of $1500 per month due to PTSD from his time in service in Vietnam.
Rodney and his daughter can now live with the security of knowing they have a secure and stable income, affordable rent and access to affordable healthcare.
Medi-Cal Share of Cost, In Home Supportive Services (IHSS), Veterans Aid & Attendance
Donna called seeking assistance regarding her parents Bill and Mary. Bill is a Korean War Veteran. Donna was told her parents needed to buy some dental insurance to wipe out their $1000 per month share of cost for Medi-Cal. They were struggling to pay their Medicare copays and Bill needed In Home Supportive Services (IHSS).
When inquiring about their income, we discovered that Bill was awarded Veterans Aid & Attendance benefits of $1218 per month about a year and a half earlier. Riverside County DPSS/Medi-Cal was counting all of Bill’s Veterans Aid & Attendance benefit as income in violation of Medi-Cal rules. They should have excluded $765 of it and only counted $453. We filed an appeal and forced Riverside County to reprocess the Medi-Cal case.
Bill and Mary were awarded 18 months of retroactive Medi-Cal coverage and Bill was approved for IHSS. Donna was shocked and dismayed that her parents were denied Medi-Cal for so long due to the County’s error.
Marjorie & Tom
Home and Community Based Services (HCBS) Medi-Cal, In Home Supportive Services (IHSS), Ball vs. Swoap Penalty
Marjorie called seeking assistance. Marjorie had to work to pay the mortgage, but her husband Tom suffered from frontotemporal dementia and it was hard leaving him at home alone. Marjorie applied for Medi-Cal, but was told that they would have a share of cost of over $2000 per month leaving them just $934 to live on.
We helped Marjorie apply for Home and Community Based Services (HCBS) Medi-Cal for Tom which uses much higher income and asset cut offs. Riverside County DPSS/Medi-Cal had never told Marjorie of the HCBS program and they were resistant to process Tom’s case under the HCBS program but we made them do it. Tom was approved and then Marjorie applied for In Home Supportive Services (IHSS). Tom was initially approved for only 25 hours per month of help, but we appealed and his hours were increased to 200 per month.
Because the county and the state were so slow to process Tom’s appeal, Tom was paid a (Ball vs. Swoap) penalty award of $4,600 by the State of California Dept. of Social Services. Marjorie finally had the support she needed to take care of Tom.
Veterans Aid & Attendance, Med-Cal, Medicare Part B Premium, In Home Supportive Services (IHSS)
Ruben, a disabled wheelchair bound amputee and Vietnam Veteran, called seeking financial assistance with the repair of his swamp box cooler as we headed into the summer.
While meeting with Ruben we asked him why he didn’t have Medicare Part B. He replied that he couldn’t afford the monthly premium so that is why he relied on the VA for his healthcare. We asked him if anyone from VA Healthcare ever told him he was eligible for Medi-Cal, a waiver of his Medicare Part B premium and Veterans Aid & Attendance benefits and he said no one ever bothered to tell him.
We helped Ruben qualify for Medi-Cal, the Medicare Part B premium waiver and IHSS. We then referred Ruben to Veterans Services where he was approved for $796 in monthly Veterans Aid & Attendance benefits. Ruben now has a livable income, access to affordable local healthcare and in home help so he can maintain his independence.
Retroactive Medi-Cal, In Home Supportive Services IHSS)
Bobby called seeking help with over $10,000 in medical bills. He had recently been in the hospital for several weeks and his only insurance was original Medicare leaving him exposed to an approximate 20% copay.
We determined that Bobby was eligible for Medi-Cal and would have been eligible for Medi-Cal for the three (3) prior months had he applied earlier. We applied for Medi-Cal for Bobby and requested three months of retroactive coverage and Bobby was approved. All of his past medical bills were paid in full. In addition, we helped Bobby apply for and receive IHSS so he can maintain his independence in his home with his companion dog Pilot.
Medi-Cal Share of Cost, In Home Supportive Services (IHSS), Protective Supervision
Jane applied for Medi-Cal because she needed help taking care of her husband Allen who has advanced Alzheimer’s. They were approved for Medi-Cal, but with a monthly share of cost (i.e., a monthly deductible) of $931. If they paid the $931 each month it would have only left them only $934 per month to live on, which is the monthly maintenance needs allowance set by the state of California that hasn’t been raised since 1989. Jane reached out for help.
We helped her apply for a $110 dental/vision plan and submitted the proof to Medi-Cal and their share of cost was wiped out and they were both approved for full Medi-Cal. In addition, Allen was approved for 280 hours of Protective Supervision under IHSS per month because of his severe condition. Jane now has the help and support she needs to continue to take care of Allen at home.
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 started 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 In Home Supportive Services (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.
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.
Brad and Tom
Medi-Cal, Veterans Aid & Attendance, In Home Supportive Services (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.
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.