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Author Topic: SSDI, on Medicaid in NY, and moving to Georgia  (Read 155 times)

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Offline lookingforu

  • Member
  • Posts: 13
SSDI, on Medicaid in NY, and moving to Georgia
« on: August 04, 2014, 04:41:19 PM »
Hi Guys!

   I need some help from anyone whose had this situation. I'm currently living in Upstate NY, was approved for SSDI a year ago, and currently on Medicaid. The Medicaid would expire June/2015 when I'll be eligible for Medicare.
   I wish to move, at some point soon, to be with my loving partner in Atlanta. From what I was reading online, in the state of Georgia, even being disabled and getting $1200 a month on SSDI I'm not eligible for any type of medical assistance.
   Sadly I have a wide range of health issues which stem from my HIV, in fact I'm having a shoulder reconstruction tomorrow because of a muscle weakness issue.
    Anyone have any idea how I can get medical assistance in Atlanta for someone who IS on SSDI?

  Please!!!!!

Offline Since1993

  • Member
  • Posts: 88
Re: SSDI, on Medicaid in NY, and moving to Georgia
« Reply #1 on: August 06, 2014, 03:10:08 AM »
Hi Guys!

   I need some help from anyone whose had this situation. I'm currently living in Upstate NY, was approved for SSDI a year ago, and currently on Medicaid. The Medicaid would expire June/2015 when I'll be eligible for Medicare.
   I wish to move, at some point soon, to be with my loving partner in Atlanta. From what I was reading online, in the state of Georgia, even being disabled and getting $1200 a month on SSDI I'm not eligible for any type of medical assistance.
   Sadly I have a wide range of health issues which stem from my HIV, in fact I'm having a shoulder reconstruction tomorrow because of a muscle weakness issue.
    Anyone have any idea how I can get medical assistance in Atlanta for someone who IS on SSDI?

  Please!!!!!

Get ready for a ride, because I went something similar moving from one state to another with similar circumstances.  I would advise patience and perseverance.  It will all work out fine.  I receive SSDI and had to get a state-exchange plan until my Medicare-eligibility early 2015.

First and most important, before moving to Georgia, deal with your emergent health issues while you are insured in New York, in New York state before moving.


Second, before moving to Georgia, have at least two months medication on hand, because the process by which you become insured in Georgia could take a while.  During that process, you will be covered by Georgia Ryan White Care Part A (primary care and labs) and ADAP (medications) for HIV-related care as long as your income is no greater than 300% of the federal poverty level (which you appear to be).  However, before you can be helped by Georgia Ryan White Care and ADAP, you will HAVE TO BE A RESIDENT OF THE STATE OF GEORGIA.


1,  Establish Georgia residency (get a bank account, drivers license, etc).
2.  Contact a local Atlanta AIDS Service Provider (ASO) and appointment with a Medical Case Manager who can connect assist you in applying for Ryan White Care Part A and ADAP, getting an immediate appointment with an HIV/AIDS specialist to make sure you don't run out of medications.  The Medical Case Manager will tell what documents you will need to bring for your appointment.  Proof of HIV infection, residency and income are mandatory.
3.  Call and notify Social Security of your Address Change: (hint:  Upon contacting them, you can print an updated SSDI award letter from  http://www.ssa.gov/myaccount/ which will show your updated address and helping you to establish residency (i.e. Drivers License Office, Ryan White/ADAP, etc.)


It will have to be determined if you are Medicaid-eligible in Georgia.  Since you have SSDI income, and although you are disabled, it doesn't automatically qualify you for Medicaid if your income is too high.  You will have to submit an application on the Georgia State Healthcare Exchange.  You will qualify for enrollment outside the normal enrollment period because you have a qualifying life event:  MOVE.  I encourage you to ask your Medical Case Manager as the local ASO to refer you to a licensed healthcare navigator to help with this process:

Georgia State Healthcare Exchange:
http://georgiahealthexchange.com/index.html

Georgia ADAP Information:
https://dph.georgia.gov/adap-program

Upon applying, it will immediately determine your Medicaid-eligibility.  If you are not Medicaid-eligible, you will have to choose a health plan and become insured in Georgia.  Now, don't panic.  I went through the same process.  I was scared I wouldn't be able to afford it (premiums, co-pays, deductibles). Understand that when you apply for healthcare coverage on the exchange, based upon your income, you will be eligible for Advanced Premium Tax Credit (APTC) which will help pay your insurance premiums (some not all the cost) AND Cost Sharing Reductions (CSR) which will reduce the amount of co-pays, deductibles and maximum out-of=pocket costs as long as you CHOOSE A SILVER PLAN on the exchange.  Based on your income, you should qualify for the 94% Silver Plan which heavily reduces the amount of co-pays, deductibles and out-of-pocket maximum you will have to pay.  Your annual deductible shouldn't be more than $750 and annual maximum out-of-pocket no more than $1500, in fact, less than.

Understand that you will be able to view the ATPC savings upon application, but the CSR savings aren't made visually available online, but rather, until after you receive notification from the insurance company your chose, typically upon arrival of your insurance card.

Once you have successfully applied for a health plan on the Georgia exchange, there is more help available to pay for the remainder of your health care premiums and HIV-related medication co-pays in Georgia.  Ryan White Care Part B/ADAP will pay for the remainder of your insurance premiums and co-pays for all your HIV-related medications.  Every state has their own medication formulary of medications they assist paying for.

1.  Inform your ASO Medical Case Manager to inform them you applied for a Georgia State Exchange insurance and need assistance from Ryan White Part B/ADAP coverage.  Make sure upon confirmation of the appointment that you have all the documents they require for eligibility before the appointment.

2.  Upon completion of your appointment, your chosen Georgia State Exchange health insurance insurance premiums will be paid in-full going forward and the co-pays for your HIV-related medications.

Now, you said you become Medicare-eligible in June 2015.  You will still need to reapply on the Georgia State Exchange in December 2014 for 2015 coverage because you need uninterrupted insurance coverage until Medicare-eligibility.  Upon notification from Medicare that you have coverage in June, you can dis enroll from your Georgia State Exchange plan, because Medicare-eligibility is considered a qualifying life event. At that point, you can receive assistance in Georgia for your Part D Medicare Premiums and any co-pays associated with HIV-related medications through Ryan White Part B/ADAP.  But this is forward down the road.  Your number one priority is getting linked into care and insured in Georgia once you move there.

This is a lot of information, but I've condensed it to the best of my ability.  If you have further questions, feel free to private message me at any time, before, during and after the process.
« Last Edit: August 06, 2014, 03:29:41 AM by Since1993 »
It is always permissible to private message questions related to Social Security Disability Process, Ryan White/ADAP, Affordable Care Act, Medicaid, Medicare and pharmacy coverage issues.  I am not an expert, but have a lot of experience to share in navigating the maze towards staying linked into care.  Supportive.  Healthcare background.  Not a physician.  Not Mr. Personality, flat affect at times.  Working on it.

 


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