Sorry, Hope this is OK, I am not exactly a caregiver, I am still able to care for myself. I had colon cancer mid year 2013, and had surgery and chemo, complications from Chemo, and wore out knees, Couldn't return to my (outside) job. I need a Yearly CT Scan, and think it's 6 months for the blood work, and get shots in my knees 4 times a year, and I think it's every 3 years, instead of 10, a colonoscopy. Plus, May have to start seeing a pain management doctor. Anyways, I WAS eligible and receiving WV State Medicaid under there QMB. (I am 62 years old, but on Medicare because of being on SSDI for over 24 months) In 2017, I was getting $1,013.00 per month. In 2018 with my recent Social security raise, of $21.00, I am now getting $1,034.00. With a $20.00 Disregard, brings me down to $1,014.00 and puts me Over The State (maybe federal) income limit of $1,012.00 So I am Over the Limit By $2.00!! That Extra $21.00 a Month Surely will not Pay for a secondary Insurance plan. So the "Big" Social Security raise actually hurt me more than helped me. Is there any way to actually Have Social security take a Few dollars off of me?

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Thank you
Helpful Answer (1)

No problem. I know it's frustrating.
Helpful Answer (2)

Sorry To Act The way I acted Becky.
Thank you for your time.
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Thanks ,
Sorry about The Attitude,
Life's made me That way.
Furthermore, It's True.
That's all these kids do around here, is get pregnant, and get on Welfare.
3 and 4 kids, with 3 and 4 different fathers.
They Ain't gonna Do Nothing For Me!
I don't know how to do it, And My case doesn't give a Damn.
She does Not Care To help me.
thanks For your Time.
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Medicare and Medicaid are separate programs and you can be dual Medicare and Medicaid. What you are over the limit for is QMB. Reapply for Medicaid and see what happens. Do not ask for QMB to pay your Medicare Part B premium. That remark about unwed mothers is uncalled for. That attitude will get you no help, if you talk to case workers with that attitude. I know it's frustrating for all people who apply for services but you're no better than any other applicant. I'm done.
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"And you don't think these are even *unintended* consequences?"
could Be.
I know if I were 18, and pregnant, I could get help.
Maybe I WILL NOT get a social security raise next year, and they will raise the income Cap,
Seems medicaid raises the Cap every Year.
I can get help next year then.
I don't think there is anything I can do.
Helpful Answer (1)

You might want to edit your last post and remove your name from it.

I wish I had anything to contribute to the discussion. And you don't think these are even *unintended* consequences?
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I sent this e mail to

I don't Know Becky, I'm not sure I can get Traditional or regular Medicaid.
because I am On medicare.
When Your on medicare, Don't you Have to stay on medicare.

They "Stuck it to me"
and that is how I see it.
"when Social Security gives the cost of living increase. " WHAT A JOKE!!
They probably Did it on purpose.

I was wondering, I was told Due to The Increase I got On my social security Disability Insurance, That I was Making too much for QMB .
I was getting 1,013.00 and got $21.00 "Raise"
and am now getting 1,034.00 .
What Can be done?
I can't afford secondary insurance. I am struggling every month as it is.
Also if You go to This Page,

It says for a Single person, only one in household,
The yearly limit is $16,146.
I am Under that.
Unless the Page is in error.
Also, Can I get Social Security to Take Back There So Called "Raise"?
As it surely did Not Help Me.

Good Afternoon Mr. XXXXXXX !! Unfortunately, there is nothing we can do when Social Security gives the cost of living increase. We have a Gross monthly income limit for the Medicare Premium Assistance program. You still receive this Program but it now obviously only covers your Part B premium and not the 20 % that it was covering before. **The website and income limit that you are referring to is for MAGI Traditional Medicaid only. This is for people not receiving Medicare.**
I am sorry we could not be of anymore help.
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He's over the federal limit on QMB, the program that pays Medicare Part B. That limit is the same limit in all states except Hawaii and one other. I would ask could I drop that part of Medicaid. That might make a difference if only asking for regular Medicaid. It would mean the $134.00 comes out of social security which it's going to anyway since over the limit for QMB
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That's Right Labs. It dosen't matter, I am a man though.
Yes, I'm 62, But since I have been on social security disability Insurance Over 24 Months,
I had to go on medicare.
I wish Social Security would just take Back the $21.00 "Raise"
That was supposed to help me, But instead hurt me.
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Got it! Is there a solution?
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Her medicare coverage is because she is on SSI disability. There is no income limit for medicare. Her problem is she is receiving over the income threshold to qualify for full medicaid coverage and and the cost of her medicare Part B.
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Oh, wait a minute! Because you are on MEDICARE you are over the income limit for receiving BOTH Medicare and Medicaid!!.

Is it possible to simply go on straight Medicaid, which you appear to qualify for?
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I don't the exact number of clients a caseworker has currently on phone calls, but it is quite high. They do have extra caseworkers at larger offices to handle overflow. I don't know why anyone would tell you it was a waste of time to go to a hearing, it isn't. I would take all of the documentation along with a printout of what the website says and go in person.
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Print out the information from the website. Ask to speak to a supervisor.
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They're telling Me No,
How Am I going to Fight them?
without a lawyer I don;t have the money for
I guess I'm done,
Have to come to terms with it.
Im going to call that legal Aid of West Virginia Next Week,
But the woman Said she don't think They handle those type of cases.
Don't Know why they put it right on the decision Paper then.
I don't know Barb,
**in the community or in an institutional setting, such as a nursing home.**
I was taking it to mean a Home of some sort.
The workers are telling me NO, I don''t see what else I can do.
I guess there is no easy answer.

That other one I know that works at the DHHR said it wouldn't pay to go to the hearing,
"Cause you can't fight the state income cap"

Thank you all.
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I reverified this am. Same information. I'm not in a position to give out someone's name. I think going in person is the most expedient way to resolve.
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It says "in the community OR in an institutional setting".
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Maybe this is why
Program Description

The West Virginia Medicaid Program provides a medical card which may be used to receive medical care
**in the community or in an institutional setting, such as a nursing home.**
This allows those who may not be able to afford medical care the opportunity to have their health needs addressed. Medicaid is administered on the Federal level by the Center for Medicare and Medicaid Services (CMS) under the Social Security Administration.
So Maybe That's for a Nursing Home?
Yep, Says, Family size, 1 $16,146
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Becky, I think I saw that Too.
Then Why when I call 877-716-1212 (WV Medicaid help center)
they are telling me 1, 032 per month, and I am over by $2.00.
1,032.00 X 12= $12,408.00
Is the WV social worker a friend of yours?
Any way you can connect me with her?
I am exhausted over all this, Will be going to bed for the night.
Will check back tomorrow.
Thank you!!
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For Ohio the maximum income is $15,800. I verified this thru AFDC manual for the State of Ohio 2018
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Google What is the income limit for getting Medicaid in West Virginia. Select the article. For 2018 the maximum income for one person is $16,146 annually. I verified this with a State of WV social worker.
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Thanks Becky, I don't like to speak badly of people, But My Case worked is Not worth a Damn.
I already made an appointment, and talked to her,
She said
"It was out of her hands" Im sure She Knows, Or could Find out some sort of way to make it Work.
personally, she acts like she don't Give a Damn.
It's Just like 2 or 3 years ago, When I was eligible for the Full QMB, The people from WV S.H.I.P. told me that they were going to increase the income Limit in March, and I should Go re apply. When I went there, I had QMB written on a Paper, And she said, Yeah, Yeah, QMN, QMB, That's all you are eligible for.
I was paying a secondary Insurance for NO REASON!
By the Grace Of God, I just happened to be talking to the WV customer service for something else, And SHE (WV medicaid customer service) Told Me I was Eligible for The Full "QMB. " (Full Medicaid)
So Customer service set me up with medicaid, Not my "Couldn't care less" case worker.
Any time I call here, I get her Voice mail, She NEVER calls back.

PS Thank You Shane 1124.
Yes, $25.00 +/- would do it.
Actually they said there is a $20.00 disregard.
Again, "The rich keep getting richer,
and The so called "Cost of Living increase" Actually Hurt me, Not helped.
Don't be doing me any favors Social Security.
Helpful Answer (1)

How long ago Did you Live In Ohio?
How much is the Plates in Ohio, because they Just this year went up from $30.00 to $50.00.
From what I understand Ohio does not have personal property tax's On Cars every year. I do not and don't see myself owning a home. (That ship has sailed)
I am a Retired mechanic, and still have my tools, and am not ready to sell them.
I also do some woodworking. and have tools for that, so an apartment will not work for me.
Hud is Giving Me a rental Voucher, and said it could be used for a small one or 2 bedroom house, or (ideally) a garage apartment.
The woman at HUD said since this is My 1st time on HUD, I could use the rental Voucher
basically In "Ans State In The USA"
(The garage is more important to me than the house)
I really don't know Now, and you did live in both states,
But I always heard everyone say "Ohio is Better" as far a welfare benefits.
Again, I don't know 1st hand.
The Ohio DHHR did say the income "cap" was the same as here.
I am just so sick over all this.
As far as 1099's, I have not filed tax's in the last 3 years The fellow at the Income tax service told me My income is non taxable.
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My mistake it's Part B premium that is paid by Medicaid. Hiring an attorney is not necessary. You need to talk to a Medicaid case worker and submit the information. There are certain things that are considered to get your gross income below the limit. They have a list of things. It is your total household income, not just your income. If you have another adult or child in the household who has income that will be included. But if you are living alone or with persons who do not have income just yours count. Medicaid and disability are two separate issues. All income whether it is from work or disability counts the same.
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See, It almost sounds here, Like if I had a family member getting my money,
(Like I know someone who gets SSI, But has a drinking and gambling Problem, and will literately Blow the whole SSI monthly income in one week, So his sister gets the Check In A separate Checking account, and pays his rent and gives him a "weekly Allowance")
So reading this (copy/pasted below) from the "west virginia income maintenance manual section 23"
But I don't Know , I would need some legal help, and it looks like That Legal Aid Of West Virginia Don't deal with Disability. (I have to call them next week, She said The system is down)
But there has to be some kind of loop hole, But again, It "Might" take a lawyer I have to pay. (And the rich keep getting richer)
Anyways, Thanks for reading.
here is the part of the manual.

West Virginia income maintenance manual section 23.
Look at section 12 please, (I don't think section 13applies)
12. Unavailable Income
Income intended for the client, but received by another person with whom
he does not live, when the individual receiving this income refuses to make it available, is excluded.

Income Received For A Non-Income Group Member
Income received by a member of the
Income Group, which is intended
and used for the care and maintenance
of an individual, whose income is
not used in determining the eligibility AG, is excluded as income.
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If you have your letter stating that you no longer qualify for Medicaid, you should follow the appeal process on the letter. If there is nothing about an appeal process via mail, you will need to go to your local office office for Medicaid and other state benefits. You will need to take with you the following information:
1. The letter you received from Medicaid.
2. Your SS award letter for 2018.
3. Receipts and bills for any medical and drug costs that you paid out of pocket.
4. A copy of a rent receipt or mortgage payment.
5. Copies of utility bills, electric, gas, telephone cable.
6. If you received HEAP, a copy of that award letter.
7. Copies of any 1099's if you had any miscellaneous income.
8. Copies of your SSDI information.
9. If you received an Earned Income award on your federal taxes, bring that, along with your state and federal tax returns.
If you have medical orders for colonoscopy, or other medical tests, you will need to bring that as well. I also the appeal would not say you were thinking of moving to Ohio. They'll probably say goodbye and good luck.

If you are appealing the state's decision, you need to show why you need to remain on Medicaid. You may be able to get Medicaid, but not the portion that pays your Medicare Part D premium.

I wouldn't consider moving to Ohio. They check things much more carefully than WV. WV receives more federal money than Ohio. I've lived in both states. Car insurance is not lower in Ohio. Car registrations are higher. Property taxes are higher. There are waiting lists for low income housing, especially for seniors and disabled. Priority is given to residents of the town where the apartments are located. Waiting lists are always about a 2-year wait for Section 8 or Senior/disability apartments. In some counties they are much longer. Food costs are higher, along with utility costs. Rents are higher and house prices are significantly higher. Getting on 'edicaid is lengthy process in Ohio. You have to apply and then wait for either a phone interview or an appointment at your county office.
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I hope it works out for you. I can’t believe there isn’t a window, like +/- $25 bucks or so.
Nice to see our government can pay attention to detail but not with Seniors or the Disabled’s social security/benefits,  for goodness sakes.
Good luck!
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Can't even Enjoy Life a Little Bit after I had to retire.
Struggle Struggle Struggle all My Life.
And Struggle Struggle Struggle, now that I'm retired too.
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The Lady Was Sort of Short with me on the phone too.
That's the trouble with these places, They make you afraid to talk to them.
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