We have applied for Medi-Cal (California's Medicaid program) for my mother, and they are telling me she does not qualify for free Medi-Cal because she makes $115. too much. Her share of cost will be $654 PER MONTH, which is absolutely ridiculous (why can't it just be the $115????). The worker told me that if she had higher insurance premiums that would reduce her income and she would qualify. We were already considering changing plans because she has been in and out of a SNF and has paid out over $6500. out of pocket this year, which has exhausted her IRA account and now all she has left is her Social Security income.
I was checking out different plans, and it appears that a Medi-Gap/Supplement plan is a better choice for her than the current Medicare Advantage (HMO) plan, as there are virtually no out of pocket expenses, and the added premium (204/month vs. the 39 she is paying now) would reduce her income to where she qualifies for free Medi-Cal.
My question (sorry for the ramble) ... is this allowed??? the social worker seemed to think so, but I've read elsewhere you can switch from medi-gap to medicare advantage, but not the other way around??? I've tried searching on Medicare's website, but of course it is full of conflicting information & now I'm more confused than ever. Anyone been through this or know if we can do this or not?? If it is possible, I want her to take advantage of the open enrollment before it is too late. Thank you!