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medicare help
Mar 21, 2013

I was diagnosed with AIDS in June 2011, and went on disability shortly thereafter. I live in Tennessee, and in this state there is a two year waiting period to receive Medicare benefits. The first year I received my meds from the TNcare program and the second I was put on Ryan White for my HIV meds and all others are out of pocket. I am set to receive Medicare in June of this year, and have been told that I will run out of benefits after 3 months. My choices seem to be throw myself at the mercy of the drug companies and hope to get a hardship status lowering the cost of my Atripla to somewhere between 6 and 800.00 per month. My other option is to leave my home and move to a state that provides a way to receive Ryan White and Medicare. I have talked to the Aids clinic in San Diego, CA and they tell me I will not have a problem if I move there. Are there other states I can move to and receive this benefit? They also told me that Ryan White would be phased out in a year or so when the new government healthcare takes over. Any advise you can give me? I still live with a T cell count lower than 170, and have had PCP Pneumonia that put me in the hospital for three weeks last time around. I hate to give up my home but it looks like I have no choice. Regards, Patrick

Response from Mr. Chambers

First let me clarify some issues. Tennesse's TNcare (called Medicaid federally) is required by federal law, but each state administers their plan differently. The same is true of programs funded by Ryan White dollars.

Medicare, however, is a federal program and the rules are the same everywhere. Persons under age 65 are automatically enrolled in Medicare once they have received Social Security Disability Insurance (SSDI) twenty-four months after the became eligible for SSDI benefits. The only exception is people under 65 and on SSDI due to End Stage Renal Disease or ALS (Lou Gehrig's Disease) get it when SSDI starts.

However, I am confused by your statement that "I will run out of benefits after 3 months." Do you mean just Ryan White program benefits or is there some reason SSDI itself is stopping, which would be very unusual. It may be that in Tennessee, persons aren't eligible for Ryan White benefits once they become Medicare eligible.

You should now be looking into whether you should be staying with regular Medicare and purchasing a Part D Prescription Drug Plan to help with your medication costs. You may also want to see if there are Medicare Advantage Plans in Tennessee you can trade your Medicare for that will cover your medications and still allow you to see the doctors you prefer. You can get help with that at www.medicare.gov.

Moving to another state will have no impact on your SSDI or Medicare benefits. Your eligibility for Medicaid and Ryan White programs will vary, however, but I encourage to explore how much Medicare will cover of your Medications under a Part D Drug Plan before leaving your home.

Good luck, Jacques



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