Linda Brandwin, R.N. Linda Brandwin is a registered nurse and a medical billing and claims specialist. For the past 10 years she has worked directly with insurance companies to give advice and guidance to the health care consumer. Readers may send email or write Linda Brandwin at 5500 Single Oak Hill Ct., Woodbridge, VA 22192.

Look into all options before making a decision
Aug 6, 2004

Q: My husband and I are both under 65 and disabled. Each month we receive a social security disability check. I also get a pension check from the Public School Retirement System. We have Medicare A and B and up until now we have been on Medicaid too. Our spend down each quarter has been about $3600.

We have been told that we can no longer receive Medicaid because of a check we will be receiving from a lawsuit. Our plan was to use this money for a down payment on a maintenance provided townhouse. Right now we are in government housing. Our rent is close to $500 a month. I believe we could own a home with monthly payments close to what we are paying now if we could use the lawsuit money for a large down payment.

I am so frustrated because if we lose Medicaid we will not be able to buy a house. Medigap insurance would run close to $600 a month. We would have to put aside this money in order to be able to afford these monthly premiums for the rest of our lives. If we could use the money to buy a house we would be able to get out of government housing. It is like we are being penalized by the government for having this money. We will never be able to improve the quality of our lives.

We looked at the Medigap plans and thought plan J was the one that provided the best prescription coverage. Our medicine runs about $1500 a month. Someone told us to go with plan C if it is offered in our state. What is your opinion? Please help us figure out what to do. We want to use the lawsuit money to improve our lives a little yet the government is making it impossible.

A: All states have their own policies and regulations regarding Medicaid. It sounds like you have already talked to your Medicaid office. If you need further assistance with Medicaid rules, perhaps a social worker who specializes in this field or a legal aid lawyer could offer you some useful information and guidance.

There are ten different Medigap plans to choose from, A through J. Each of them provides different coverage and, therefore, the premiums vary. Call your local Medicare office and request their booklet on Choosing a Medigap Policy. You may also order the booklet online. The booklet is quite informative and it is free. You can also call your State Insurance Department about the Medigap policies sold in your area and any insurance related problems. Also your State Health Insurance Assistance Program may be able to help. In your state the numbers are 1-800-726-7390 or 1-800-390-3330 respectively.

Drug coverage seems to be the key to your financial situation. There are many programs now available for discounted prescription drugs for people who meet specific financial requirements. You can ask your physician and your pharmacists for this information. You may be able to find the information online. You can also contact individual drug manufacturers and see if they offer free or discounted medicine.
Many people save money by filling their mail order prescriptions by pharmacies in Canada. I am not endorsing this since I have no direct experience with Canadian pharmacies. But it is another possibility to explore.

If you can significantly lower your monthly prescription costs, you may be able to have a less expensive Medigap policy. You may then be able to save enough money to move out of government housing and buy the townhouse you want. There are many resources available, look into all of them.