Medicare and AHCCCS: What’s going on?

The state of Arizona’s Medicaid program will pay the Medicare premium for people with income below $1,333 for an individual) or $1789 for a couple. I wrote about the details of this assistance last year: Help for Low-Income Medicare Beneficiaries.

In the past two days I received phone calls from two clients who have been receiving this financial assistance for several years.  One woman received good news and the other received bad news.  In both situations, AHCCCS (the Arizona’s Medicaid program and pronounced  “access”) had their income information wrong.  I wonder what’s going on with AHCCCS (Arizona Health Care Cost Containment System)?

Donna (not her real name) called me yesterday to say she received a card from AHCCCS and a letter saying she qualifies for “full AHCCCS” . This means the state will not just pay her Medicare premium – the state will also pay her medical co-pays.  That is great news for Donna  because she lives on $1,089 per month.  The confusing thing is that her income is above the threshold for getting “full AHCCCS”. That income limit  is $992 per month.

Today I got a phone call from a client who got bad news from AHCCCS.  Elena received a notice in June from AHCCCS saying her income is too high to get help through the Medicare Savings Program.  The form said her income is $2,231 per month.  But Elena’s income is only $1,109 per month and she told this to an AHCCCS representative in a phone call. The AHCCCS rep said she would fix Elena’s record and that someone would be calling her. That was two months ago and she never got the phone call.

Elena did get a letter from Social Security saying the state would no longer pay her Medicare premium and that she makes too much money to get help with her drug costs (Low-Income Subsidy), a program that is run through Social Security. Ouch!  Elena needs that $104.90 each month to live on. And she needs help with her prescriptions costs.

So how did the wrong income information get into her AHCCCS record? I told Elena I will see who I can talk to to get this straightened out.  The Tucson office for ALTCS (Arizona Long Term Care System) used to be able to help local residents with the Medicare Savings Program. But they no longer do that work.

I called the DES Client Advocates office and talked to a person there who said she would call Elena.  I’m hoping this person will follow through because talking to AHCCCS is next to impossible these days – and Elena already talked to them and they dropped the ball.

I hope I don’t get more calls from clients whose AHCCCS records are messed up.  Though, if there is a clear pattern of wrong information in the system, the problem would likely (hopefully) get addressed ASAP.