Medicare and AHCCCS Clerical Error

I wrote recently about a client who was thrilled to receive notice from AHCCCS that she qualifies for additional help for her medical costs. I told her something must have changed at AHCCCS because her income is about $60 too high to get this help.

Donna called AHCCCS today to say thanks and to sign up for an AHCCCS health plan – but it seems there was a “clerical error” and she should not have gotten the letter with the AHCCCS card.  The card had been made up with Donna’s name and her AHCCCS id number, so this “clerical error” had been in the system for a while.

Donna is pretty bummed out, but she knows the income limits for getting help and she knows hers is just a bit too high. With all the research she did about AHCCCS and her options if she had been qualified as a “dual eligible”, I told Donna she is now an expert on this complicated issue.

Another clerical error?

In my last post I wrote about another error at AHCCCS – and that one has not been fixed yet.  Elena was told by AHCCCS in June that their records show her income is over $2,000 per month.  But this is wrong and Elena told them so back in June.  The person she spoke with said he would fix her record – but that did not happen.  Now Elena has been told by Social Security that she is losing her “extra help” with her drug costs as well as her Medicare premium help.  But this should not have happened!

I called someone I know who works for AHCCCS and she checked Elena’s AHCCCS record.  It shows that Elena has two Social Security incomes (!!).  Is that even legal?  And of course it is wrong information. Elena gets one Social Security check for around $1,200 per month.

The person I spoke with said she will get confirmation from Social Security as to Elena’s income.  Then she will talk to her supervisor to see how she can get Elena’s record fixed.

If Elena has to re-apply for AHCCCS, it could take 45 days to get processed and approved.  In the meantime, Elena will get $105 less in her Social Security check each month (to pay her Medicare premium).  Elena can’t afford to have $105 less each month.

Hopefully my contact is in a position to get Elena’s problem fixed.  Thankfully, I know someone in AHCCCS who is willing to do work that is not part of their job – but is willing to go the extra mile to help someone like Elena.