She waited a year to tell me this...
October 20, 2010 1:52 PM   Subscribe

Any suggestions to help my (unemployed, uninsured, high-risk) mother get insurance or assistance with apparent macular degeneration? Difficulty: she's in California, I'm in Oregon and we're both broke.

My mother has been in forced retirement for a few years now (it's a long story, her employer really screwed her). She is barely getting by wrt finances. Trouble is she's too poor to take care of things herself, but makes too much (very small pension) to be eligible for most assistance options.

She noticed her vision starting to go about a year ago. She finally went to the ER a while back and the doctor told her it's macular degeneration and she needed to see an optometrist immediately. That was in July.

We talked last night and she has lost complete vision in her right eye, and most in her left. She can only read very large print with contacts, trifocals and a 5000x magnifying glass. Even then it's hard.

She called me yesterday to let me know she found an insurance option, but it'll cost $600 a month, which neither of us have. Between my sister and I we could help out with that in the short term but to be honest we can't afford it long-term. It seems pretty high to me anyway.

She's 60, ineligible for Medi-Cal and high risk (two previous heart attacks). She lives in Sacramento. I can only do so much research from 600 miles away; I haven't lived in California in well over a decade so I have no idea what's available there anymore. I was told about the Lion's club, but they appear to be more community-based than individual so I'm not sure if they could help.

I'm not looking for a handout, I will definitely contribute what I am able, but I really can't afford very much.

I'm very grateful for any help and suggestions I can get.
posted by geckoinpdx to Health & Fitness (6 answers total) 2 users marked this as a favorite
When is the last time that you checked her eligibility for Medi-Cal? If her vision is as bad as you say (complete blindness in one eye, and extremely bad vision in the other), she very well may qualify as "statutorily blind"--vision of less than 20/200 with corrective lenses.

If she does qualify as legally blind, then she's eligible for SSI and should be automatically enrolled in Medi-Cal. By going onto SSI, she'll also start to receive a small cash payment every month, which should help her even more.

You can find info about SSI here: SSI/SSP eligibility
posted by iminurmefi at 2:30 PM on October 20, 2010

California Pre-Existing Condition Insurance Plan
California Major Risk Medical Insurance Program

Not a CA resident, but my understanding is that both of these programs have waiting lists. Phone numbers on those sites can get you started, but what you really need is a social worker to advocate for your mother and navigate you through this.
posted by fontophilic at 2:53 PM on October 20, 2010

Response by poster: Many thanks to you both.

I called the County and they told me that since she's technically disabled (though not yet certified), she qualifies for Medi-Cal. Her husband is taking her to the office this afternoon.
posted by geckoinpdx at 3:43 PM on October 20, 2010

Your mother needs my old ophtho:

James Aguayo Martel, MD

Martel Eye Medical Group
11216 Trinity River Dr, #H
Rancho Cordova, CA95670

(916) 635-6161

(916) 635-5145

I'll MeMail you. You want James, not Joe (his brother)-- insist on Jim.
posted by fairytale of los angeles at 4:46 PM on October 20, 2010

Glad to hear that, geckoinpdx.

You should be aware that Medi-Cal eligibility and SSI eligibility are often run by separate agencies, and if she qualifies for Medi-Cal because she's disabled there's a very, very good chance she'd qualify for SSI (or even SSDI, which is a similar program for disabled people who have some years of work experience paying payroll taxes). Signing up for SSI usually automatically enrolls you in Medi-Cal but I'm not sure the opposite is true, so you if she isn't getting signed up for SSI automatically you should encourage her to go to her local Social Security office and talk to someone there about whether she qualifies for SSI or SSDI.

My grandmother qualified for SSI in the last years of her life, after she was diagnosed with lung cancer, and it made a huge difference for her--she had a bit of extra money to help pay for utilities and food every month, which was a load off of her mind. As I said to her, she spent 50 years of her life working and paying into the system, and the whole point of mandatory disability insurance (which is part of what your payroll taxes are going to) is to be a safety net when you need it.
posted by iminurmefi at 8:52 AM on October 21, 2010

Response by poster: Additional for anyone still reading this;

She finally did the paperwork for CMISP/Medi-Cal but was told that it would take three to four weeks to be processed. That seems like a long time.

I'm making a few calls to the County today but appreciate any input, as always...
posted by geckoinpdx at 1:57 PM on October 26, 2010

« Older What are some good ideas to boost my income using...   |   Why are most of the colleges I'm finding for my... Newer »
This thread is closed to new comments.