Colleen’s mother Maureen was abruptly dropped from her Medicare drug plan because of an error regarding her change of address several years before, and her essential medications were no longer covered. Maureen, who has a limited income, was forced to pay out of pocket for the costly prescriptions she desperately needs.
A Medicare Rights counselor worked persistently with Maureen’s drug plan and Medicare to fix the problem and make sure her drug coverage was reinstated. Medicare Rights also ensured that Ms. M was reimbursed for the out-of-pocket costs she paid when she was left without coverage. Finally, her counselor helped her enroll in assistance programs for people with low incomes that help pay health care and prescription drug costs.
“Medicare Rights makes the world a better place. They can literally save people’s lives.” – Maureen’s daughter Colleen, New York, NY
Erika, a hardworking mom, and her 14-year-old son T were referred to Medicare Rights for help accessing T’s life-saving prescription drugs. Erika was paying out of pocket for her son’s vital medications prescribed to prevent rejection of his transplanted kidney, as she was hitting roadblocks when trying to enroll him in Medicare.
Medicare Rights worked with Erika to help T enroll into Medicare and gain coverage for his medications. T was also eligible for an assistance program, which lowered the high out-of-pocket costs of his prescriptions as well as ongoing care related to his End-Stage Renal Disease (ESRD). Through the diligent advocacy of Medicare Rights, working with T’s health care providers and government agencies, the family now has peace of mind knowing that T is getting his necessary care.
“Thanks to the Medicare Rights Center, I’m confident my son will get the critical treatment and medications he needs to stay well following his transplant operation. Their dedicated counselor made sure that he got the Medicare benefits he was entitled to receive and now we don’t have to worry about paying the high out-of-pocket costs. Thank you for all that you do!” – Erika, Mechanicville, NY
Christine, who suffers from early stages of dementia, called Medicare Rights’ helpline overwhelmed by threatening letters that she was getting from a diagnostic center about a complicated billing issue. Medicare Rights helped resolve the problem, and in the end, Christine’s plan covered the bill, and she was not responsible for paying out of pocket for the care she needed.
“Because of the Medicare Rights Center, my medical billing issue was resolved. I was sick over this and could not have done it on my own. Thank you from the bottom of my heart.” – Christine, Selden, NY
Michael, a 65-year old man with cancer, called the Medicare Rights Center because he couldn’t afford his medications. Michael had received a notice saying he had lost his Extra Help, a benefit that helps people with low incomes pay for their Medicare drug coverage and prescriptions. Fortunately, Michael’s Medicare Rights counselor was able to get his benefit restored so he could continue with his cancer treatments.
“Now I don’t worry about how I am going to access or afford my medications; I sleep well knowing I have the benefit Medicare Rights helped me receive.” – Michael, Lake Ronkonkoma, NY
When Estelle called Medicare Rights’ helpline, she was upset and at a loss after her Medicare drug plan kept billing her for $8,000 that she did not owe. The out-of-pocket costs of her medications had already been covered by Extra Help, a Medicare prescription drug assistance program for people with low incomes. However, Social Security mistakenly dropped her from the program going back the full six years that she was enrolled.
A Medicare Rights counselor advocated tirelessly on Estelle’s behalf and, after several months of communication with multiple offices and government agencies, Social Security finally corrected their mistake. The drug plan stopped billing Estelle, and she did not have to pay anything for her prescriptions for all the years she was rightly enrolled in the Extra Help program.
“There was no way I could ever have paid this bill, and I have enough to worry about while living on a fixed income and dealing with Multiple Sclerosis. I can’t say enough about how grateful I am to the Medicare Rights Center. There really are good people out there.”
– Estelle, Baltimore, MD
As an 80-year-old retired flamenco instructor, Barrie was used to leading an active lifestyle. That changed when he developed a condition which affected his inner ears—he found himself no longer able to dance or to work. Then, he lost his employer health coverage.
Barrie called the Medicare Rights Center to learn about his Medicare coverage and affordability options. One of Medicare Rights’ counselors worked with him to help him enroll in programs that pay a portion of his premiums and deductibles, as well as lower his out-of-pocket costs for prescription medications.
“Medicare Rights was really the gateway to my understanding of Medicare. They helped me understand things that were so complex to me, and without Medicare I would have been lost.” – Barrie, New York, NY
Rose, a 66-year-old Florida resident, called Medicare Rights because she was provided a power wheelchair that she was unable to use. She needed repairs on her the wheelchair she owned, so her supplier provided a replacement, but it was much too big for her and difficult to maneuver. Rose told her counselor at Medicare Rights that the replacement chair was preventing her from doing everyday activities at home and spending time with her neighbors. Rose’s counselor advocated on her behalf to the equipment supplier and helped her secure a suitable replacement chair, which allowed Rose to resume her everyday life again.
“You don’t have to sit here and just feel like a nonperson. You got people that will fight for you.” – Rose, Plant City, FL
When Elana called the Medicare Rights Center, she was losing her health coverage and had been misinformed about when and how to enroll in Medicare. Elana was facing a delay in getting coverage—devastating for anyone, but especially so for Elana, who suffers from lupus and a number of other debilitating health issues and needs access to critical, lifesaving medical equipment. Her Medicare Rights counselor worked with the Social Security office and was able to help Elana enroll in Medicare.
“When no one would help me, when there was no place to turn, Medicare Rights was my champion. I am truly grateful for all their time, effort, caring, and professionalism, and not giving up giving up—as other agencies did.” – Elana, Hewlett, NY
While undergoing treatment for cancer, Michael was forced to cancel his radiation therapy when a Medicare processing error left him without health care coverage. When he called the Medicare Rights Center, a counselor helped him resolve the problem and get the critical treatment he needed.
“There’s an old saying that goes, ‘When one door closes, another one will open.’ In my case, when my Medicare coverage was cancelled in error, I ended up knocking on dozens of doors, trying to resolve the problem on my own . . . with no success. When I contacted Medicare Rights, all it took was one single ‘knock’ and the door was opened. The unusually high quality of their customer service resulted in the recent re-instatement of my coverage.” – Michael, Daytona Beach, FL
Peter, who lives on a limited income, feared that he was going to have to choose between paying his rent or Medicare premiums until the Medicare Rights Center helped him enroll in cost-saving benefits that allowed him to access the affordable health care he needed.
“Medicare Rights worked tirelessly to help me as they have done for countless others. You can turn to The Medicare Rights Center with the feeling that they will fight tooth and nail to help you get the benefits you need.” – Peter, Bronx, NY
When William first called Medicare Rights’ helpline, he was desperate for help. Due to misinformation he had received about when and how to enroll in Medicare Part B, he had medical bills totaling over $300,000 and no medical insurance to cover his treatment for an incurable form of cancer. He had mistakenly thought his retiree insurance was his primary health coverage, until the insurance plan informed him otherwise—a year later.
A Medicare Rights counselor worked with the Social Security office, and through a special relief opportunity, was able to help William receive retroactive Part B coverage that would pay his medical expenses for the previous year and his cancer treatments going forward.
“The Medicare Rights Center is a fantastic organization. They were the only ones who were able to help me get the Medicare coverage I needed to keep me alive.” – William, Punta Gorda, FL
Medicaid is a vital program that provides health security for many Americans, including 11 million low-income people with both Medicare and Medicaid, like Ti. Ann was Ti’s partner and his caregiver, and their story is one of love and caring—but also one filled with advocacy, on Ann’s part, to preserve the Medicaid program, without which she and Ti could not survive.
Medicare Rights helped Ann and thousands of others who depend on Medicaid to raise their voices against these proposals, so their voices could be joined with millions more. It is stories like this one that will help Medicare Rights continue to protect the care of older adults and people with disabilities now and in the future.
“Medicare Rights has it boots on the ground—listening to, learning from, and advocating for all Medicare/Medicaid recipients. Their very critical policy leadership takes its lead from the needs of the grassroots users of services.” – Ann, New York, NY
Regina, a 97-year-old New Yorker, turned to the Medicare Rights Center when she was having trouble obtaining necessary home care services. While Medicare Rights answered Regina’s home care questions, her counselor also determined that she was eligible for two assistance programs: Extra Help, which helps meet the cost of her prescriptions, and a Medicare Savings Program, which covers her Part B premium.
“I was paying a fortune for eye drops to treat my macular degeneration. My Medicare Rights counselor helped me apply for Extra Help, and now I’m paying much less. It has been such a lifesaver since I take so many medications.” – Regina, New York, NY
Monet was anxious about her transition to Medicare. She became eligible due to disability and contacted Medicare Rights for help navigating her coverage options. Ms. H’s counselor helped her choose a prescription drug plan that would cover her specialty medications, as well as a Medicare supplement to help with cost sharing.
“I was overwhelmed with the different options for my Medicare coverage, and the Medicare Rights Center assisted me with the best coverage for my needs. I am so grateful to Medicare Rights.” – Monet, Brooklyn, NY
Erma was prescribed a hospital bed by her doctor to help her recover from open heart surgery. A year later, she started getting alarming calls from the medical supplier saying that the bed wasn’t paid for, so they were coming to take it away. Her Medicare Rights counselor was a persistent advocate, communicating with Medicare and Erma’s plan to make sure the plan representatives were investigating the problem. After weeks of uncertainty and receiving distressing phone calls from the supplier, Erma was finally notified and relieved to hear that the bed was rightfully hers.
“I was appointed a wonderful counselor who worked tireless hours until my problem was solved. If you have a problem you can’t solve, contact the Medicare Rights Center. They will work hard on your behalf. I would like to give thanks to them for a job well done.” – Erma, Miami Gardens, FL
A few months before Sandra was planning to retire, she called Social Security to ask about her Medicare enrollment and received misinformation about when she should enroll in Medicare Part B. When Sandra followed these instructions and tried to enroll in Part B, she was told she was ineligible. After contacting the Medicare Rights Center, Sandra was guided through the equitable relief process, which gives people who were misinformed by a federal employee an opportunity to enroll in Medicare. Sandra was finally enrolled in Part B, and felt secure knowing she no longer needed to worry about not having health coverage.
“Essentially, with the assistance of the Medicare Rights Center, what had been a terrible nightmare had resolved itself in a very pleasant dream. I could relax, I had coverage, and I did not have to be anxious. I cannot express deeply enough how much I appreciate the extraordinary assistance that the Medicare Rights Center gave me.” – Sandra, New York, NY
Charlotte was sent a bill for $8,000 after an emergency room visit. She tried communicating with her Medicare Advantage plan and the hospital, but neither would straighten out the issue. While her plan agreed she should only owe a small copay, Charlotte kept receiving bills from the hospital. A Medicare Rights counselor advocated on her behalf to her plan and the hospital billing department, and the issue was finally resolved with Charlotte owing none of the $8,000 cost she was incorrectly billed.
“What my counselor did for me causes me to see her as a friend. Each time she called me, it made me feel as though someone cared. She listened, she gave me advice and went overboard to help me. Her professionalism and compassion will never be forgotten. Thank you!” – Charlotte, Las Vegas, CA
Murali left work due to disability and was covered by a disability plan through that employer. Years later, the employer plan suddenly stopped paying primary for his health care due to a coordination of benefits problem, leaving Murali without primary health insurance. Medicare Rights helped Murali enroll in Medicare Part B through a special relief process for disabled individuals, ensuring he had no gaps in coverage or penalties and could continue the care he needed.
“It was an absolute pleasure to work with the Medicare Rights Center. They are very competent, courteous, helpful and above all very compassionate towards my concerns. They were always there with quick responses and guiding me every step of the way in navigating the complex and confusing world of Medicare rules and resolving my case successfully.” – Murali, Frisco, TX
Samantha’s son, who has Medicare due to disability and Medicaid, was abruptly dropped from his Medicaid and Medicare Savings Program benefits, which allowed him to afford essential health care. A Medicare Rights counselor worked with Samantha and her family, communicating with the necessary New York government agencies, to ensure Samantha’s son was placed back on the Medicaid program retroactively and was reimbursed for the out-of-pocket costs he had struggled to afford.
“When I called the Medicare Rights Center, I discovered a warm, caring, knowledgeable person. We hope that we will not need the services of Medicare Rights again, but it is wonderful to know that such a group exists to serve those who often cannot assist themselves.” – Samantha, Schenectady, NY
Ramona received a bill of nearly $500 for a critical medication. She could not afford to pay the cost out of pocket and believed her drug plan and assistance program would cover the cost. When Ramona contacted the Medicare Rights Center, her counselor communicated with the assistance program, the Medicare drug plan, and the billing company to have the bill corrected, and Ramona did not owe any balance for her necessary, high-cost drug.
“Every person I have spoken to over the last six or seven months has been courteous and persistent in their attempts to help me. I heartily thank Medicare Rights for their excellent, generous, and very necessary work.” – Ramona, White Plains, NY
Grace was facing roadblocks when trying to enroll her young adult son, who has End-Stage Renal Disease (ESRD), in Medicare. Grace’s son needed Medicare to get coverage for a crucial kidney transplant. With the help of the Medicare Rights Center’s advocacy, Grace’s son was successfully enrolled in Medicare for people with ESRD, enabling him to receive his necessary transplant and ongoing ESRD-related care.
“Medicare Rights folks do their work with heart, with empathy, with compassion. Thank you Medicare Rights Center!” – Grace, New York, NY
Stephanie experienced confusion about Medicare enrollment and coverage options when transitioning from employer health coverage to Medicare, as many people do. After speaking with one of Medicare Rights’ counselors about her choices, she was able to make informed decisions about the timing of her enrollment, her drug coverage, and her Medigap plan and felt secure in her health care going forward.
“Thanks so much to the Medicare Rights Center for your help with my Medicare enrollment.” – Stephanie, New York, NY
Tara, who has terminal cancer, delayed enrollment into Medicare Part B because of misinformation from her employer that COBRA would become her coverage when she left her job. Tara continued her cancer treatments without Medicare coverage until COBRA stopped paying. Tara was left without health insurance, thousands of dollars in medical bills, and providers who were going to cut off her treatment because she didn’t have coverage. Luckily, Tara was able to use a special enrollment period for individuals with disabilities and, after months of advocacy with Medicare Rights’ assistance, received Medicare Part B to cover her critical cancer treatments.
“When I found myself in a difficult and confusing situation, turning to the Medicare Rights Center was the best move I could have made. Medicare Rights provided detailed guidance and support, with people there helping to find a solution. I could not have managed without Medicare Rights.” – Tara, Trenton, NJ
Matthew applied for the Medicare Savings Program (MSP), an assistance program for people with low incomes that helps pay for Medicare costs. Matthew received a notice that he was approved for the MSP, but his Medicare Part B premiums continued to be deducted from his limited income every month. With Medicare Rights’ advocacy on Matthew’s behalf, the necessary state agency corrected the issue, and Matthew was able to access his needed health care without worrying about unaffordable costs.
“Medicare Rights resolved my problem right away. It’s a great organization with great people.” – Matthew, New Rochelle, NY
Erica was having trouble navigating the rules of Medicare enrollment and its coordination of benefits with other insurance, like COBRA, before her retirement. After receiving incorrect information from her employer, she called Medicare Rights’ helpline. Erica’s counselor explained the guidelines of Medicare enrollment, as well as Erica’s options for drug coverage and supplemental health plans. With this knowledge, Erica could make educated decisions about her health care during this often stressful transition.
“Thank you seems insufficient—Medicare Rights has helped me sleep more easily and allowed me to move on to retirement knowing I have made the right Medicare-related decisions. I am so very grateful that your organization exists and is staffed by knowledgeable, patient, and wonderful people.” – Erica, Verona, NJ
Ian contacted the Medicare Rights Center because he realized he needed Medicare coverage but could not afford it. He did not enroll in Medicare when he became eligible due to the costs. Medicare Rights determined that Ian’s low income qualified him for a Medicare Savings Program that would pay both his Part A and B premiums; eliminate his late enrollment penalty; and pay his Medicare deductibles, coinsurances, and co-pays, providing him with the affordable coverage he needs.
“I am very thankful for the Medicare Rights Center’s assistance in enrolling in Medicare and applying for the Medicare Savings Program so I can afford my Medicare. The staff members that helped me put in an enormous amount of work and were dedicated to providing the personalized assistance I needed. Because of the Medicare Rights Center’s efforts, I now have the insurance I need to stay healthy.” – Ian, New York, NY
Mary received misinformation from a Medicare Advantage plan representative that caused her to delay enrollment and miss her chance to switch plans during Medicare’s open enrollment period. Mary contacted the Medicare Rights Center’s helpline, and her counselor advised her that she was eligible to request a special enrollment period to change plans, as she had received misleading information from a plan representative. Mary used Medicare Rights’ advice to advocate for herself, and her transition to a new plan that better suited her health care needs and covered all of her medications was processed seamlessly.
“All I had to do was call your office and go from there. The staff at the Medicare Rights Center went to bat for me. You’re doing a great job and more people need to know about your organization.” – Mary, Athens, GA
Beth went to a new physical therapist to help treat her stage 4 cancer. She was billed a $40 copay and was supposed to receive a total of 10 sessions. Beth is enrolled in a Medicare Savings Program that covers her cost sharing, and could not afford the $400 on her fixed income. When Beth called the Medicare Rights Center, her counselor helped her communicate with her plan, informing them that Beth is protected from cost-sharing due to this low-income assistance program. Beth was no longer billed by her physical therapist, and she was able to continue her critical treatments.
“Thank you so much for helping me. You were so nice and caring for calling my plan with me.” – Beth, Syracuse, NY
Phoebe delayed enrollment in Medicare because she received misinformation that she was not eligible when she first tried to enroll. When Phoebe contacted Medicare Rights, she was facing a late enrollment penalty that would cost her hundreds of dollars each year for the rest of her life. With Medicare Rights’ assistance, Phoebe successfully applied for a relief opportunity that waived her penalty.
“I was facing a two-year penalty when I enrolled in Medicare because I received misinformation when I applied two years before. Thanks to Medicare Rights, I have not been penalized. I could not have done this on my own.” – Phoebe, Buffalo, NY
William was overwhelmed when he learned his mother would be discharged from the hospital after a fall. He wanted to make sure he was choosing the right skilled nursing facility (SNF) for his mother’s needs, but only had 24 hours before the discharge. A Medicare Rights counselor explained Medicare coverage rules for SNFs, how to choose a facility, and how the facilities are rated for quality. With Medicare Rights’ assistance, William was able to confirm that his mother qualified for SNF care, select a quality facility, and ensure his mother had a smooth discharge.
“My mother was being discharged from the hospital, and I needed to find her a skilled nursing facility. I really had no idea where to begin and didn’t have the ability to do research beforehand. My counselor explained everything to me and helped me understand the rating systems for these facilities. Now my mom is getting the care she needs.” – William, New York, NY