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Terri Esselman, EBS of Clark County, helped a client negotiate a $10 per month repayment plan with SSA for an SSI overpayment. The client was incarcerated, and had incurred an SSI overpayment totaling over $2,000. The client did not deny that he was overpaid, and did not want to request a reconsideration or waiver. Instead, he just wanted to reduce his monthly repayment amount so SSA would not take his full checks. At first, SSA told the client the lowest amount they could accept was what could be repaid over 12 months, then they said 36 months. However, Terri was able to use the POMS rule that a person receiving LIS (Part D Low Income Subsidy) qualifies for a repayment amount as low as $10 per month. After educating SSA about this policy, he was granted this repayment amount and can now pay it off slowly over time as he re-enters the community post-incarceration.
8/31/2023
Story #104
Tiffany also assisted a 66-year-old client who was referred in May because she was terminated from her job and was unable to afford the high cost of Trulicity, a new drug her doctor prescribed for her diabetes. The client was enrolled in SeniorCare Level 2B but did not have funds to pay the $850 deductible. Because of her loss of income, Tiffany helped her successfully apply for the Qualified Medicare Beneficiary (QMB) Program in May, and her benefits became effective June 1st. Meanwhile, Tiffany also assisted her with an application for Social Security retirement benefits. Due to this new source of income, her QMB enrollment will only last for one month. However, as a result of having been enrolled in the QMB program, she will have full Extra Help/Low-Income Subsidy (LIS) for the rest of the year. The client was finally able to fill her prescription and she paid the $10.35 co-pay under LIS. Fortunately, she was offered a job which starts next month. The client is very pleased with the assistance she received from Tiffany during a very stressful time in her life.
Monetary Impact = $850
6/1/2023
Story #88