In History: Medicare and Medicaid Celebrates the 55th Anniversary

On July 30, 1965, Medicare and Medicaid programs were establish when President Lyndon B. Johnson signed the legislation them into law. This year marks the 55th anniversary of these important healthcare programs and they have continued to protect the health and well-being of millions of families, saving lives, and improving the economic security in the United States.

To learn more about Medicare and Medicaid in San Francisco follow this link: https://www.cms.gov/media/405741

Resources:

https://www.medicareresources.org/basic-medicare-information/brief-history-of-medicare/

COVID-19 ADAP Update from the California Department of Public Health Office of AIDS

  • For all participants whose enrollment expired or was set to expire before August 30, 2020
    • ADAP & PrEP-AP has extended eligibility to August 31, 2020
  • OA-HIPP, EB-HIPP & MDPP enrollments have been extended through September 30, 2020
  • New ADAP applicants can reach out by phone or email to an enrollment worker
  • If you are having difficulty finding an enrollment worker, call 844-421-7050 for assistance
  • Until July 15, 2020, applicants can provide their 2018 tax returns as proof of income for program eligibility

How to Qualify for Social Security Disability Benefits With HIV/AIDS

If you have HIV or AIDS, and your symptoms have advanced and made it impossible for you to work and earn a living, you may qualify for Social Security Disability benefits. The Social Security Administration (SSA) oversees two different disability programs that offer monthly benefits to disabled workers. A medical guide, which is called the Blue Book, is used to determine if an individual meets the medical criteria to qualify for disability benefits. There are several listings in the Blue Book that may apply to an HIV or AIDS diagnosis, but there is a specific listing that focuses on the condition itself.

Meeting the Medical Criteria

Section 14.00 of the Blue Book applies to adult immune system disorders. Listing 14.11 itself applies to HIV infection itself. To qualify using this listing, you must provide documentation to confirm your diagnosis, and you must also be able to prove one of the following:

  • Multicentric Castleman disease that affects multiple groups of organs containing lymphoid tissue or lymph nodes OR
  • Primary effusion lymphoma OR
  • Progressive multifocal leukoencephalolopathy OR
  • Primary central nervous system lymphoma OR
  • Pulmonary Kaposi sarcoma OR
  • Absolute CD4 count of 50 cells/mm3 or less OR
  • Absolute CD4 count of less than 200 cells/mm3 or CD4 percentage of less than 14 percent, and one of the following – BMI measurement of less than 18.5, hemoglobin measurement of less than 8.0 grams per deciliter, or complications of HIV infection requiring a minimum of three hospitalizations within a 12-month period at least 30 days apart with each hospitalization lasting no less than 48 hours.

For your claim to be successful, you must provide hard medical evidence that includes test results and different laboratory tests that confirm your diagnosis and that support your claim. Any opportunistic diseases that you have been diagnosed with should have indications of a cell-mediated immunity and should have been diagnosed by the proper testing. As an example, provide biopsy results for any cancer diagnosis and biopsy results for toxoplasmosis of the brain. You should provide detailed records that confirm any systems, restrictions, and limitations, such as headaches, fever, brain lesions, and seizures.

Even if your diagnosis does not meet any of the specific Listings set out above, you can still be found disabled if you can show that your impairment prevents you from being able to perform the functions of your past relevant work or other full time work.

Medical tests, including positive serology tests, should be provided to help confirm the diagnosis and its severity. Some blood tests, including CD4 tests, aren’t adequate for confirming a diagnosis of HIV or AIDS. Remember, hard medical evidence and supporting documentation are essential for a disability claim to be successful.

Applying for Disability Benefits

If you are unable to work because of HIV or AIDS, or because of an opportunistic disease resulting from either of those conditions, you should apply for Social Security Disability benefits. You can start your application process online at the SSA’s website or by calling 1-800-772-1213 and talking with a representative or by scheduling an appointment at your local SSA field office. While it sometimes takes months for a claim to be approved, the more documentation that you provide to support your claim, the more likely you are to get an approval and be awarded disability benefits.

Resources:

https://www.disability-benefits-help.org/social-security-disability-locations/

https://www.ssa.gov/disability/

https://www.ssa.gov/disability/professionals/bluebook/14.00-Immune-Adult.htm

https://www.ssa.gov/disability/professionals/bluebook/14.00-Immune-Adult.htm#14_11

https://www.disability-benefits-help.org/glossary/social-security-disability-medical-sources

https://www.ssa.gov/applyfordisability/

Check out the new ADAP Client Portal!

On September 3, 2019, the California Department of Public Health, Office of AIDS released the AIDS Drug Assistance Program (ADAP) Client portal.

Using the portal, clients enrolled in ADAP can:

  • View their client ID, enrollment site, enrollment worker contact information, eligibility status, and eligibility end date
  • View the Insurance Assistance Program information if enrolled, including program type (OA-HIPP, EB-HIPP, or MDPP), insurance carrier, eligibility status, and eligibility end date
  • Elect to receive automatic notifications about eligibility and re-enrollment
  • Recertify if there are no changes to residency or health insurance and annual household income is within program limits

To request access to the Client Portal, contact the ADAP Call Center at 1-844-421-7050, Monday-Friday, 8:00 AM – 5:00 PM. After requesting access, the client will receive an email with a URL to the client portal. Using the link, the client will enter their email address as the username and a temporary password, and then be prompted to create a new password. Contact the ADAP Call Center, with any issues accessing the Client Portal.

For more information about ADAP, go to California Department of Health Office of AIDS webpage.

If you are interested in ADAP and not yet enrolled, contact an ADAP Enrollment Worker to apply. To find an Enrollment Worker in your area, go to ADAP Enrollment Site Locator.

SSI Recipients Can Now Receive CalFresh Benefits

Beginning in June 2019, California residents receiving Supplemental Security Income (SSI) who also receive a State Supplementary Payment (SSP) can get CalFresh benefits.

The SSP program was intended to replace the Food Stamp program (now known as CalFresh in California) for SSI beneficiaries when it was implemented in 1974. Over the years, the SSP benefit has remained relatively stable, while CalFresh benefits have increased to reflect inflation. Given the relative loss of value of SSP benefits, the California legislature passed Assembly Bill 1811 to allow SSI/SSP recipients also to receive CalFresh benefits.

This means more opportunities for SSI/SSP beneficiaries to purchase nutritious food

CalFresh is a free nutrition assistance program that enhances the food budgets of low-income individuals. Monthly CalFresh benefits range between $15 to $192 based on household size, income, and monthly expenses. SSI/SSP recipients can apply for CalFresh benefits to purchase food at vendors who accept EBT such as grocery stores, farmers markets participating in the Market Match, and restaurants participating in the Restaurant Meals Program (View Map). SSI/SSP beneficiaries who receive CalFresh will have no reduction to their SSI/SSP payment.

Assembly Bill 1811 also resulted in a monthly grant increase of $10 for recipients of the Cash Assistance Program for Immigrants (CAPI) so that SSI/SSP benefits and CAPI benefits are equal. CAPI beneficiaries will remain eligible for CalFresh benefits.

Households already receiving CalFresh who had an excluded SSI beneficiary may receive an increase to their CalFresh benefits. However, this change will increase the overall income for some households as SSI/SSP income will no longer be excluded, which may cause a reduction in the monthly CalFresh grant. For those households who would experience a reduction in CalFresh Benefits, the Supplemental Nutrition Benefit (SNB) and Transitional Nutrition Benefit (TNB) programs will provide additional benefits to avoid any reduction to overall nutrition benefits.

There are three ways to apply

Each applicant may need to provide proof of income, residency, and identity. HSA may be able to help with obtaining these required documents. Learn more about benefits and eligibility.

NOTE: Due to the high volume of new applicants, applicants may experience extended wait times at HSA service centers and by phone in June and July 2019. Consider applying online or call (415) 558-4700 to schedule an in-person appointment.