Roughly 7 million low-income Medicare beneficiaries qualify for Medicare Savings Programs — which can cover Part B premiums entirely — but are not enrolled in them, according to KFF. For many of them, the gap isn’t eligibility. It’s awareness, paperwork, and exhaustion. Felicia Velasquez almost became one of those 7 million.
I first came across Felicia in a Facebook group called Alabama Retirees & Senior Support Network, where she had posted a short, matter-of-fact message in late November 2025. She wasn’t asking for sympathy. She listed three things that had happened to her that year — premiums doubled, rent up 30%, cosigned loan in default — and asked whether anyone had successfully applied for Medicaid at 65 while still working part-time. I sent her a direct message that evening. She responded within ten minutes.
When I sat down with Felicia Velasquez over a video call a week later, she had a yellow legal pad in front of her covered in handwritten numbers. She is 65 years old, single, with no dependents, and works part-time as a custodian at a Birmingham public elementary school. She has shared a two-bedroom apartment with a roommate for the past four years — an arrangement she described not as struggle, but as strategy. The legal pad, it turned out, was full of budgets she had already run and re-run.
The Year Three Things Broke at Once
Felicia had been managing fine — not comfortably, but fine — until 2025. She was working roughly 24 hours a week at $12.50 an hour, bringing in approximately $15,600 a year. Her health coverage through the school district had required her to work a minimum of 30 hours weekly. When her hours dropped below that threshold in early 2025 due to a restructuring in the custodial department, she lost her subsidized employer plan.
She moved onto a marketplace plan at $215 a month — manageable, barely. Then she turned 65 in September 2025 and transitioned to Medicare. Medicare Part B alone cost $185 a month. Adding a Medigap supplement plan to cover out-of-pocket costs brought her total to $430 a month. Her health coverage costs had essentially doubled in under a year.
Her rent had been $720 a month. At her October 2025 lease renewal, her landlord raised it to $936 — a 30% jump she had no leverage to negotiate. Her roommate split the cost, but even Felicia’s half grew by $108 a month. That same month, she learned her nephew had stopped making payments on a personal loan she had cosigned for him two years earlier. The remaining balance was $9,200. The lender was coming after her.
She wasn’t angry at her nephew when she said this — or if she was, she’d already processed it. What Felicia Velasquez is, at her core, is analytical. She had already calculated exactly how much damage each crisis was doing per month. She just needed to find what, if anything, could absorb some of it.
What Alabama’s Medicaid System Actually Offers at 65
Alabama has not expanded Medicaid under the Affordable Care Act, which means the program remains tightly restricted for working-age adults without disabilities. But at 65, with Medicare enrollment, a different pathway opens: the Medicare Savings Program (MSP), administered through Alabama Medicaid.
The MSP is not full Medicaid coverage. It is a set of four assistance categories that help low-income Medicare beneficiaries pay for premiums and cost-sharing. The two most relevant for someone in Felicia’s income range are:
- Qualified Medicare Beneficiary (QMB): For individuals with income at or below 100% of the Federal Poverty Level ($15,060/year for a single person in 2025). Covers Part A and Part B premiums, deductibles, and copays.
- Specified Low-Income Medicare Beneficiary (SLMB): For individuals with income between 100% and 120% FPL ($15,060–$18,072/year). Covers the Part B premium only — which is $185/month in 2025.
Felicia’s gross income of approximately $15,600 placed her just above the QMB threshold but squarely within the SLMB range. She did not know this when she posted in the Facebook group. She had assumed that because she was still technically employed, she wouldn’t qualify for anything.
The Application: Slower Than It Should Be
Felicia told me she submitted her SLMB application to the Alabama Medicaid Agency in late October 2025. The process required proof of Medicare enrollment, income documentation, proof of residency, and a completed application form. She had everything ready within a week.
The approval took eleven weeks.
“I called so many times in December I had the hold music memorized,” Felicia told me, with a dry laugh that carried more exhaustion than humor. “They kept saying it was processing. Nobody could tell me anything.” According to CMS guidelines, states are generally required to process MSP applications within 45 days. Alabama’s eleven-week turnaround on Felicia’s case exceeded that standard.
SNAP as a Second Line of Relief
While waiting on the Medicaid decision, Felicia also applied for SNAP benefits through the Alabama Department of Human Resources. At her income level, she fell well under the 130% FPL gross income threshold for SNAP eligibility — approximately $19,578 for a single-person household in fiscal year 2025, per USDA FNS.
She was approved within three weeks and began receiving $188 a month on an EBT card starting in November 2025. It wasn’t life-changing, but it was concrete. Her grocery budget, which had dropped to under $50 a week, stabilized.
“The SNAP application was actually straightforward compared to Medicaid,” Felicia said. “The DHR office near me had a worker who sat down with me and went through it step by step. That mattered.” She paused before adding, “I wish someone had done that with the Medicaid paperwork too.”
Where Things Stand — and What Still Hurts
When I followed up with Felicia in late March 2026, her situation had improved in measurable ways. The SLMB approval eliminated her $185 monthly Medicare Part B premium, effectively recouping that cost. Combined with her $188 in monthly SNAP, she had recovered roughly $373 a month compared to her lowest point in October 2025.
She still pays $245 a month for her Medigap supplement plan, which SLMB does not cover. She still pays $187 a month toward the cosigned loan. The rent remains at $936, with her half sitting at $468. Her budget is functional now — tightly, provisionally functional.
The cosigned loan is the wound that hasn’t closed. Her nephew has not resumed payments. She does not want to discuss legal remedies against him. “That’s my family,” she said quietly. “I made the choice. I’ll figure it out.” It was the one moment in our conversation where her analytical composure softened into something more complicated.
Felicia Velasquez is still mopping floors at an elementary school in Birmingham three mornings a week. She says she has no plans to stop. Not because she needs the money alone, but because she says the routine keeps her grounded. The children wave at her in the hallways. She knows all their names.
Her legal pad still sits on the kitchen table. The numbers change monthly, she told me, but the habit of writing them down does not. For a woman who has spent a year being blindsided by costs she didn’t see coming, that legal pad represents the only kind of control she has left — watching, carefully, what comes next.
Related: She Retired from USPS at 33 With a Spine Condition — Then Her Health Insurance Bill Hit $612 a Month
Related: The IRS Deadline in 2026 That Could Cost You Thousands in Unclaimed Economic Relief
Leave a Reply