An example of how I supposedly have and don't have medical coverage

I hope the recent reforms change this, because right now at the same
time I do and don't have medical coverage. Here's how it works:

Because of my disability, I have Medicare A and B. The Part B premium is
covered by state Medicaid under a thingy called QMBY, so there's no
deduction out of my disability check. However, I do not get Medicaid per
se unless I spend $60 of my own money, while at the same time I have to
deal with Medicare deductibles.

So what this means is if I wanted to get a new pair of glasses, I would
have to spend $60 on the process of getting one and then have the rest
billed to Medicaid. This is what is known as a Spend Down rule. This
sort of thing likely also applies if I need counseling and the like.

What's messed up about this is that I can't exactly afford $60 out of my
pocket every month. I'm barely covering my obligations for the month.
Getting some steady work might help. I wonder what my mom would have
said if she saw how different things are for me. She never had to pay
anything out of her pocket, but then her disability check was just a bit
less than that I get. It's not fair I get screwed.

So while yes, I have Medicare A and B for what they're supposed to
cover, I might as well not have anything anyway because of what I have
to go through to use it. It's not worth my time to figure it out. It's
too confusing.

I hope the health care reforms eliminate the need for a "spend down" as
well as deductibles for what I'm supposed to have.