I Met Theresa at a Pharmacy Counter. Her $1,580 SSDI Check Covers Less Every Single Year.

The pharmacist was patient, I’ll give her that. She walked Theresa Reeves through the GoodRx options twice, then pulled up a manufacturer coupon on a tablet, angling the screen so Theresa could read it. Theresa nodded slowly, the way someone nods when they’ve stopped being surprised by any number on any screen. I was waiting for a refill two spots behind her in line at a Walgreens on New Bern Avenue in Raleigh, North Carolina, on a Tuesday afternoon in February 2026.

I introduced myself after she stepped aside. She looked at my notepad and said, with something close to a shrug, “Sure. Why not. It’s not like the situation is a secret.”

A Benefit Check That Arrives on Time but Still Runs Short

When I sat down with Theresa Reeves a week later at a diner near her apartment, she pulled out her phone and showed me her most recent SSA deposit notification without me asking. The direct deposit hit on the third Wednesday of January 2026 — $1,580.42 after Medicare Part B premium deductions. That is her entire monthly income from Social Security Disability Insurance, the program she qualified for in late 2022 after a degenerative spine condition made sustained physical work increasingly unreliable.

She still works when she can. She picks up shifts as a machine operator at a mid-size manufacturing facility outside Raleigh — roughly 18 to 22 hours a week, carefully tracked to stay beneath the SSA’s Substantial Gainful Activity threshold, which sits at $1,550 per month for non-blind SSDI recipients in 2026. Those factory shifts add another $610 to $720 most months, but they are not guaranteed, and in the two months before I met her, a flare-up had cut that factory income nearly in half.

Theresa’s fixed monthly expenses — her $680 share of rent split with a roommate, the Medicare Part B premium of $185 (already deducted from her check), out-of-pocket prescription costs of roughly $310, utilities, and a minimum payment on $28,400 in remaining student loan debt from a graduate program in public administration she completed in 2017 — come to approximately $1,810 on a lean month. The SSDI check covers $1,580 of that. The gap is not abstract. It is $230, recurring, every month, filled by factory shifts when her spine cooperates.

What the COLA Actually Looked Like in Her Bank Account

The Social Security Administration applied a 2.5 percent Cost-of-Living Adjustment to benefits beginning January 2025. For Theresa, who was receiving approximately $1,544 per month at that point after deductions, the adjustment translated to a gross increase of roughly $38.60. After the corresponding uptick in her Medicare Part B premium — which also adjusts annually — her net take-home increase was closer to $22.

She remembers opening the SSA notification letter that October 2024. “I actually laughed,” she told me, stirring her coffee. “Not because it was funny. Just because — what else do you do? Twenty-two dollars. My copay for one of my medications went up thirty dollars in the same month.”

The COLA formula is based on the Consumer Price Index for Urban Wage Earners and Clerical Workers, known as CPI-W, measured during the third quarter of the previous year. Critics have long argued — and SSA’s own historical data makes visible — that the CPI-W does not weight healthcare and prescription costs the way older and disabled beneficiaries actually spend money. For Theresa, that gap between the formula and her reality is not a policy abstraction. It is the pharmacy counter on New Bern Avenue.

The Graduate Degree That Didn’t Change the Math

Theresa spent four years working toward a master’s degree in public administration at a mid-tier university in North Carolina, finishing in 2017 at age 51. She borrowed $34,000 in federal graduate loans to do it, believing — and she was not wrong, at the time — that the credential would open doors in local government or nonprofit administration. She got one offer, at a county agency, paying $41,000 a year. She took it.

By 2019, chronic back pain that had started as an occasional nuisance had become structural. By 2021, she was cycling through FMLA leave and doctor’s visits. She left the county job in early 2022. Her SSDI application, filed in March 2022, was denied the first time. The approval came fourteen months later, in May 2023, backdated to her established onset date — but the backpay calculation, she said, was complicated by her part-time factory work during the waiting period.

The student loans remain. She is on an income-driven repayment plan, and her current monthly minimum is $147. “I have a master’s degree and I’m 60 years old and I’m still paying for school,” she said, not with anger, just with a flatness that felt heavier than anger. “I don’t even think about the degree anymore. It doesn’t connect to anything in my life right now.”

The Pharmacy Visit, and What Came After

The prescription she was asking about at the Walgreens that Tuesday was a muscle relaxant she takes during flare-ups — not a daily medication, but one she needs reliably when the pain peaks. Her Medicare Part D plan covers part of it. After the plan’s cost-sharing, she was looking at $94 for a thirty-day supply. The GoodRx price the pharmacist found was $61. She chose the GoodRx route, which meant paying out of pocket and the purchase not counting toward her Part D deductible.

“I’ve gotten good at the math,” she told me. “Which version of paying is least bad this month. That’s basically a skill I have now.”

She has applied for the Medicare Extra Help program — formally called the Low Income Subsidy — which assists with Part D premiums and cost-sharing for beneficiaries below certain income thresholds. Her application was pending at the time of our conversation. She has also contacted a local nonprofit that assists beneficiaries in navigating pharmaceutical manufacturer assistance programs for two of her three regular medications.

Going Through the Motions, Month After Month

I asked Theresa whether the financial stress still registers the way it used to. She took a moment before answering, and I thought she was going to say something about resilience, the way people sometimes do when they’ve found a way to reframe difficulty. She didn’t.

“I think I just stopped feeling it like a crisis,” she said. “It’s not that things got better. It’s that this is just what my life is. You adjust your expectations down and down until the floor is wherever you’re standing.”

She is five years from full Social Security retirement age under current rules, though her SSDI will convert automatically to retirement benefits at that point. She is not counting on that transition to change much. “The number might shift a little,” she told me, “but the math won’t.”

Her Extra Help application was still pending when I followed up with her in March 2026. She had received one manufacturer coupon approval — for a blood pressure medication — which reduced that copay from $58 to $12 per month. The other two applications were waiting on documentation. She appreciated the savings, she said, in the same flat tone she’d used throughout our conversations: not grateful exactly, just noting that $46 a month is $46 a month, and she would take it.

Driving back from that second meeting, I kept thinking about the pharmacist on New Bern Avenue — patient, methodical, turning the tablet screen toward a 60-year-old woman who has a graduate degree and a degenerative spine and a benefit check that lands like clockwork every third Wednesday. The check arrives. The bills arrive. The gap between them has a name now: $230. And Theresa Reeves has gotten very, very good at living inside it.

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