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Disability Medicare


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9 replies to this topic

#1 truman

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Posted 09 August 2008 - 10:04 AM

I just received a letter from SSDI regarding a test program they are considering. It would allow recent disability benefit payees to get immediate Medicare in lieu of waiting for the two year period. They will be calling me next week for a 40 minute interview. The good news is that it would exit my nearly $800/month insurance premium but the bad news is that it's limit is $100,000. Since my last hospital stay was in excess of $50,000, one has to consider if it's worth participating in the program or just staying in COBRA and waiting until Medicare takes over in two years. If accepted into the program, it does not affect either your SS payment or future Medicare.

Word of note: My husband's cousin has Medicare through SSI and only one doctor in her plan was listed in our state; all others were in Staten Island. I hope this is not true of all their plans. She is also having difficulty getting her BP medication, as Medicare has written her brand off the list. Obviously in either event if this is any indication, those on Medicare must obtain a supplemental policy.

I'd appreciate your opinions.........
Tru

It is what it is...........

#2 Purr

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Posted 09 August 2008 - 11:56 AM

Linda,

I know absolutely nothing about medicare. After reading your post, you better believe I'm going to start doing some serious research. I'm sure you will too. If I learn anything important :huh: I'll let you know (and visa versa? (did I spell that right?)).

Christy
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#3 Sweet

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Posted 10 August 2008 - 11:10 AM

Hmmm this is very interesting. I'll keep a look out for a letter like that too. I wonder what their criteria is in selecting people. Having a $100,000 ceiling is a bit concerning, but for me it might be worth it. I wanted to clarify a couple of things. Can you accept it or refuse it? If you accept it, will you always have a $100,000 limit or will that change when the two year period is up?

I've scaled my insurance way back due to too high a premium, so for me it might be worth it. I have no medication coverage at this time and a very high deductible.

Keep us posted.
Warm and gentle hugs,

Pamela
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International Scleroderma Network (ISN)

#4 truman

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Posted 10 August 2008 - 11:50 AM

Sweet:

You can refuse it at no penalty and the $100,000 limit is only for this venture. Nothing else changes; not your payment or future Medicare. If you have no med coverage, check out the Walmart $4.00 prescriptions. I can email you their list. I think SSD is choosing the newest on their list and from what I read, it's the first 2,000. I'll know more tomorrow when I call.
Tru

It is what it is...........

#5 Peggy

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Posted 10 August 2008 - 12:48 PM

My only concern is this......................you are able to opt into the Medicare program and have 80% coverage, but will you also be able to opt into a supplemental to cover the other 20% now or deo you have to wait until you are actually eligible for Medicare? If so, great! The $100,000 limit is a little bit worrisome. I am assuming that the normal Medicare isn't restricted to $100,000 - is that right? Will you also be able to opt into a Medicare Part D right away too so you can have prescription coverage right away too?

Lots to think about............. but knowing you you will do your homework and will do your investigating before you make a decision.

warm hugs,

Peggy

#6 Sweet

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Posted 10 August 2008 - 01:12 PM

Hi Tru,

I am aware of the Walmart $4. program, but none of my meds are on it unfortunately!
Warm and gentle hugs,

Pamela
ISN Support Specialist
International Scleroderma Network (ISN)

#7 LisaBulman

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Posted 11 August 2008 - 04:11 AM

Tru,
This is very interesting. Keep in mind with any insurance there is an allowed amount on all claims. For example, your last hopsital stay was $50,000 but Medicare would only allow and pay (their agreed allowed amount with the hospital) which might be $10,000. The hospital would have to accept that as payment in full. Of course you would still be responsible for deductibles and copays if applicable. I took my daughter to the dr.'s two weeks ago. They charged my insurance $125.00. My insurance allowd $88.00 for the visit, less my copay of $20.00 so the insurance paid $66.00 and the difference between $125 and $88 is written off.

Make sure your dr.'s are part of medicare (I beleive the majority are) and definately ask about a supplement policy to fill in the gaps! You definately don't want to be left with huge bills to pay.

Hugs,
Lisa
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#8 truman

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Posted 11 August 2008 - 04:15 AM

Thanks for the info Lisa; all definitely good points :)
Tru

It is what it is...........

#9 truman

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Posted 11 August 2008 - 04:41 AM

SSD just called me for the interview. In order to be eligible, you have to have NO insurance coverage what so ever and then you may not qualify as they examine the group for other determinations (I'm assuming income). It never ceases to amaze me that because you do the right thing and carry insurance at an exhorbident premium which barely leaves enough money to carry other monthly expenses, we don't get benefits that are given to others. :blink:
Tru

It is what it is...........

#10 Sweet

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Posted 11 August 2008 - 06:13 AM

Hmmmm Well there goes that!

I'm with ya Tru - the system doesn't work the way it should.
Warm and gentle hugs,

Pamela
ISN Support Specialist
International Scleroderma Network (ISN)