Medicare

[beej]

Tis true, in my state there are few specialists that take Medicare OR Medicaid!  I live in the 5th largest metro area of the US and there are not enough doctors for the per capita population. My son has both of these and needs lots of specialists for his disabilities and health care.  There are less than 5 Urologists, less than 6 Psychiatrists, less than 8 Occupational/Physical Therapists and less than 6 Psychologists in this area that will take him because they are swamped and do not need to accept the low dollar and paperwork of Medicare/Medicaid.  We have neurological specialists only because there is a teaching hospital here that has neurology as the core of training, but no other specialties.  You can't imagine how long we have to wait for an Opthamologist, Gastroenterologist, Orthopaedic Surgeon, etc.  States in the US are allowed to determine how funds for Medicare and Medicaid are allotted.  Thus, Arizona has one of the lowest reimbursement rates and disallows so many health procedures and testing. 

In California, the state has always provided far more care to those on the "public insurance" than other states.  If we were back in Iowa we would be in good shape, but the last 6 1/2 years here in Arizona has been very frustrating.

[Billydude]

That is amazing and dissappointing that things can vary from state to state so much.

[inga]

It would be nice to provide every one with a basic level of care....(and that does not mean 5 second opinions or millions spent on end of life care) for every one.  I think if people could by a policy that is an 'upgrade' of the basic policy if they could afford it, that would be reasonable.

Medicare is going to go broke if we keep putting pacemakers into centegenarians.  I am nearing Medicare....7 years to go, and don't think it will be there for me....let alone my kids, who should not have to subsidize executive level care for people, while trying to pay off school loans, and deal with an ever shrinking economy. 

Yes, I am disabled, but have been for while and have not worked....I guess it depends on who reviews your claim.  I haven't paid into SS for over 10 quarters, which makes me inelligible for SSDI, and we make too much for SSI.  If I don't live to 62, it is all for not.

I don't expect to get the care my parents got for as long as they did.....it makes me feel awful to get such expensive treatment right now, and others have nothing, but then again, we have a very expensive insurance premium, which we will soon be making out of our own pocket.  Hubby works only to pay for this insurance.  My life span is likely forshortened due to this disease.  (I have major systemic issues.)  I would love for him to be home with me for a while before I check out.  Pretty soon he will have to be home with me, because I don't know how long I will be able to take care of myself.

If I had to burden my kids directly with the cost of my care.....I would check out.  Problem is, we as a generation are not looking at who is paying our bill as Medicare and social security recipients. 

[irish]

I am confused about the phrase "just got disability and received my medicare card" or something like that. What I am confused about it that a person usually has to be on disability for 2 years before they can receive medicare.

Also, the statement about the Medicare Advantage is correct. It is a troublesome choice. It is best to stay with the old Medicare and take a supplement. As was said, you do need to know what policy is the primary policy. My medicare is primary and BCBS is secondary. Thankfully most doctors take medicare patients. However, if you are a medicare patieint look at your statements from medicare. The amount that the doctor charges is never paid. They are paid only what medicare allows.

I just had my submandibular gland removed and had to have the nerve monitoring and a nerve moved. The doctor was paid about 400$. I thought that was not enough. My gosh, he has a lot of education and experience that enables him to remove that gland without me being paralyzed on that side of my face.

I think that basically the medicare is very close to broke now. I know that when it is gone I will lose most of the medical treatment that I am now getting. I doubt that any of us will be able to afford health insurance at that time. I doubt that that a government health care policy would even be affordable---especially if most of us are out of work or unable to work. Iwill not panic as the old timers got by and I think the rest of us  will just have to make due also.  It will be one of those things that we will just have to accept.

Hang in there. We don't know what is coming and it isn't worth worrying about it. Life is never certain. Irish

[Billydude]

Irish,  Medicare starts two years after the date you state as when you first became disabled.   If you are just approved and your disability started two years ago then you get an initial payment that goes back to that date and your Medicare starts.

[inga]

It is hard to think of us as a third world country....but we are going to be at this rate.

I was reading something on the calculation of poverty rates for seniors, and they are based on numbers from the 1950's.  A senior couple with an income of over 15K is not considered poor!  Lord, that barely pays your supplemental insurance!  I would have been willing to pay double my SS and medicare tax to ensure my retirement included SS and medicare.  I don't want to give the impression that we are in dire straights, we are not.  We have a pension, and a plan to cover our insurance....at today's rates...but, BCBS stated in some states, they are going to raise premiums by 56%.....56%!!!  That is insane. We don't have BCBS but another large insurer....who is perpetually trying to get out of paying for our needs.   We are fairly well off for retirement (in that we will have a roof over our heads, heat and food---no trips to the Bahamas)....I wonder if people have considered how much it will really cost.  Boomers staying in the work force longer, means less advancement for younger people...it also means less burden for my kids.

I think seniors my have to accept HMOs...for you and me Irish, that will likely mean no IVIG after a certain point if at all.  Canadians have a terrible time getting IVIG.   This is hard for me to accept because I languished away my 40's in an HMO that did not think it had the responsibility to look into rare things....I was labeled 'depressed, and with fibro' even AFTER, I went and got my OWN lip biopsy and it was +.  This large, and for some reason well respected private clinic does not refer to academic settings and gives people the impression it can handle everything....it can't.  Thanks to their repressive policies, and my own blind trust, I have severe neuropathy.

  I have seen on some forums, that some doctors have offered IVIG to people well past their natural lifespan. IVIG can run 90,000$ per year.  At what point, is it too much??  It sounds like the two of us, have a handle on the fact that we will be cut off at some point.
I have one friend whose father was given a pacemaker at age 85....and he had severe dementia!  The money that is spent on treatment in the last two weeks of life is phenomenal.  Pacemaker placement is a 50,000$ procedure.   I have arrhythmia and syncope and I was told it was so expensive that I would need to pass out first...and if it was the 'big' one, oh well.

Being a nurse, you have seen this.  I think if people had to pay a portion of this from their income, they would decline some of this 'treatment'.  This is not 'death panel' stuff...for years, doctors and nurses have counseled patients and their familes on end of life issues.  Nothing is worse than a full code on a 99 year old person with dementia, suffering from bedsores or some other hideous malady.....It is inhumane!  Becasue we can do something, doesn't mean we should.

I also think the two year wait from disability to getting Medicare is nuts.....what, you are disabled and can't pay insurance due to no income and they don't give you health benefits?!   What...do they hope you die in the first two years of disabilty??  "Oh here, let us help you....no insurance tho...."

Also for me, not working for 10 quarters.....I haven't been on vacation...I was waiting for docs to make up their freaking minds.  Geez, I was in a head on and all beat up and had Lyme. I was on SSDI and was booted off....they told me if I could carry an empty paper bad I couldn't have it.  I thank God for a devoted husband who has a decent job and health insurance and even life insurance to provide for me.

You are right Irish, doctors do not get much from Medicare or Medicaid.  If we had to take that kind of bite, I wonder if we would do it.  I would not go to work for 25% of the normal salary.  The other issue is the increase in price of procedures for people who have NO insurance....they pay more for any procedure or office visit than an insured person.  Is that sane?

Anyway, it is going to be an interesting 20 some years.....I wonder what things will look like in the future.

OK, end of rant.  Sorry if I offended any one....nothing personal.  Some things don't make sense to me and I get riled up.  I hope every one gets the care they NEED.

[anita]

Rants are good to clear the cobwebs...lol

I know all about the IVIG...big bucks.  Did it for 11 years (beginning at once a month, then every 3 weeks, the last two years was splitting doses every 10 days)...$$$$$  Unfortunately I had to stop for 6 months for insurance review and when i restarted, I had severe allergic reaction (aseptic menengitis with 700+ WBC present in CSF).  So never again now :-(     I did have to stop treatment a couple times (short term) due to shortages of the product itself...1-2 times a year.  So over use of it comes at a price for those who really benefit.

They also put off my pacemaker for a couple years, but the autonomic dysfunction was so bad they had no choice in 2004....heart rate sitting in a chair would drop to 38...which makes docs very, very nervous.

The two wait for disability just about killed me itself.   Financially i was ruined.  but I did curtail some of my treatment because I was ruining my family's financial future in the process.  However, it takes almost two years to get approved sometimes.

The entire system needs an overhaul.

[inga]

Yeah, I don't see the reasoning by delaying Medicare for disabled for two years...I mean, what do they expect people to pay for their insurance with....the measley SSDI?  It is better than nothing, but totally eaten up by Cobra or any insurance premium.  I don't know if medicaid covers for those two years?

Well, maybe we will get health care reform.

[navydad]

Right now I;m on short term disibility through my Union, I still make co-pays on my health insurance for me and my wife, if i didnt,, well I;d have nothing,, the company still thinks I;m going back to work,, but I just cant see myself doing it,, after the 26 weeks of short term is over,, we have a plan through hte union for 5 years of long term disibility, hopefully SSD will come through,, but in the meantime,, i wonder what were going to do for insurance,, I sure cant afford cobra,, I mean I probably could,, but we would be livingunder a bridge eating rats,,
End of life,, well,, thats what a living will is for,, make sure you have one,, and when our time comes,, just let me go in peace,, no heroic stuff,, just let it be,,
    Inga,, your so right,, this nonsense has probably shortened our lives,, its pretty much destroyed a good quality of life, and I feel so much pain after being the man of thehouse for ever and now have to rely on my wife and boys for so much,, it just makes it hard to accept,
And I did the dance with some really messed up doctors ,, watching my nervous system destroy itself befoire someone started to listen,, now the damage is done,, those doctors dont deserve a dime from medicare,,

[beej]

Since I work with/for the state government as my job, I attend training sessions on Medicare/Medicaid/Social Security/Social Security Disability.  The general public in the US does not know that getting the health care provisions is tremendously time-consuming and difficult.  It has been years this way, that it takes many months and often years to actually GET the benefits.

My goal (!) is to stay working until I have documentation from doctors that I must quit, so I can get Social Security Disability.  This would mean a difference of an extra $500 per month in payments over regular Social Security.  Once you get SSD, you will automatically get Medicare/Medicaid.  However, this extra benefit amount would only last to the "official" retirement age, now 67.  Then I would immediately drop to regular Social Security.

Did you know that the average person is denied three times in two years BEFORE they are granted Social Security Disability?  We US taxpayers pay in all our life for SS and SSD, yet few collect.  It is also extremely difficulty to be granted SSD when the medical condition is CFS, lupus, fibromyalgia, and I would expect SJ too.  Did you know that you cannot even apply for SSD until you have one year of documentation for your condition?  This means that I will have to wait a year, then wait two more years before I am eligible for the healthcare and the monthly payments.  So, I have to hold out really healthy as long as possible and hope that the laws and rules change to smooth the process.  When I can finally leave my job, I will only have a couple years at most with decent monthly payments before I get to the much reduced rate.

Since I have always worked jobs that did not provide a pension or retirement plan, I will have to depend on whatever I can get from the government.  Not a good prospect for being able to pay for my basic living expenses, let alone medical care and prescriptions.

This is the reality that those in the US who oppose any kind of healthcare reform are not seeing.  It seems to be all about "what is in it for me" and these folks seem to have short term goals of one's taxes at the present time, and no forethought about a chance these folks may suddenly need assistance.  Will they ever be shocked should they or a family member come upon a catastrophic illness or medical condition and there are no savings or health insurance that will pick up the slack until the government assistance can help.  My son has had Medicare and Medicaid since birth for severe disabilities.  His care averages $20,000 per month.  Without the government insurance, there is NO healthcare or insurance that would cover him.  I think if you had your medical condition and disability since birth, you are "lucky", for those of us that find such challenge later in life truly have a hard go of it.  Poverty in America is not often brought to light, but I fear going from my "lucky" status of living paycheck to paycheck into living far below the poverty level.

Sorry for the rant, I am deeply worried about my ability to have care at all, let alone good care.

[beej]

Just re-read my rant, and I sure am the little ray of sunshine today, eh?  I will concentrate on the positives for a while and look for the tiny bits of hope and joy.

[irish]

beej, I think that we are all little rays of sunshine. We live in a very strange period of time. All the technology that is around and it hinges on us being able to afford insurance when most of us can't work anymore. If that isn't a catch 22 I don't know what is.

As for the IVIG, it will be interesting. I can just feel the beat of the drums that signal that medicare will stop paying on many of the medical treatments. I have been on the IVIG 39 months now and it really hasn't changed my blood work much but I have better days with much less of that horrible fatigue or the times when I feel like I will quit breathing from my myasthenia.

We will all have to just wait and see what happens with this economy. Will just continue to live within our means. Guess that means no more trips to exotic tropical islands. Yeah, like that will ever happen. Irish

[eyeamdry]

Beej, I'm right now in the spot where your EXTRA money on SSDI drops.  I think I just got my next to final check for the EXTRA.  My SS is not that much, as my income was never on the high end to speak of and I did have to retire early.  Oh, well my husband's income is better and even with my disability EXTRA (hah) stopping we'll be ok.  I got in free to have our income taxes done, maybe I'll ask if we'll be ligible for food stamps.  Wouldn't that be something?

I doubt it because we do have some IRA $$.  But even though things are tough for most of us, such as my daughter has been out of work for a year, we are better off than many places on the planet.   How am I going to adjust to that $400 EXTRA that is stopping?  I'm laughing because it was never extra in as we could do stuff with it.  I usually used to pay our medical stuff. 

[Billydude]

My social security representative said that the amount will not drop but remain the same when you reach retirment age.  Are you sure about that?

[Bernice]

Inga,

I guess until some are personally forced to beg for the live of a parent, someone else they love or themselves as my father did they would be under the opinion that money should not be spent to save even a 74 year old. Some would be so misinformed to believe that 'NEW" policies to determine the value of life "Death Panel" are to be legalized as something NEW under the "new health bill" These lawmakers will say anything to snow people that insist on remaining in the dark on issues trusting them with the "truth". Because they know most things we the voters don't learn until we are faced with it headon because we really don't care until it affects us or can be used to argue our points! THE POINT IS THEY ALREADY EXIST!!!!!!!!!

I got that wake up call myself when I went daily to doctors visits with my father with them openly telling us that they were making assessments whether or not my father's life was worth the money and time to save his life. I begged them to understand that my father was just a month ago out working the average man, climbing ladders never missing a beat, mind more alert than mine or theirs in hopes of them referring him to an oncologist to treat the lung cancer that recently was discovered after regular physicals.

We went back and forward with this for weeks, unfortunately during the Christmas /New Years holidays,with them taking time of for vacations and such while we waited for an answer, then another two or so weeks waiting for the paperwork to be delivered for appointment once they decided to ALLOW him treatment. All the while calling and going trying to push them alone. My father at this time told me "It's like they don't care" Those words are words NEVER forgotten, in fact the entire experience including caring for him while he died and hearing his last breath will NEVER be forgotten. PEOPLE DEATH PANELS ALREADY EXISTS!!! THEY REALLY DO!

The experience of hearing the oncologist tell me not once, but twice that IF they had sent him earlier he could have helped my father will NEVER be forgotten! It leaves you quite speechless, numb, shocked and in disbelief that in a society such as ours that such could go on. I must say that it is an experience that I would not wish on my worst enemy.

This experience changed my thoughts on the value placed on life. ALL life is worth doctors who pledged to heal to do ALL they can for ALL unless the patient or family decides otherwise! My father wanted to live, he fought to live, but no help was given in time!!