I am Starting to wonder!!! need your help!

anonymous

New member
Hi, i am a 23 year old Male with CF i was diagnosed at 8 months old....i have been sick my entire life and was unable to finish high school or work due to my Health.
I have Medicaid funded health insurance....and with all this news i hear/read that alot of states are cutting like 4 and 500,000 sick/disabled/and poor people from Medicaid! if this happned to me i would'nt live 6 months! anyone else worried about loosing there Health care? i live in Michigan...and i cant get any Real Health insurance plan due to my CF they have all said because its a Pre-Exsiting Disease...and even if they did cover me i am unable to work at all!!!! what do other CF adults do? thanx
 

anonymous

New member
I believe under the new HIPPA laws an insurance company cannot "discriminate" against you because of the PORTABILITY part of HIPPA. I may be wrong, but I think it would definelty be worth looking into. Portability meaning that your past health issues are "portable" and able to be brought to and covered under a new insurance.
 

anonymous

New member
I work in medical billing and I believe that they cant apply preex to you in a group plan as long as you have had continuous coverage for the length of the preex clause which could be 6 months up to a year. I think when you get an individual plan on your own they can apply preex for up to one year. Maybe you could get an individual plan with your medicaid. Then when they deny preex medicaid would pick up at least for a year and then once the waiting period is over you would gave coverage. Beware though individual policies usually have a high deductible so I would not get rid of medicaid until the states takes it away from you.

Hope this helps, let me know. I am sorry you have all of this stress on top of your health. If there is anything else I can do let me know.

Teri
8 yo daughter w/cf<img src="i/expressions/musicnote.gif" border="0">
 

MullMuzzler

New member
My name is Jim and i also live in Michiagn i will be 23 this coming April. I was Diagnosed with CF at 5 months old. For the first 10 years of my life i pretty much lived in the hospital i was always sick...i was never able to go school much untill i got about 12 years old and i finally started to get better. I never graduated neither or was able to work due to my CF. I am drawing SSI and i also have Medicaid. I also keep hearing about how Medicaid is cutting a TON of sick and disabled PPL for Health care. I am in a tough situation too...i am Unable to work due to my health and i have talked with many jobs and i have spoken with Health care companys and they ALL have said i can not be covered under there policys due to having a pre-exsiting condtion. I also can't get married because i will loose my SSI and Medicaid and i can get covered under my finacee's health insurance neither. she was ganna join the ARMY so i could get health care if we got married but even they have tuned me down! So if Michigan cuts the Medicaid for CF ppl i have no clue what i would do!
 

anonymous

New member
Wait a minute, I am in the navy and my husband has CF and is covered by Tricare. Tricare is the insurance carrier for all active duty members and dependents of any branch of the military. I also joined mainly because of the health benefits to my husband. We have never had problem with tricare paying for anything except nutritional supplements (boost plus). Who gave you that information? Tricare does NOT have a preexisting condition clause, and they should and will cover you if she joins the military. Where do you live, I can give you the number to the Tricare office for your area if you are interested and you can do some research for yourself.
I have question for you, why is is that you will loose your SSI If you get married. I have heard this mentioned before on this website but never understood why.
Also, why will you loose your medicaid coverage? My husband was also covered by medicaid in the state of Washington, but it was after we got married. The didn't cover me because I was healthy, able to work and working... but they did cover him just because he had CF. You might want to dig a little deeper into that one.
 

MullMuzzler

New member
My brother Inlaw is in the 101 st Army Division and is my sisters husband.We were looking in the Tricare book and it said CF was not covered? i even called the number and talked to them about it they said if i got married and my wife joined the army i would not be covered! i dont think they will even cover if a married couple has a child with cf??? who knows! when was your Husband Diagnosed with CF? how did he get into the Navy with having CF? he must be in Great shape!

The Reason i was told i will loose my SSI and medicaid if i get married is due to Her income. SSI is baised on all other income coming into the household same with medicad. its the dumbest sh** i ever heard but thats how it is. I cant draw SSD becasue i did'nt have enough work credits. i cant own a House, or car due to the assest clause...something like 2,000 dollars to my name or i will loose everything.
 

anonymous

New member
IT also depends on the state your in. Medicaid and SSI both are income based. but if your in the state of texas if you get SSI you automatically get medicaid and as long as you get one dollar in ssi you keep medicaid but once you loose ssi you loose medicaid.

Sounds like you lucked into getting your hubby covered by TriCare...Maybe its also different state to state...I know alot of insurances have different types of policies based on the stae. Like texas blue cross blue sheild has a thing just for texas residents and one medicare based. The government policies although same by income based they are also differnt on how they work state to state...income is the same but like texas if you get one you get the other. Its confusing and stupid and its been this way for years and years. I had to even "divorce" my husband to keep health care coverage. *sigh*
 

cfgirl38

New member
I just got on Disability as I am on leave from work and it's been over 8 months. Anyway I own a car and am paying a mortgage . I live in Michigan as well. I am not sure who told you that you couldn't have those things. I know they have a max of $2000 in assetts such as life ins, cemetary expense, stocks etc... for SSI. So maybe that's what your thinking. But you can own a home and a car they can not touch that. The lady from Social Security told me that as we filled out my papers. Eva
 

anonymous

New member
What tricare book is this that says CF is not covered. Visit http://www.tricare.osd.mil/ And a clarification, I am in the military, NOT my husband. You cannot join with a medical condition like that. He was diagnosed with CF at 18 months old, and Tricare and the military was well aware of his condition when I joined, we have NEVER had any problems getting covered. And because Tricare is a Department of Defense (DOD) based program, their benefits do not vary from state to state. We lived in Washington, Chicago and now California and NOTHING has changed as far as his benefits go. I don't know where you are getting this information, but I can tell you from personal experience it is wrong. I am going to look into it a little further and if I find anythink out I will post it on this site under this post-ok.
As far as the SSI/SSD goes... You may not have a signifigant enough work history to substantiate SSD, but did you know that you are able to pull off of your parents Social security benefits? Might be something worth looking into and talking to them about. You can visit the social security site for more information and contact numbers to talk to an "expert" about that one.
If I hear anything else or get any new info I will be sure to pass it along to you, but I would encourage you to dig a little depeer.

Julie
 

anonymous

New member
I am not sure about all the legistics of the SSD pulling off of your parents and how it effects them. I would recommend you call the social security administration and ask them those questions. For your situation I would ask the following questions.
1. If you are able to draw off one of your parents, would it lessen the amount they recieve monthly when they are elgible?
2. (If not the above question) If it doesn't lessen the dollar amount they get every month, does it shorten how long (how many years) they are elgible to recieve income?
these are questions that someone at the social security administration should be able to answer for you, and I think it would be worth your time to get in touch with someone and talk to them about it. Even a social worker, (do you see one that helps out with CF stuff?), might be able to answer those questions.
As far as the Tricare thing and CF goes. I stand by what I initially said-they do cover Cystic Fibrosis-whether it's a child with CF that is born to and active duty member or a spouse . and I didn't luck out by getting him covered because there are other CF patients that are dependents of Active duty military members at the Clinic my husband is seen at. We go to the Naval medical center in San Diego and as long as we are seen at the military hospital everything is covered at 100%. They have Cystic Fibrosis sepecialists in the Pulmonary clinic, dieticians, social workers (we kind of had to put our own "team" together, but all the different departments we might ever need to visit are here at the hospital-including infertility treatments.) If CF wasn't a covered benefit, they wouldn't have physicians working at a military hospital that are CF specialists. If you want to find out for yourself, the clinic number is 619-532-7600.
If you talk to someone about the social security stuff, let me know what they say about using your parents SS. I will look into it too next week and see if I can come up with something.
Best of luck with everything and feel free to ask more questions if you need to because I think you are getting some seriously incorrect information.

Julie
 

kybert

New member
im not in the US but im in a similar situation. the government here wants to 'clean up' the disability pension list and im worried that i will be one of those people wiped off it seeing as people with cf already have to lie to get it. what will i do if that happens? id have to give away my cats and put down my dog and move in with my parents who will have to finanically support me 100%. healthcare here is cheap so id be semi healthy and miserable at the same time <img src="i/expressions/face-icon-small-tongue.gif" border="0">
 

anonymous

New member
Jim, I looked up some resources tonight at work and found these things that might help you.

-For fast answers to specific Social Security questions, contact Social Security toll-free at (800) 772-1213.

-ACCESS
(Advocating for Chronic Conditions, Entitlements and Social Services) is a free service offered by Quantum Health Resources. They will answer questions and advise about applying to Social Security Disability, SSI, Medicaid, Medicare, and COBRA. They have an excellent track record; call them at 1800-999-5433, ask for Peter, Brian or Rick.

-For more information and advice about handling insurance denials you may call the Cystic Fibrosis Alliance at 305-463-4440, during normal business hours Eastern standard time. This group is comprised of CF adults, caregivers, and parents of PWCF who wanted to be part of the solution for non discriminatory health care for CF patients. We educate our elected representatives, insurance case managers and whomever impacts CF health. We have seen the President of the U.S. and Hillary, we have hand delivered three of our packages of information to them. Please call if anyone has any questions, we are eager to assist.

-HIPAA (10/97)
The Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191, went into effect July 1, 1997. The Act is designed to protect health insurance coverage for workers and their families when they change or lose their jobs.
There are certain conditions in order for the HIPAA law to apply. A state insurance commissioner's office said that: 1) the prexisting condition must have been covered by a previous policy 2) you must not have a lapse in coverage greater than 60 days and most importantly, 3) HIPAA only applies to group - not individual - plans. Anyway, this is what I was told. HIPAA is a federal, not state, law and since you're dealing with a new regulation, you might want to call your state insurance regulatory office for details before suddenly changing any current policies though. For more information: http://www.hcfa.gov/regs/HIPAACER.HTM
For the text of the law go to http://www.access.gpo.gov/su_docs/aces/aaces002.html and select the database "Public Laws, 104th Congress", then search on Public Law 104-191. You'll get many hits; click on Public Law 104-191.

Good luck and let me know how things turn out!

Julie
 

MullMuzzler

New member
Thank you for all your help Julie! I was wondering what state you and your husband are from?How old are you guys?Did you have to go to War at all?? Monday morning i will go down and talk with the SS place again. I also think that ALL people children/adults with CF can get Childrens Special Health care program. Does anyone else on the board have it?
 

anonymous

New member
Originally we are from Washington State. But in May I got orders to San Diego California, so now we both live down here. I haven't gone to war, thank god, and hopefully I never will. I don't believe in what is going on over there and what we are doing and don't want to fight for something I don't believe in. I work at Balboa Naval Hospital as a hospital corpsman-which is pretty much like a nurse but without the degree. The only things I can't do that a nurse can is give blood transfustions, hang narcotic IV medications, give narcotic medications and draw blood for a transfusion type and cross-I think that's it. I work on a cancer/gynecology ward and right now I work 12 hour night shifts but every 8 weeks we switch from days to nights.
My husband is 24 and I am 21. We have been together since I was 16, (he was 19) and got married the day after my 19th birthday (he was 21 almost 22). We don't have any kids yet, for obvious reasons but we are working on getting our finances more stable and then having children.
How about you and your fiancee? How long have you been together? Here's something that might help you in the mean time with finances. Do you two live together? I would double check this with an accountant, or I can ask mine when I do my taxes in Jan/Feb, but here's an idea. She can claim you as a dependent (as long as no one else does-like your parents, grandparents...) and therefore claim your out of pocket CF expenses as medical expenses (and you do keep track of your food and deduct for over and above what a male your age, weight, height would eat-if not I can give you more information if you need it. That amount, which is attributable soley to CF is deductible). That would give her more money back on her federal tax return. You could claim the deductions yourself, but if you don't work, or dont earn very much if you do (and therefore don't pay much in Federal Tax) then it won't really benefit you. If you don't work and don't have any taxable income-then having her take you as her dependent might be a good idea financially.
Good luck with everything, and if you go on monday and somebody tells you what they have been telling you all along, I would ask to talk to a supervisor. There are people out there who are willing to go the extra mile to help out, but you have to go through a lot of idiots to get to them. That's the experience I have had thusfar trying to advocate for my husband and all his "cf stuff". If I am not satisified with an answer I keep pushing and prodding till I find someone who is willing to take the time to help me out. Good luck and let me know how things go. If I can be of any more assistance, let me know and I will try to help out.
 

MullMuzzler

New member
My Finacee and i have been together for about 3.5 years now...and been engaged a little over a year.We do live together in our own Apt.I think this year she will claim me. she works 40 hours a week at a day care and goes to college part time at nights...she is going to Cosmotology school. I also qualified for the home Help program so she gets paid to help take care of me.
 

anonymous

New member
Good, I would definetly take advantage of her claiming you this year. Do you keep track of your food expenses (above and beyond someone your age, weight, height would eat) and deduct them as medical expenses. If you need help, I can proved you with an example of how my husband and I keep track. Believe it or not, we are able to deduct $6000-7000 every year JUST for food, not even copays or anything else we have to pay out of pocked JUST FOOD. Believe me, it helps out when you can get all the money back you paid in taxes.
What's this home help program? is it specific to your state? I would be interested to learn about it, see if CA has anything like that avilable.
Take care

Julie
 

anonymous

New member
Jim,
here are a few more sights that might be informative for your individual situation.

http://www.ssa.gov/notices/supplemental-security-income/text-resources-ussi.htm

http://www.ssa.gov/pubs/10153.html

http://www.ssa.gov/pubs/englist.html#SSI

http://www.ssa.gov/dibplan/dqualify10.htm


There is various information about what is counted as resources (and you can own a house that you live in and one car per adult in the household without it counting against you), how you can benefit from your parents social security...

I am still curious about the home help thing that you mentioned. If you could give me a bit more information that would be great. Is it contained within your state or is it a federal thing? and anything else you can think to tell me about it.

Julie
 

MullMuzzler

New member
Thanks for all your help Julie! The home help program i think is federal issued so no matter where you live you could get it. I went down to the FIA (Family Independance agency) and got a Adult case worker.
I then filled out the forms along with my CF docters and was able to get it. How it works is my Finacee in a way works for me becuase i need help with alot of stuff like..driving,cooking,cleaning,shopping,laundry, and help with all my meds. so the states payers her like a in home helper i qualified for $235.00 bucks a month its not alot but every dollar for us HELPS! ya know what i mean. And if your husband would qualify he has the leagal right to pick his own "helper" "care taker" and the check is made out to both of you. We get these check list papers where i check off what things i need help with. They base it on how many hours a week/month that your ganna need help with. I also got my slef a Cripple Critter HAHAHA! ppl with CF qualify in EVERY WAY to get one! Everyone looks at me all funny and some even get real ignorant with me when i use it .....and i can see why because im so young and using a handycapped sopt but....thats how it is. A few years back my PFT's hit below 45% so i was able to get put on the double lung transplant list...I declined and said No dont put me on it. As of now i think im at 40%. I also have a Feeding tube that i have to use Everyday i was real bad off when i was about 9 then and after 2 failed surgerys it finaly worked right and my body accepted it. Now that im older i am doing better my weight is finally gaining. i am 6'0 and weigh 155 instead of 118 like before!! that food thing you were talking about is a GREAT idea! would we be able to claim some food bills this year? do we have to save all of our food recipts...or how ever ya spell it LOL.
 

anonymous

New member
Jim,
I will look into the home help program with our case worker. My husband doesn't wish to be on a lung transplant list either. His PFT's are still 65-75% (depending on the day, how he feels...) but he says when the time comes he doesn't want one. You can find more information at: http://www.cff.org/UploadedFiles/living_with_cf/Files/tax%20tips%20for%20food%20deductions.pdf (or go to www.cff.org and put 'food deductions' in the search engine). But yes we do save our reciepts, it's essential to do so in case you ever get audited. At the end of every month I take our food reciepts and total individual reciepts minus anything that is not a food product, and it's pretty easy, just take off anything that you paid tax on and most stores put a 't' or 'f' so they make it fairly easy for you. Then I record them on an excel spread sheet. I have 4 columns, Date/Location/Amount/Method, so i will put the purchase date, the store/location it was bought at, the amount spend on food, and how I paid (cash, credit, debit). And then come the end of the year, I add up all the end of the month totals and find the average by dividing by 12, (or however many months I kept the record for). After I get that total, which is usually about 700-800, I take off 25% (because I don't eat that much) and then take off 25-50% for "non CF" related food expenses. What is left over is deductible (and it's usually 300-400, and multiply that by 12 an you have your YEARLY deduction amount). Just remember you can only deduct above and beyond what the "average" person you age, weight, height would need. We even get a letter from the dietician every year discussing Mark's dietary needs, additional calorie intake, protein intake... so we have proof that it is necessary, if we ever need proof. I also keep track of protein shakes that we pay for out of our pocket on a separate spread sheet, but unlike the food, I use 100% of what we spend for deductions. Since if he didn't have CF, we wouldn't need the supplements. We are able to deduct anywhere from 5-8K every year. It's a good way to go. And then I just get 12 envelopes at the end of the year, put each months reciepts in them, put them in a big manilla envelope with the year on it and file it away.
I told my husband he should get a handicapp parking spot, but he refuses at this point. I guess we'll get it whe he decides he REALLY needs it.
Sorry I didn't write earlier, I work nights and sleep all day so that's what I was doing today.
I can email you the file of food/supplement decutions if you want a template to go off of.

Julie
 
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