Medical Bills HELP????

anonymous

New member
I need some help here:

My medical bills always are pilling up. I am currently on SSDI receiving benefits due to my CF, Crones disability. Do most patience work at all? How do you keep up with expenses and have a life? Do most live with parents, the alleys or what? I am trying to make a life for myself and stay on top of the game for CF.

Please can someone give me advice? It seems like everytime I turn around there is another bill and my SSDI in a small amount. I do have Mediacare to help but that does not cover prescriptions.
The prescriptions are a real killer.

Thanks all for your help!!!!

Mark

go cubs
 

anonymous

New member
Some of the drug company have programs to give you the drugs at a greatly reduced price. An example is found on the opening web page for the Tobi foundation. Check with your social worker at the CF clinic. Perhaps you may apply for some help from Boomer's site.
 

anonymous

New member
Mark i have medicare and medicaid all i have to pay is a co pay of just two or three dollars for a prescription, and i live in illinois so maybe try applying for medicaid they pay what medicare doesn't unless you already have it and still can't afford scripts then i dunno man.


crzy dimon

3200 St. Louis.......GO CARDS!!!!!!
 

jamey

New member
i also live in illinois and have medicaid, the only thing i ever pay is 3 bucks for certain prescriptions and the generacs are free and the medicaid pays all the hospital stays and whatever else.and i worked the last 7 years up untill april, then i quit and signed up for social security disabilty and got approved in 2 months. but i had medicaid even while i worked through a workers with disabilities program.
 

anonymous

New member
Jamie,

I understand the "Medicaid" solution. That does work for some. I worked fulltime for years before getting sicker and needing Disability to help with insurance needs too. Can you tell me more on the workers with disabitlies program you mentioned? My income level from SSDI is too high to qualify for Medicaid. Thank for your help!

CF/MR

go cubs
 

anonymous

New member
I would call your local SSI office to ask if your state has a disability work program. There are still income guidelines w/ that, but I know it's not as strict as SSI income guidelines.
Your social worker at the CF Clinic should be able to shed some light into if your state offers this type of program too.
Someone mentioned TOBI previously.....if you're on Pulmozyme, they have an endowment program to help pay for it too.
Good luck.
 

anonymous

New member
Mark check with the CF hosp that you use the social worker is there to help you even though my son is only two our social worker said if the bills get to be to much she is just a phone call away.
 

anonymous

New member
I am a 32 yr old with Cf and live in Illinois. I do not work and I actually got turned down for SSI!!! Any suggestions and how do you qualify for Medicaid. The copays you quoted for medicine and what they pay for hospital stays are fantastic. I do have insurance thru my husband but I have pricey copays and the hospital stay costs me $1500 and then anything else is picked up at 100% after my $1500 out of pocket! It is all really expensive even with insurance. Thank the Lord for insurance coverage! If you have any suggestions on requalifying for SSI and/or Medicaid, I would love to hear them!

Thanks
Jennifer
 

jamey

New member
cf/mr,
the medicaid i recieved while i was working basically was the same except for with regular medicaid if you make over a certain amount you have a spenddown, but through the workers program you dont you just pay a monthly premium. example-when i first got on it my spenddown through meicaid was about $300 then when i switched based on how much i was making i only had to pay $13 a month.the program is called Health Benefits for Workers with Disabilities. and you get the same exact medical card and coverage and everything. i especially liked it because i could make like so much more money without having to give it up.before i actually turned promotions because i figured why make more money just to have it taken away.and theres ways to get on even if you dont work.(on ssdi). if u have another question about it let me know.
 

anonymous

New member
Yes Jamey,
That is the program I am working towards! Does it take long to get on it? I am currently applying for that for prescriptions. Health Benefits for Workers with Disabilities, that is.

Before my spendown was around "$800" for each time I needed medicine. And then I was constantly trying to find something to count for the spend down? What a cycle, when you get behind?
Anyway you are right, that program is tops. How long did it take you to get it? Take Care.

CF/MR

go cubs
 

anonymous

New member
Jennifer,
You're kind of over a barrel because you are married. They will consider your husband's income for SSI, and I'm just guessing that he makes too much for you to qualify. It would be nice if there were programs out there for the working class that makes just over the requirement to get SSI.
It is hard when you make too much to qualify for assistance, but then after you pay the bills, groceries, etc, there's no money left!
If you are on Pulmozyme or TOBI, ask for assistance. Your social worker at the CF Clinic should be able to direct you where to go for any assistance available.
 

jamey

New member
cf/mr
it didnt take long at all, actually i had my social worker call them and they worked it out so my records all got faxed directly to them so didnt have to wait on mail.then i got approved pretty quick, and each month i would get a bill for $13 and send it off then they would send my card. i also like the program alot better because it allows alot more assets then regular medicaid. good luck to ya .
 

anonymous

New member
Jennifer what was the reason for them turning you down? Did you appeal the process? Also I have a private insurance and I also have a secondary insurance called "Childrens speical health care". It's for adults and children with CF and some other diseases qualify. They also go by your income but as they do that they also deduct costs you accumulate through expenses. Such as uniforms or apparel I had to use for work, Gas milage to and from dr appts., any equipment you use for your CF, I can't think of all the things right now they deduct out of your income. Anyway after deductions I qualified. I had to pay $20.00 a month for my insurance (which is great by far) but they pay for everything my private ins don't. Persciptions 100% and CF dr copays. I am currently on leave from work and they are paying my cobra paymnt. They only pay for things related with CF. I haven't been admitted to hosp before so I'm unsure if they pay for that or not. Haven't checked into that part. I guess. Anyway CF Center has info on it or call your local community health center. It's sometimes called "crippled childrens insurance". Don't let them tell you there's an age limit because I have a pamphlet that says CF age limits are waived. Hope this helps someone. Good luck. Eva 35wCF
 

anonymous

New member
They did consider my husbands income so I could not get any financial assistance that way. But I did get turned down for plain ol' disability. They said I could still work even thought they did admit I have some hurdles. Some, if they ever really knew and or understood. Thanks for the responce, over the barrel made me laugh!


Jennifer
32 yrs old with CF
 

anonymous

New member
Thanks, Eva for the info! I will check out that program called "crippled Childrens insurance". I am not sure why they turned me down, they said based on the jobs I have had, I could still go back and do some customer service work.They just do not get it!! It really frustrates me cause I do not work cause of CF. It just takes too much out of me and I am so fortunate enough that financially my husband can provide and I do not have to work. But, they do not get it. I am on Pulmozyme, Tobi, Zithromax, Xopenax and I do the flutter. On top of getting my rest (meaning I sleep in, in the morning) and doing all the meds and treatments there is just no time to work. I also go into the hospital once a year for a "tune up". Well, I will look into the above mentioned program and thanks so much for all the info! It is so great to share concerns with other people that are in the same boat!


Jennifer
32 yr with CF
 

anonymous

New member
Jennifer,
My husband just won his disability case in december 2004. We initially filed in October 2002 and got turned down twice-then asked for a hearing which took 17 months to get. Don't stop now. I have some good websites to give you about social security requirements on CF and digestive issues and such. We really worked hard on his case. If you want to email me, so I can give you those direct links (because they don't post well here and it's so frustrating!!!) it's division902@hotmail.com


Julie
 

anonymous

New member
Jennifer, I agree. I would appeal the denial from SS Disability. They very often deny people the first time. In my state, it's like 80+% of the time, you get denied the first time you file.
Keep after it and be very detailed in how much time it takes to do treatments, go shopping, how much sleep you need, etc.
Elle
 

anonymous

New member
It's true they often deny. Don't give up I beleive the best fight is when you appeal and have a hearing. That way their face to face. They have to listen. When I filed I wrote down how long my treatments took me also. So they could get a time span. Because some people takes longer depending on what type of unit you have to nebulize. I don't know how I worked and did all my treatments. I know I rarely slept. In fact fell asleep alot as I was nebulizing. HeeHee. Anyway,I was very lucky and was accepted the first time. Which I never heard of. I know my Cf dr had alot to do with it as she was the one pushing me to file. So try to get your CF center behind you 100% and know what's going on. Every little bit helps so make sure you appeal that. Eva
 

anonymous

New member
Thanks everyone for the info on appealing social security decisions. Eva, I will appeal it or just fill out another app. Since I am not working, I do have the time, that is for sure!

Thanks again!

Jennifer
32 w/ CF
 

anonymous

New member
Jennifer,
whatever you do, DO NOT fill out a new application!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

If you do appeal it, and down the road you get approved (even if it takes 10-20 months) they BACK PAY you for all that time. but if you file a brand new application, that does not apply and you only get "credit" for the time you file that second application. Here's some stuff from the Social security website:

(Paste this into your browser) http://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm

Then you want to go to 3.00 RESPIRATORY, and then 3.04 Cystic Fibrosis. If you don't MEET all of these 3 listings exaclty, sometimes they rule in your favor if you meet part of two of them, or have a combination of digested problems as well. That is called "equaling" a listing. Because CF is a disease with so many different aspects and things it effects, there are many things that they need to consider when deciding your case. But you have to make that clear to them, they aren't going to do the research so you have to. Also look in the digestion listing (5.00) to see if you meet any of that.

3.04 Cystic fibrosis. With:

A. An FEV1 equal to or less than the appropriate value specified in table IV corresponding to the individual's height without shoes. (In cases of marked spinal deformity, see. 3.00E.);

or

B. Episodes of bronchitis or pneumonia or hemoptysis (more than bloodstreaked sputum) or respiratory failure (documented according to 3.00C, requiring physician intervention, occurring at least once every 2 months or at least six times a year. Each inpatient hospitalization for longer than 24 hours for treatment counts as two episodes, and an evaluation period of at least 12 consecutive months must be used to determine the frequency of episodes;

or

C. Persistent pulmonary infection accompanied by superimposed, recurrent, symptomatic episodes of increased bacterial infection occurring at least once every 6 months and requiring intravenous or nebulization antimicrobial therapy

There is a "table" on the website I posted that shows the FEV requirements.


My husband also kept a 2 month log of all his activities including, when he woke up, anytime he ate, any time he did his meds including time to clean the nebulizer and reuse, any chest pt, any naps, any time spent on homework (he did not and does not work), anytime he got sick (threw up) any and all coughing attacks and duration including anything that might have provoked it. If you are interested in seeing the layout that we used for the judge, I would be happy to email it to you. It was very effective for our case to have this informatoin. We also included his activities throughout the night, when he got up to eat, coughing attacks, periods of time he couldn't sleep.

Julie
 
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