Julie's right if you still have time to appeal the judgement. Do that. Because you can recieve all that back pay. I know it's really difficult to log everything but sometimes we don't have a choice but to do so. I also logged everything. Be really honest about it, don't be embarrased to write how long it takes you to do something, or how long to get groceries, or how many times you have to run errands for perscriptions. etc.. Don't except thier reasons for things. My CF center even gave me some #'s of some CF'ers that had been through the system if I felt I needed guidance. Your social worker at the CF center can be a really big help. I didn't call them because for some reason it went really smooth. But it ticks me off when people need something and get denied. It's crazy. I know there weeding out the fraudulant people but I feel they need to take a look at individuals instead of paperwork. If you need anything you can email me as well. sam001@charter.net put CF in the message line or I will delete it. Eva
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Medical Bills HELP????
- Thread starter anonymous
- Start date
My neice has CF and is 5 years old and lives in Southern California. My sister has been turned down for SS benefits for her and all govt. assistance she has applied for due to her income being too high, even though it is not high, it is too high for her to qualify. Her insurance only pays 80% of some medical bills. They don't pay hardly anything of her prescriptions which cost her out of pocket $1,000/month. They also do not cover her formula for her feeding tube because the insurance co. considers it "food". A recent hospital stay resulted in over $50,000 in medical bills not paid by the insurance. I am desperate to find any information, links, tips, on finding reduced cost prescriptions, reduced cost formula, and help with medical bills - or info on where to apply for help with these things. My sister is depressed and overwhelmed by all of this and I really need to help her get some information that can help her and my neice. Please, if you have any info that can help us, email me at: kymry.perez@verizon.net
#1, appeal, appeal appeal that insurance company denial of the formula. Have her CF doctor write a detailed letter of the reasons for needing the RX and what the potential problems are from the baby not having access to it (have the doctor spell out the WORST that could happen, although don't blatantly state it's the worst that could happen. If they deny the appea, appeal again. If they deny that, request a hearing.
#2, appeal the SS denial. as I have previously posted on this thread, and as many others can tell you- SS denies almost anybody intially unless it's something ovbious like the person is blind or COMPLETELY crippled and can't communicate... They might deny her appeal as well. Don't give up then either. Request a hearing. There is criteria that a CFer has to meet for social security disability standards. I posted the link on the first page (toward the bottom) of this thread. Check it out.
#3, what type of formula does the child use? sometimes if you contact the company/distributor of the formula, they have a cost share or assistance program. If it is something like ensure or boost (ensure being name brand) there is a company called ROSS NUTRITION that helps patients with these expenses. If you are interested, let me know and I will post the link, (I have to look it up and don't want to do so if it's not applicable)
#4, is your sister aware that ALL of the food, supplements and such that her daughter eats in a year are TAX DEDUCTIBLE. I can also give you the link to that if you are interested. How i do it, is I keep EVERY food reciept (fast food, dine in, grocery store, starbucks-EVERYTHING) and do an excel spread sheet for every month. I total the monthy food expense, and take 25% of the total off for the food I eat (your sister might want to do more considering the CFer is a child, and even more if she has a spouse), then I take 25-50% off for non-cf related food expenses (I did research on the average amount of food consumed by someone his age, weight, height, sex). What is left over is totaled every month and that is what I use as a medical deduction. 100% of the formula she uses for her feeding tube is tax deductible though, because the average person without CF WOULD NOT use it, therefore you don't need to find a percentage.
#5, has you sister applied for any type of medicaid? If not, she needs to do so ASAP. I know in the state of CA they will go back 3 months and pay for medical expenses if the person qualifies.
#6, has your sister contacted the GHPP program (genetically handicapped persons program) in Southern CA? They specifically help out with expenses related to people with CF. My hubbie (who has CF) and I also live in souther california and have Tricare insurance through the military. But...they dont' cover all of our expenses, so GHPP covers what they won't. We have to go see one of "their" doctors every 6 months to keep the "coverage" but it's worth it. If you want that information, let me know and I will also look that up.
I live in S. CA too, if your sister, or you want to email me directly please do so division902@hotmail.com
Julie (wife to mark 24 w/cf)
#2, appeal the SS denial. as I have previously posted on this thread, and as many others can tell you- SS denies almost anybody intially unless it's something ovbious like the person is blind or COMPLETELY crippled and can't communicate... They might deny her appeal as well. Don't give up then either. Request a hearing. There is criteria that a CFer has to meet for social security disability standards. I posted the link on the first page (toward the bottom) of this thread. Check it out.
#3, what type of formula does the child use? sometimes if you contact the company/distributor of the formula, they have a cost share or assistance program. If it is something like ensure or boost (ensure being name brand) there is a company called ROSS NUTRITION that helps patients with these expenses. If you are interested, let me know and I will post the link, (I have to look it up and don't want to do so if it's not applicable)
#4, is your sister aware that ALL of the food, supplements and such that her daughter eats in a year are TAX DEDUCTIBLE. I can also give you the link to that if you are interested. How i do it, is I keep EVERY food reciept (fast food, dine in, grocery store, starbucks-EVERYTHING) and do an excel spread sheet for every month. I total the monthy food expense, and take 25% of the total off for the food I eat (your sister might want to do more considering the CFer is a child, and even more if she has a spouse), then I take 25-50% off for non-cf related food expenses (I did research on the average amount of food consumed by someone his age, weight, height, sex). What is left over is totaled every month and that is what I use as a medical deduction. 100% of the formula she uses for her feeding tube is tax deductible though, because the average person without CF WOULD NOT use it, therefore you don't need to find a percentage.
#5, has you sister applied for any type of medicaid? If not, she needs to do so ASAP. I know in the state of CA they will go back 3 months and pay for medical expenses if the person qualifies.
#6, has your sister contacted the GHPP program (genetically handicapped persons program) in Southern CA? They specifically help out with expenses related to people with CF. My hubbie (who has CF) and I also live in souther california and have Tricare insurance through the military. But...they dont' cover all of our expenses, so GHPP covers what they won't. We have to go see one of "their" doctors every 6 months to keep the "coverage" but it's worth it. If you want that information, let me know and I will also look that up.
I live in S. CA too, if your sister, or you want to email me directly please do so division902@hotmail.com
Julie (wife to mark 24 w/cf)