Medicare & CFRD

JustDucky

New member
Part B picks up the bill for supplies (lancets, alcohol wipes, needles and glucometer), Part D picks up the bill for the meds (insulin, glucophage, prandidn etc...). Part B is used for durable medical equipment, diabetes meters and supplies fall under that. Hope this helps.
Jenn
 

JustDucky

New member
Part B picks up the bill for supplies (lancets, alcohol wipes, needles and glucometer), Part D picks up the bill for the meds (insulin, glucophage, prandidn etc...). Part B is used for durable medical equipment, diabetes meters and supplies fall under that. Hope this helps.
<br />Jenn
 

JennifersHope

New member
@Jenn, do you have to have all those parts if you have Medicaid too? I am asking for me since I know or think the additional parts of Medicare cost more then the basic, I know the basic is free, and since medicaid will be my secondary I am not sure I need all those additional parts. do you have any thoughts on that?
 

JennifersHope

New member
@Jenn, do you have to have all those parts if you have Medicaid too? I am asking for me since I know or think the additional parts of Medicare cost more then the basic, I know the basic is free, and since medicaid will be my secondary I am not sure I need all those additional parts. do you have any thoughts on that?
 

JennifersHope

New member
@Jenn, do you have to have all those parts if you have Medicaid too? I am asking for me since I know or think the additional parts of Medicare cost more then the basic, I know the basic is free, and since medicaid will be my secondary I am not sure I need all those additional parts. do you have any thoughts on that?
<br />
<br />
 

JustDucky

New member
I have all of those parts, I sadly make too much on my SSDI to qualify for medicaid which really sucks but I always try to figure out ways around things like home IV's. I have the original Medicare along with mutual of Omaha for my supplemental which picks up the 20% that part B does not cover and any additional hospital/doctor bills (saved me thousands!). I have Medco as my part D which is my prescription coverage, I get the highest coverage they allow, costs more but saves me the most in the end as I get the IV's through there (generics) at no cost. Can be really confusing, but I find that this arrangement works best as I see doctors in 3 different states (I live really close to MA, CT ) and like the freedom I have as far as finding good healthcare. I could go to Alaska for treatment if I wanted as long as they accept Medicare. I did not opt for a HMO because of this, I do not like managed care and because I have other complex issues other than CF, the original plus supplemental policy was the best fit.
You probably are okay as Medicaid picks up your meds and other services if Medicare doesn't....so you wouldn't need part D. Part B is DME, doctor's visits and home nursing care....Medicaid I think covers that too right? So keeping part A is a good thing as it is free and covers hospitalizations for the most part, I don't think there would be no harm in keeping that one.
I hope I have helped, if you have any more questions, ask away <img src="i/expressions/face-icon-small-smile.gif" border="0">
Jenn
 

JustDucky

New member
I have all of those parts, I sadly make too much on my SSDI to qualify for medicaid which really sucks but I always try to figure out ways around things like home IV's. I have the original Medicare along with mutual of Omaha for my supplemental which picks up the 20% that part B does not cover and any additional hospital/doctor bills (saved me thousands!). I have Medco as my part D which is my prescription coverage, I get the highest coverage they allow, costs more but saves me the most in the end as I get the IV's through there (generics) at no cost. Can be really confusing, but I find that this arrangement works best as I see doctors in 3 different states (I live really close to MA, CT ) and like the freedom I have as far as finding good healthcare. I could go to Alaska for treatment if I wanted as long as they accept Medicare. I did not opt for a HMO because of this, I do not like managed care and because I have other complex issues other than CF, the original plus supplemental policy was the best fit.
You probably are okay as Medicaid picks up your meds and other services if Medicare doesn't....so you wouldn't need part D. Part B is DME, doctor's visits and home nursing care....Medicaid I think covers that too right? So keeping part A is a good thing as it is free and covers hospitalizations for the most part, I don't think there would be no harm in keeping that one.
I hope I have helped, if you have any more questions, ask away <img src="i/expressions/face-icon-small-smile.gif" border="0">
Jenn
 

JustDucky

New member
I have all of those parts, I sadly make too much on my SSDI to qualify for medicaid which really sucks but I always try to figure out ways around things like home IV's. I have the original Medicare along with mutual of Omaha for my supplemental which picks up the 20% that part B does not cover and any additional hospital/doctor bills (saved me thousands!). I have Medco as my part D which is my prescription coverage, I get the highest coverage they allow, costs more but saves me the most in the end as I get the IV's through there (generics) at no cost. Can be really confusing, but I find that this arrangement works best as I see doctors in 3 different states (I live really close to MA, CT ) and like the freedom I have as far as finding good healthcare. I could go to Alaska for treatment if I wanted as long as they accept Medicare. I did not opt for a HMO because of this, I do not like managed care and because I have other complex issues other than CF, the original plus supplemental policy was the best fit.
<br />You probably are okay as Medicaid picks up your meds and other services if Medicare doesn't....so you wouldn't need part D. Part B is DME, doctor's visits and home nursing care....Medicaid I think covers that too right? So keeping part A is a good thing as it is free and covers hospitalizations for the most part, I don't think there would be no harm in keeping that one.
<br />I hope I have helped, if you have any more questions, ask away <img src="i/expressions/face-icon-small-smile.gif" border="0">
<br />Jenn
 

JustDucky

New member
Home health care is under part A....good grief, this can be confusing lol.....Wouldn't it be nice to have just one part for everything? Would make things a bit less confusing! Here's a bit on parts A, B,c (medicare advantage, HMO's usually) and D :http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-a.aspx

You are dual eligible for medicare/medicaid, here's a site that helps with the ins and outs of having both: https://www.cms.gov/apps/firststep/content/medicare_dualelig.html

http://en.wikipedia.org/wiki/Medicare_dual_eligible

Another good site: http://wnylc.com/health/entry/102/

One thing I am reading over and over is that you will have to choose a part D plan??? Before Medicare goes into effect, you should talk to your case worker assigned to your medicaid to confirm what you need to do or what is recommended. Since I have never had Medicaid and Medicare together, I am probably missing some things. Of course the government has to make it confusing, eh? lol.....

Jenn
 

JustDucky

New member
Home health care is under part A....good grief, this can be confusing lol.....Wouldn't it be nice to have just one part for everything? Would make things a bit less confusing! Here's a bit on parts A, B,c (medicare advantage, HMO's usually) and D :http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-a.aspx

You are dual eligible for medicare/medicaid, here's a site that helps with the ins and outs of having both: https://www.cms.gov/apps/firststep/content/medicare_dualelig.html

http://en.wikipedia.org/wiki/Medicare_dual_eligible

Another good site: http://wnylc.com/health/entry/102/

One thing I am reading over and over is that you will have to choose a part D plan??? Before Medicare goes into effect, you should talk to your case worker assigned to your medicaid to confirm what you need to do or what is recommended. Since I have never had Medicaid and Medicare together, I am probably missing some things. Of course the government has to make it confusing, eh? lol.....

Jenn
 

JustDucky

New member
Home health care is under part A....good grief, this can be confusing lol.....Wouldn't it be nice to have just one part for everything? Would make things a bit less confusing! Here's a bit on parts A, B,c (medicare advantage, HMO's usually) and D :http://www.medicare.gov/navigation/medicare-basics/medicare-benefits/part-a.aspx
<br />
<br />You are dual eligible for medicare/medicaid, here's a site that helps with the ins and outs of having both: https://www.cms.gov/apps/firststep/content/medicare_dualelig.html
<br />
<br />http://en.wikipedia.org/wiki/Medicare_dual_eligible
<br />
<br />Another good site: http://wnylc.com/health/entry/102/
<br />
<br />One thing I am reading over and over is that you will have to choose a part D plan??? Before Medicare goes into effect, you should talk to your case worker assigned to your medicaid to confirm what you need to do or what is recommended. Since I have never had Medicaid and Medicare together, I am probably missing some things. Of course the government has to make it confusing, eh? lol.....
<br />
<br />Jenn
 

JennifersHope

New member
Thanks for your reply... I hate Medicaid except for the cost of it. They deny just about everything that my doctor orders, or prescribes the first time around. It took several months to get approval of xopenex for me, they insisted on albuteral in spite of my tachy heart rate. They refused to let me go to National Jewish for anything other then consult, no testing etc.

I was told by National Jewish with Medicare I could come and not have to get PA or anything... I would be willing to pay out of pocket for extra care and not having to go through an HMO. Right now, if Medicaid approves of my script, I only have to pay less then four dollar which is great.

I have not done home IVs since being on Medicaid. but I am now culturing MAC and waiting for sensitivities to come back. I do not know, but the doctor pretty much said I will be on IV's and at least two or so orals....


I guess that is a good idea to talk to my Medicaid people and see what they think is the best for me to do. It is so overwhelmingly confusing all the different parts of medicare when you have dual Medicaid. I keep trying to read it and my mind goes insane..... I would rather do a thousand hours of microbiology of chemistry then try to figure out this mess.

Thanks for the site information, you are always so sweet and so helpful....
 

JennifersHope

New member
Thanks for your reply... I hate Medicaid except for the cost of it. They deny just about everything that my doctor orders, or prescribes the first time around. It took several months to get approval of xopenex for me, they insisted on albuteral in spite of my tachy heart rate. They refused to let me go to National Jewish for anything other then consult, no testing etc.

I was told by National Jewish with Medicare I could come and not have to get PA or anything... I would be willing to pay out of pocket for extra care and not having to go through an HMO. Right now, if Medicaid approves of my script, I only have to pay less then four dollar which is great.

I have not done home IVs since being on Medicaid. but I am now culturing MAC and waiting for sensitivities to come back. I do not know, but the doctor pretty much said I will be on IV's and at least two or so orals....


I guess that is a good idea to talk to my Medicaid people and see what they think is the best for me to do. It is so overwhelmingly confusing all the different parts of medicare when you have dual Medicaid. I keep trying to read it and my mind goes insane..... I would rather do a thousand hours of microbiology of chemistry then try to figure out this mess.

Thanks for the site information, you are always so sweet and so helpful....
 

JennifersHope

New member
Thanks for your reply... I hate Medicaid except for the cost of it. They deny just about everything that my doctor orders, or prescribes the first time around. It took several months to get approval of xopenex for me, they insisted on albuteral in spite of my tachy heart rate. They refused to let me go to National Jewish for anything other then consult, no testing etc.
<br />
<br />I was told by National Jewish with Medicare I could come and not have to get PA or anything... I would be willing to pay out of pocket for extra care and not having to go through an HMO. Right now, if Medicaid approves of my script, I only have to pay less then four dollar which is great.
<br />
<br />I have not done home IVs since being on Medicaid. but I am now culturing MAC and waiting for sensitivities to come back. I do not know, but the doctor pretty much said I will be on IV's and at least two or so orals....
<br />
<br />
<br />I guess that is a good idea to talk to my Medicaid people and see what they think is the best for me to do. It is so overwhelmingly confusing all the different parts of medicare when you have dual Medicaid. I keep trying to read it and my mind goes insane..... I would rather do a thousand hours of microbiology of chemistry then try to figure out this mess.
<br />
<br />Thanks for the site information, you are always so sweet and so helpful....
 

JennifersHope

New member
I literally qualified for medicaid to the exact dollar, I think for I was allowed to make 905 dollars a month from SSDI and they have a 20 dollar grace rule, I make on SSDI 922.00 a month, plus I am allowed to earn on my own one thousand dollars a month or less, so when I can I still work one day a week.

If my SSDI payment would have been a few dollars more, I would not qualify for medicaid, and I would be up the creek.. I let my COBRA go once I was qualified for Medicaid because it was so much money.. more then my mortgage payment.......

Sad how people who have college degrees, worked as hard as they could to be self sufficient have to end up with such a crumby system... but at least we have something right/

Thanks again for being so sweet
 

JennifersHope

New member
I literally qualified for medicaid to the exact dollar, I think for I was allowed to make 905 dollars a month from SSDI and they have a 20 dollar grace rule, I make on SSDI 922.00 a month, plus I am allowed to earn on my own one thousand dollars a month or less, so when I can I still work one day a week.

If my SSDI payment would have been a few dollars more, I would not qualify for medicaid, and I would be up the creek.. I let my COBRA go once I was qualified for Medicaid because it was so much money.. more then my mortgage payment.......

Sad how people who have college degrees, worked as hard as they could to be self sufficient have to end up with such a crumby system... but at least we have something right/

Thanks again for being so sweet
 

JennifersHope

New member
I literally qualified for medicaid to the exact dollar, I think for I was allowed to make 905 dollars a month from SSDI and they have a 20 dollar grace rule, I make on SSDI 922.00 a month, plus I am allowed to earn on my own one thousand dollars a month or less, so when I can I still work one day a week.
<br />
<br />If my SSDI payment would have been a few dollars more, I would not qualify for medicaid, and I would be up the creek.. I let my COBRA go once I was qualified for Medicaid because it was so much money.. more then my mortgage payment.......
<br />
<br />Sad how people who have college degrees, worked as hard as they could to be self sufficient have to end up with such a crumby system... but at least we have something right/
<br />
<br />Thanks again for being so sweet
 

maryiris

New member
My husband has GREAT insurance through his company - so I have been lucky. However, he is hitting his 26th year there and can't retire because of my medical costs - would eat up everything we have saved. So just started looking into medicare - I don't even use it as secondary because I don't want the private ins. and medicate tossing bills back and forth deciding who pays. Is that a mistake? not using the medicare that is. And with Medicate - what do you need for RX, equipment (compressors, vest, etc.) cayston, pulmozyme, etc. Any advice?
 

maryiris

New member
My husband has GREAT insurance through his company - so I have been lucky. However, he is hitting his 26th year there and can't retire because of my medical costs - would eat up everything we have saved. So just started looking into medicare - I don't even use it as secondary because I don't want the private ins. and medicate tossing bills back and forth deciding who pays. Is that a mistake? not using the medicare that is. And with Medicate - what do you need for RX, equipment (compressors, vest, etc.) cayston, pulmozyme, etc. Any advice?
 

Treble

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>julie</b></i>

Jennifer, again, this post has NOTHING to do with MedicAID, so I don't for the life of me understand why you keep referencing it. As I stated in my initial response to you, her questions were about mediCARE, which I am in the process of researching. NOT medicAID. There is a huge difference. You and I have had this discussion before.



Immature? No, far from it. Fed up with you and your lies and dishonesty- absolutely.</end quote>

<br>Jerry! Jerry! :>
 
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