Medicare

[Kelli]

It SUCKS!!!

I tell everyone all the time how horrible it is. And I'm not meaning to complain or minimize anything anyone else goes thru...but Medicare does NOT work for me. I am only allowed to make a certain amount of money per year to get benefits. Which include $500 a month and Medicare. My medical bills are thru the roof!

I got a bill today for $1400+. It's crazy. Medicare is primary (so I've been told) and my husbands insurance (where I work too but he carries the insurance) is secondary and I have thousands of $ of bills coming. I seriously do not understand how this system works....or doesn't work for my sake.

It would have been better for me to work and get as much $ as I could than to only work part time, have limited funds, get a small amount of $ from SSDI and then get Medicare. I guess I thought when I was going to get Medicare, my problems would be solved. They aren't.... it's a bigger hassle, I'm paying a fortune for RX at the pharmacy (like $250 for Advair), etc.

Please check into all of this before you apply. I am thinking of dropping Medicare/SSDI and just making whatever $ I can. It is such a horrible headache, I hate every bit of it. Especially since I see ZERO benefit.

So please take time to check out how it would work for you, what you'd get VS. what you give up. You need to do a lot of homework. Call your insurance provider and go over everything you can in order to be educated about it. I swear, I need a social worker or something to help me out.

I am currently trying to get approved for BCMH and then I can drop the other stuff, keep my insurance and be done with this whole nightmare.

Good luck to you! I hope it works better for you than what it is for me.
Kelli
30 f CF

 

[Kelli]

It SUCKS!!!

I tell everyone all the time how horrible it is. And I'm not meaning to complain or minimize anything anyone else goes thru...but Medicare does NOT work for me. I am only allowed to make a certain amount of money per year to get benefits. Which include $500 a month and Medicare. My medical bills are thru the roof!

I got a bill today for $1400+. It's crazy. Medicare is primary (so I've been told) and my husbands insurance (where I work too but he carries the insurance) is secondary and I have thousands of $ of bills coming. I seriously do not understand how this system works....or doesn't work for my sake.

It would have been better for me to work and get as much $ as I could than to only work part time, have limited funds, get a small amount of $ from SSDI and then get Medicare. I guess I thought when I was going to get Medicare, my problems would be solved. They aren't.... it's a bigger hassle, I'm paying a fortune for RX at the pharmacy (like $250 for Advair), etc.

Please check into all of this before you apply. I am thinking of dropping Medicare/SSDI and just making whatever $ I can. It is such a horrible headache, I hate every bit of it. Especially since I see ZERO benefit.

So please take time to check out how it would work for you, what you'd get VS. what you give up. You need to do a lot of homework. Call your insurance provider and go over everything you can in order to be educated about it. I swear, I need a social worker or something to help me out.

I am currently trying to get approved for BCMH and then I can drop the other stuff, keep my insurance and be done with this whole nightmare.

Good luck to you! I hope it works better for you than what it is for me.
Kelli
30 f CF

 

[Kelli]

It SUCKS!!!

I tell everyone all the time how horrible it is. And I'm not meaning to complain or minimize anything anyone else goes thru...but Medicare does NOT work for me. I am only allowed to make a certain amount of money per year to get benefits. Which include $500 a month and Medicare. My medical bills are thru the roof!

I got a bill today for $1400+. It's crazy. Medicare is primary (so I've been told) and my husbands insurance (where I work too but he carries the insurance) is secondary and I have thousands of $ of bills coming. I seriously do not understand how this system works....or doesn't work for my sake.

It would have been better for me to work and get as much $ as I could than to only work part time, have limited funds, get a small amount of $ from SSDI and then get Medicare. I guess I thought when I was going to get Medicare, my problems would be solved. They aren't.... it's a bigger hassle, I'm paying a fortune for RX at the pharmacy (like $250 for Advair), etc.

Please check into all of this before you apply. I am thinking of dropping Medicare/SSDI and just making whatever $ I can. It is such a horrible headache, I hate every bit of it. Especially since I see ZERO benefit.

So please take time to check out how it would work for you, what you'd get VS. what you give up. You need to do a lot of homework. Call your insurance provider and go over everything you can in order to be educated about it. I swear, I need a social worker or something to help me out.

I am currently trying to get approved for BCMH and then I can drop the other stuff, keep my insurance and be done with this whole nightmare.

Good luck to you! I hope it works better for you than what it is for me.
Kelli
30 f CF

 

[Kelli]

It SUCKS!!!

I tell everyone all the time how horrible it is. And I'm not meaning to complain or minimize anything anyone else goes thru...but Medicare does NOT work for me. I am only allowed to make a certain amount of money per year to get benefits. Which include $500 a month and Medicare. My medical bills are thru the roof!

I got a bill today for $1400+. It's crazy. Medicare is primary (so I've been told) and my husbands insurance (where I work too but he carries the insurance) is secondary and I have thousands of $ of bills coming. I seriously do not understand how this system works....or doesn't work for my sake.

It would have been better for me to work and get as much $ as I could than to only work part time, have limited funds, get a small amount of $ from SSDI and then get Medicare. I guess I thought when I was going to get Medicare, my problems would be solved. They aren't.... it's a bigger hassle, I'm paying a fortune for RX at the pharmacy (like $250 for Advair), etc.

Please check into all of this before you apply. I am thinking of dropping Medicare/SSDI and just making whatever $ I can. It is such a horrible headache, I hate every bit of it. Especially since I see ZERO benefit.

So please take time to check out how it would work for you, what you'd get VS. what you give up. You need to do a lot of homework. Call your insurance provider and go over everything you can in order to be educated about it. I swear, I need a social worker or something to help me out.

I am currently trying to get approved for BCMH and then I can drop the other stuff, keep my insurance and be done with this whole nightmare.

Good luck to you! I hope it works better for you than what it is for me.
Kelli
30 f CF

 

[Kelli]

It SUCKS!!!

I tell everyone all the time how horrible it is. And I'm not meaning to complain or minimize anything anyone else goes thru...but Medicare does NOT work for me. I am only allowed to make a certain amount of money per year to get benefits. Which include $500 a month and Medicare. My medical bills are thru the roof!

I got a bill today for $1400+. It's crazy. Medicare is primary (so I've been told) and my husbands insurance (where I work too but he carries the insurance) is secondary and I have thousands of $ of bills coming. I seriously do not understand how this system works....or doesn't work for my sake.

It would have been better for me to work and get as much $ as I could than to only work part time, have limited funds, get a small amount of $ from SSDI and then get Medicare. I guess I thought when I was going to get Medicare, my problems would be solved. They aren't.... it's a bigger hassle, I'm paying a fortune for RX at the pharmacy (like $250 for Advair), etc.

Please check into all of this before you apply. I am thinking of dropping Medicare/SSDI and just making whatever $ I can. It is such a horrible headache, I hate every bit of it. Especially since I see ZERO benefit.

So please take time to check out how it would work for you, what you'd get VS. what you give up. You need to do a lot of homework. Call your insurance provider and go over everything you can in order to be educated about it. I swear, I need a social worker or something to help me out.

I am currently trying to get approved for BCMH and then I can drop the other stuff, keep my insurance and be done with this whole nightmare.

Good luck to you! I hope it works better for you than what it is for me.
Kelli
30 f CF

 

[JustDucky]

My big problem with medicare is that they dont cover home IV's..they gladly pay for inpatient care though which to me, doesn't make any sense as it is much much cheaper to administer IV's at home. I am usually tossed into the hospital about 4 times a year for IV's, with some stays as long as 10 weeks for IV's! (Not all of them in a hospital, sadly I have had to be transferred to a sub acute care center that can take on my vent as well once the hospital stabilizes me). All of my hospital stays are in an ICU so you can imagine how expensive this is relative to home care. *sigh*
I have Medigap insurance as well...medicare covers 80% of my bills, the medigap ins. covers the remaining 20%. Prescription coverage is a real pain in the butt too. My doctors have had to become very creative as far as they go. My TOBI, pulmozyme and Xopenex are covered under Medicare B and Medigap ins because they are nebulized through DME. My other meds are covered to some extent by medicare part D which you chose out of many plans available in your state...in NY, there are no policies that cover both generic and brand names through the "doughnut hole" which I hit after a few months into the new year. My generics are covered though. My doctor belongs to a state run clinic so she has access to the many programs offered to people like me with huge medicinal needs...as a result, alot of my brand name drugs are covered. It really is a hassle...I do miss the insurance that I used to have prior to Medicare as it covered nearly everything with managable copays, even home IV's...Once my COBRA ran out, I had no choice but to fall back on Medicare.
They have been pretty good about covering my DME stuff like my vents and supplies without too much hassle.
Hope this helps, Hugs...Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[JustDucky]

My big problem with medicare is that they dont cover home IV's..they gladly pay for inpatient care though which to me, doesn't make any sense as it is much much cheaper to administer IV's at home. I am usually tossed into the hospital about 4 times a year for IV's, with some stays as long as 10 weeks for IV's! (Not all of them in a hospital, sadly I have had to be transferred to a sub acute care center that can take on my vent as well once the hospital stabilizes me). All of my hospital stays are in an ICU so you can imagine how expensive this is relative to home care. *sigh*
I have Medigap insurance as well...medicare covers 80% of my bills, the medigap ins. covers the remaining 20%. Prescription coverage is a real pain in the butt too. My doctors have had to become very creative as far as they go. My TOBI, pulmozyme and Xopenex are covered under Medicare B and Medigap ins because they are nebulized through DME. My other meds are covered to some extent by medicare part D which you chose out of many plans available in your state...in NY, there are no policies that cover both generic and brand names through the "doughnut hole" which I hit after a few months into the new year. My generics are covered though. My doctor belongs to a state run clinic so she has access to the many programs offered to people like me with huge medicinal needs...as a result, alot of my brand name drugs are covered. It really is a hassle...I do miss the insurance that I used to have prior to Medicare as it covered nearly everything with managable copays, even home IV's...Once my COBRA ran out, I had no choice but to fall back on Medicare.
They have been pretty good about covering my DME stuff like my vents and supplies without too much hassle.
Hope this helps, Hugs...Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[JustDucky]

My big problem with medicare is that they dont cover home IV's..they gladly pay for inpatient care though which to me, doesn't make any sense as it is much much cheaper to administer IV's at home. I am usually tossed into the hospital about 4 times a year for IV's, with some stays as long as 10 weeks for IV's! (Not all of them in a hospital, sadly I have had to be transferred to a sub acute care center that can take on my vent as well once the hospital stabilizes me). All of my hospital stays are in an ICU so you can imagine how expensive this is relative to home care. *sigh*
I have Medigap insurance as well...medicare covers 80% of my bills, the medigap ins. covers the remaining 20%. Prescription coverage is a real pain in the butt too. My doctors have had to become very creative as far as they go. My TOBI, pulmozyme and Xopenex are covered under Medicare B and Medigap ins because they are nebulized through DME. My other meds are covered to some extent by medicare part D which you chose out of many plans available in your state...in NY, there are no policies that cover both generic and brand names through the "doughnut hole" which I hit after a few months into the new year. My generics are covered though. My doctor belongs to a state run clinic so she has access to the many programs offered to people like me with huge medicinal needs...as a result, alot of my brand name drugs are covered. It really is a hassle...I do miss the insurance that I used to have prior to Medicare as it covered nearly everything with managable copays, even home IV's...Once my COBRA ran out, I had no choice but to fall back on Medicare.
They have been pretty good about covering my DME stuff like my vents and supplies without too much hassle.
Hope this helps, Hugs...Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[JustDucky]

My big problem with medicare is that they dont cover home IV's..they gladly pay for inpatient care though which to me, doesn't make any sense as it is much much cheaper to administer IV's at home. I am usually tossed into the hospital about 4 times a year for IV's, with some stays as long as 10 weeks for IV's! (Not all of them in a hospital, sadly I have had to be transferred to a sub acute care center that can take on my vent as well once the hospital stabilizes me). All of my hospital stays are in an ICU so you can imagine how expensive this is relative to home care. *sigh*
I have Medigap insurance as well...medicare covers 80% of my bills, the medigap ins. covers the remaining 20%. Prescription coverage is a real pain in the butt too. My doctors have had to become very creative as far as they go. My TOBI, pulmozyme and Xopenex are covered under Medicare B and Medigap ins because they are nebulized through DME. My other meds are covered to some extent by medicare part D which you chose out of many plans available in your state...in NY, there are no policies that cover both generic and brand names through the "doughnut hole" which I hit after a few months into the new year. My generics are covered though. My doctor belongs to a state run clinic so she has access to the many programs offered to people like me with huge medicinal needs...as a result, alot of my brand name drugs are covered. It really is a hassle...I do miss the insurance that I used to have prior to Medicare as it covered nearly everything with managable copays, even home IV's...Once my COBRA ran out, I had no choice but to fall back on Medicare.
They have been pretty good about covering my DME stuff like my vents and supplies without too much hassle.
Hope this helps, Hugs...Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[JustDucky]

My big problem with medicare is that they dont cover home IV's..they gladly pay for inpatient care though which to me, doesn't make any sense as it is much much cheaper to administer IV's at home. I am usually tossed into the hospital about 4 times a year for IV's, with some stays as long as 10 weeks for IV's! (Not all of them in a hospital, sadly I have had to be transferred to a sub acute care center that can take on my vent as well once the hospital stabilizes me). All of my hospital stays are in an ICU so you can imagine how expensive this is relative to home care. *sigh*
I have Medigap insurance as well...medicare covers 80% of my bills, the medigap ins. covers the remaining 20%. Prescription coverage is a real pain in the butt too. My doctors have had to become very creative as far as they go. My TOBI, pulmozyme and Xopenex are covered under Medicare B and Medigap ins because they are nebulized through DME. My other meds are covered to some extent by medicare part D which you chose out of many plans available in your state...in NY, there are no policies that cover both generic and brand names through the "doughnut hole" which I hit after a few months into the new year. My generics are covered though. My doctor belongs to a state run clinic so she has access to the many programs offered to people like me with huge medicinal needs...as a result, alot of my brand name drugs are covered. It really is a hassle...I do miss the insurance that I used to have prior to Medicare as it covered nearly everything with managable copays, even home IV's...Once my COBRA ran out, I had no choice but to fall back on Medicare.
They have been pretty good about covering my DME stuff like my vents and supplies without too much hassle.
Hope this helps, Hugs...Jenn <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[suellan]

i got medicare after 12 months of having ssdi. And yes it sucks they on;y cover 120 days of hospital stays and i have to fight with medicare b and d to get my meds covered. i've been doing this for 5 yrs. but as long as you have applied for ssdi or ssi you can get medicaid from your state to cover the rest and while you wait for medicare to kick in.

 

[suellan]

i got medicare after 12 months of having ssdi. And yes it sucks they on;y cover 120 days of hospital stays and i have to fight with medicare b and d to get my meds covered. i've been doing this for 5 yrs. but as long as you have applied for ssdi or ssi you can get medicaid from your state to cover the rest and while you wait for medicare to kick in.

 

[suellan]

i got medicare after 12 months of having ssdi. And yes it sucks they on;y cover 120 days of hospital stays and i have to fight with medicare b and d to get my meds covered. i've been doing this for 5 yrs. but as long as you have applied for ssdi or ssi you can get medicaid from your state to cover the rest and while you wait for medicare to kick in.

 

[suellan]

i got medicare after 12 months of having ssdi. And yes it sucks they on;y cover 120 days of hospital stays and i have to fight with medicare b and d to get my meds covered. i've been doing this for 5 yrs. but as long as you have applied for ssdi or ssi you can get medicaid from your state to cover the rest and while you wait for medicare to kick in.

 

[suellan]

i got medicare after 12 months of having ssdi. And yes it sucks they on;y cover 120 days of hospital stays and i have to fight with medicare b and d to get my meds covered. i've been doing this for 5 yrs. but as long as you have applied for ssdi or ssi you can get medicaid from your state to cover the rest and while you wait for medicare to kick in.

 

[ElizabethlovesChris]

Hi Skye,
In my opinion as the spouse that deals with ALL of my husband's medical bills/EOBs/insurance phone calls etc... Medicare as primary insurance SUCKS. We have always had the benefit of having Medicare secondary for the last 7 years because either I was working full-time and he was covered through my primary ins., or he was working full-time and that insurance was primary... but since Sept 07 he had to stop working full-time (and I'm not either), so although we pay COBRA still for Blue CrossBlue Shield, it had to move down to his secondary coverage and Medicare moved into primary status (they told me that COBRA has to be secondary to Medicare).

We use BCBS for all our rx drug coverage, rather than messing with Medicare Part D. But from what I understand (in my many very muddled, incoherent phone conversations with Medicare brilliant representatives) each time he goes inpatient now with Medicare as primary there is an automatic $993 charge (forget whether they call it a copay or deductible, whatever) PLUS then they still only cover 80%. That's why we definitely are continuing to pay for COBRA separately because theoretically those bills will roll over to our secondary insurance of BCBS and that will help. But just plain Medicare Part A & B on it's own causes you to carry a trememdous financial burden. Perhaps that "Medigap" that others have referred to helps with those costs.

Best of luck to you - I really HATE the anxiety that all this causes ... for pete's sake, don't CF's have enough s*** to deal with already!!!!

 

[ElizabethlovesChris]

Hi Skye,
In my opinion as the spouse that deals with ALL of my husband's medical bills/EOBs/insurance phone calls etc... Medicare as primary insurance SUCKS. We have always had the benefit of having Medicare secondary for the last 7 years because either I was working full-time and he was covered through my primary ins., or he was working full-time and that insurance was primary... but since Sept 07 he had to stop working full-time (and I'm not either), so although we pay COBRA still for Blue CrossBlue Shield, it had to move down to his secondary coverage and Medicare moved into primary status (they told me that COBRA has to be secondary to Medicare).

We use BCBS for all our rx drug coverage, rather than messing with Medicare Part D. But from what I understand (in my many very muddled, incoherent phone conversations with Medicare brilliant representatives) each time he goes inpatient now with Medicare as primary there is an automatic $993 charge (forget whether they call it a copay or deductible, whatever) PLUS then they still only cover 80%. That's why we definitely are continuing to pay for COBRA separately because theoretically those bills will roll over to our secondary insurance of BCBS and that will help. But just plain Medicare Part A & B on it's own causes you to carry a trememdous financial burden. Perhaps that "Medigap" that others have referred to helps with those costs.

Best of luck to you - I really HATE the anxiety that all this causes ... for pete's sake, don't CF's have enough s*** to deal with already!!!!

 

[ElizabethlovesChris]

Hi Skye,
In my opinion as the spouse that deals with ALL of my husband's medical bills/EOBs/insurance phone calls etc... Medicare as primary insurance SUCKS. We have always had the benefit of having Medicare secondary for the last 7 years because either I was working full-time and he was covered through my primary ins., or he was working full-time and that insurance was primary... but since Sept 07 he had to stop working full-time (and I'm not either), so although we pay COBRA still for Blue CrossBlue Shield, it had to move down to his secondary coverage and Medicare moved into primary status (they told me that COBRA has to be secondary to Medicare).

We use BCBS for all our rx drug coverage, rather than messing with Medicare Part D. But from what I understand (in my many very muddled, incoherent phone conversations with Medicare brilliant representatives) each time he goes inpatient now with Medicare as primary there is an automatic $993 charge (forget whether they call it a copay or deductible, whatever) PLUS then they still only cover 80%. That's why we definitely are continuing to pay for COBRA separately because theoretically those bills will roll over to our secondary insurance of BCBS and that will help. But just plain Medicare Part A & B on it's own causes you to carry a trememdous financial burden. Perhaps that "Medigap" that others have referred to helps with those costs.

Best of luck to you - I really HATE the anxiety that all this causes ... for pete's sake, don't CF's have enough s*** to deal with already!!!!

 

[ElizabethlovesChris]

Hi Skye,
In my opinion as the spouse that deals with ALL of my husband's medical bills/EOBs/insurance phone calls etc... Medicare as primary insurance SUCKS. We have always had the benefit of having Medicare secondary for the last 7 years because either I was working full-time and he was covered through my primary ins., or he was working full-time and that insurance was primary... but since Sept 07 he had to stop working full-time (and I'm not either), so although we pay COBRA still for Blue CrossBlue Shield, it had to move down to his secondary coverage and Medicare moved into primary status (they told me that COBRA has to be secondary to Medicare).

We use BCBS for all our rx drug coverage, rather than messing with Medicare Part D. But from what I understand (in my many very muddled, incoherent phone conversations with Medicare brilliant representatives) each time he goes inpatient now with Medicare as primary there is an automatic $993 charge (forget whether they call it a copay or deductible, whatever) PLUS then they still only cover 80%. That's why we definitely are continuing to pay for COBRA separately because theoretically those bills will roll over to our secondary insurance of BCBS and that will help. But just plain Medicare Part A & B on it's own causes you to carry a trememdous financial burden. Perhaps that "Medigap" that others have referred to helps with those costs.

Best of luck to you - I really HATE the anxiety that all this causes ... for pete's sake, don't CF's have enough s*** to deal with already!!!!

 

[ElizabethlovesChris]

Hi Skye,
In my opinion as the spouse that deals with ALL of my husband's medical bills/EOBs/insurance phone calls etc... Medicare as primary insurance SUCKS. We have always had the benefit of having Medicare secondary for the last 7 years because either I was working full-time and he was covered through my primary ins., or he was working full-time and that insurance was primary... but since Sept 07 he had to stop working full-time (and I'm not either), so although we pay COBRA still for Blue CrossBlue Shield, it had to move down to his secondary coverage and Medicare moved into primary status (they told me that COBRA has to be secondary to Medicare).

We use BCBS for all our rx drug coverage, rather than messing with Medicare Part D. But from what I understand (in my many very muddled, incoherent phone conversations with Medicare brilliant representatives) each time he goes inpatient now with Medicare as primary there is an automatic $993 charge (forget whether they call it a copay or deductible, whatever) PLUS then they still only cover 80%. That's why we definitely are continuing to pay for COBRA separately because theoretically those bills will roll over to our secondary insurance of BCBS and that will help. But just plain Medicare Part A & B on it's own causes you to carry a trememdous financial burden. Perhaps that "Medigap" that others have referred to helps with those costs.

Best of luck to you - I really HATE the anxiety that all this causes ... for pete's sake, don't CF's have enough s*** to deal with already!!!!