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My new situation. Good or bad?
- Thread starter Treble
- Start date
I believe that Ultrase has a patient assistance program. You can tell them that at this moment you are not well and cannot afford the payments. Your job is not secure etc.... I once got Ultrase for free from a patients assistance program so I know they have one. IF for some reason they no longer have one ask your doctor to switch you to Pancrease or Pancrecarb. They both have patient assistance programs. They do not need a letter seeing your income. All they want to see is a letter from your doctor. Good luck
Even if they asked to see your bank statement, how can a person live with CF and pay for enzymes and food? There is something that is missing here.
Even if they asked to see your bank statement, how can a person live with CF and pay for enzymes and food? There is something that is missing here.
blindhearted
New member
did you try to contact Beth Sufian? She's the only other person I could think of that might be any help.
I think that for the time being, maybe we ought to leave the politics regarding a universal medical system/drug coverage... out of this particular thread as none of it is going to help Treble at this point. It's one thing to mention the differences, it's another thing to write an entire page about it without addressing the issue the poster is asking/stating. It's definately a hot topic, but it should probably be discussed in it's own thread as to not take away from this one.
Treble, the thing that worries me is that now you are insuranceless, you are kind of screwed if you get on another private insurance plan because they can refuse coverage of any CF related treatement for a certain waiting period because you had a gap in coverage. They can also deny you coverage all together because of this gap in coverage.
That being said, is there a reason why you are now off the cobra? To be honest, i'm not extrememly familiar with cobra, but is there a time limit and your's was up or what? Could you just not afford the premiums, and if so, maybe i can put you in touch with some CF resources that can give you a bit of $$ to pay for those premiums.
YOu are right, earning 800-900 at your part time job does make you inelgible for SSDI (because you are already earning at the substantial level) although I'm not 100% sure it makes you inelgible for the SSI because you can still earn a certain amount of money each month for the family (based on the family size) and get SSI. I believe you previously mentioned you live with your parents though (correct me if I'm wrong) and that could be what is making you inelgible because their income IS counted for SSI. Is that the case?
I agree with what other's have asked, is there another job you can do that won't be so stressful and taxing to you? Could you do an 8 hour a day desk job? That would give you ins. benefits after a certain amount of time.
Also, even if you aren't elgible for SSI you can still be elgible for medicaid coverage. Have you at least applied for that benefit?
Debbie makes a good point, you could quit working all together and you would be immediately elgible for medicaid with no income. Apply for SSDI but it's wise to know if you have enough work credits first. I think I already sent you some stuff on that, but if not, let me know and I can. THe best way is to go in to you SSA office (DON'T call them but rather go in) and ask them how many credits you have based on how much you've earned. Then you can make the decision debbie mentioned. Although if you weren't working at all, while you waited for your SSDI decision, you should get ins. coverage, but then again, that would also depend on your living situation (do you live with your parents, if so, medicaid might count their income but medicaid is different in every state so they may not count your parents income which would be to your benefit.
Treble, the thing that worries me is that now you are insuranceless, you are kind of screwed if you get on another private insurance plan because they can refuse coverage of any CF related treatement for a certain waiting period because you had a gap in coverage. They can also deny you coverage all together because of this gap in coverage.
That being said, is there a reason why you are now off the cobra? To be honest, i'm not extrememly familiar with cobra, but is there a time limit and your's was up or what? Could you just not afford the premiums, and if so, maybe i can put you in touch with some CF resources that can give you a bit of $$ to pay for those premiums.
YOu are right, earning 800-900 at your part time job does make you inelgible for SSDI (because you are already earning at the substantial level) although I'm not 100% sure it makes you inelgible for the SSI because you can still earn a certain amount of money each month for the family (based on the family size) and get SSI. I believe you previously mentioned you live with your parents though (correct me if I'm wrong) and that could be what is making you inelgible because their income IS counted for SSI. Is that the case?
I agree with what other's have asked, is there another job you can do that won't be so stressful and taxing to you? Could you do an 8 hour a day desk job? That would give you ins. benefits after a certain amount of time.
Also, even if you aren't elgible for SSI you can still be elgible for medicaid coverage. Have you at least applied for that benefit?
Debbie makes a good point, you could quit working all together and you would be immediately elgible for medicaid with no income. Apply for SSDI but it's wise to know if you have enough work credits first. I think I already sent you some stuff on that, but if not, let me know and I can. THe best way is to go in to you SSA office (DON'T call them but rather go in) and ask them how many credits you have based on how much you've earned. Then you can make the decision debbie mentioned. Although if you weren't working at all, while you waited for your SSDI decision, you should get ins. coverage, but then again, that would also depend on your living situation (do you live with your parents, if so, medicaid might count their income but medicaid is different in every state so they may not count your parents income which would be to your benefit.
- In jersey, they won't give me insurance unless I go on the welfare program.
- The ultrase patitent assistance program wouldn't help me. They would only bring my ultrase costs from 3,000 a month to 2,000 a month. and pancrease dosen't work on me. Nor does Creon (anymore).
- Cobra booted me because they only agreed to carry me for so long (around 18 months), and that time is up now. I was able to meet their retarded premiums though. Even with them going up on me twice during it.
- I can't apply for medicade directly with an application for SSDI pending. Since I sent in my SSDI app already, I can't app for medicare seperatly for one year. I also can't withdraw my SSDI app in order to fix that and get just medicare.
- The only insurance avalible to me would be medicade, to cover my basic things like enzyms. In order to get that, I need to quit my job (looking liky my best option)
- No, I can't work a full time job period. 2-3 months into it, I always get some massive infection, and im laid out for a week or two. Then they fire me.
One of the biggest mistakes I made, was applying for SSDI, instead of straight for medicare. It only takes 30 days for them to make a decision, well it takes months for the SS offices to make their decision.
The best advice I was given by the person as the SS offices, was to stop working, try to get my enzyms covered with a program that he let me have the number for (they were closed when i got off the phone with him, so I don't know if it'll work or not yet), have my doctor (two faced ass) to write a letter to SS offices about me being disabled and why I have trouble holding down a full time job.
Meanwhile, im getting little to no support from my family on going in this direction, instead of toughing it out, and trying to work full time (AGAIN). I guess it's hard to ask them to understand though. Hence why im coming to places like this alot now.
- The ultrase patitent assistance program wouldn't help me. They would only bring my ultrase costs from 3,000 a month to 2,000 a month. and pancrease dosen't work on me. Nor does Creon (anymore).
- Cobra booted me because they only agreed to carry me for so long (around 18 months), and that time is up now. I was able to meet their retarded premiums though. Even with them going up on me twice during it.
- I can't apply for medicade directly with an application for SSDI pending. Since I sent in my SSDI app already, I can't app for medicare seperatly for one year. I also can't withdraw my SSDI app in order to fix that and get just medicare.
- The only insurance avalible to me would be medicade, to cover my basic things like enzyms. In order to get that, I need to quit my job (looking liky my best option)
- No, I can't work a full time job period. 2-3 months into it, I always get some massive infection, and im laid out for a week or two. Then they fire me.
One of the biggest mistakes I made, was applying for SSDI, instead of straight for medicare. It only takes 30 days for them to make a decision, well it takes months for the SS offices to make their decision.
The best advice I was given by the person as the SS offices, was to stop working, try to get my enzyms covered with a program that he let me have the number for (they were closed when i got off the phone with him, so I don't know if it'll work or not yet), have my doctor (two faced ass) to write a letter to SS offices about me being disabled and why I have trouble holding down a full time job.
Meanwhile, im getting little to no support from my family on going in this direction, instead of toughing it out, and trying to work full time (AGAIN). I guess it's hard to ask them to understand though. Hence why im coming to places like this alot now.
I just got an e-mail back from beth. She's saying that that insurance company can't refuse me like they are due to new jersey law. So im gonna call them back later today, and speak with a supervisor.
Maybe I'll get lucky have have some real work for beth. <img src="i/expressions/face-icon-small-tongue.gif" border="0">
Maybe I'll get lucky have have some real work for beth. <img src="i/expressions/face-icon-small-tongue.gif" border="0">
I hope Beth is able to help you out with this one. If you aren't working you should qualify for medicaid and they do cover everything.
I don't understand what you mean about the biggest mistake you made was applying for SSDI, instead of straight for medicare. You can only be on medicare if you are retirement age or if you are on SSDI AFTER 24 months of being on it. It leads me to believe that your local office isnt' giving you accurate information.
Who told you that you can't apply for medicaid with a SSDI application pending? Medicaid is different in every state (medicare is a federal program) but I'm pretty sure that this too is inaccurate, Mark was on medicaid with his SSDI application pending for over a year.
I do wish you luck, but I really think whoever you are talking to doesn't know their job very well.
I don't understand what you mean about the biggest mistake you made was applying for SSDI, instead of straight for medicare. You can only be on medicare if you are retirement age or if you are on SSDI AFTER 24 months of being on it. It leads me to believe that your local office isnt' giving you accurate information.
Who told you that you can't apply for medicaid with a SSDI application pending? Medicaid is different in every state (medicare is a federal program) but I'm pretty sure that this too is inaccurate, Mark was on medicaid with his SSDI application pending for over a year.
I do wish you luck, but I really think whoever you are talking to doesn't know their job very well.
I found a clause that I knew existed from when I worked at our local hospital. This is from the SSA website:
Certain aged people who do not qualify for Medicare hospital insurance under these rules may be able to get it by paying a monthly premium. They must also always enroll in medical insurance (Part B) to get this coverage. Certain disabled people who lost premium-free hospital insurance due to work can get Medicare hospital insurance again by paying a premium.
Medicare Medical Insurance (also known as Part B)
Almost anyone who is 65 or older or who is under 65 but eligible for hospital insurance can enroll for Medicare medical insurance by paying a monthly premium. Aged people don't need any Social Security or government work credits for this part of Medicare.
Certain aged people who do not qualify for Medicare hospital insurance under these rules may be able to get it by paying a monthly premium. They must also always enroll in medical insurance (Part B) to get this coverage. Certain disabled people who lost premium-free hospital insurance due to work can get Medicare hospital insurance again by paying a premium.
Medicare Medical Insurance (also known as Part B)
Almost anyone who is 65 or older or who is under 65 but eligible for hospital insurance can enroll for Medicare medical insurance by paying a monthly premium. Aged people don't need any Social Security or government work credits for this part of Medicare.
Melissa,
I'm trying to interpret this one. It's talking about aged people paying a monthly premium; I don't think Treble is aged though <img src="i/expressions/face-icon-small-smile.gif" border="0">. The disability one (second sentence, 1paragraph) would apply but he'd have to have medicare elgibility initially (after 24 months on SSDI). Are you reading this the same or am I missing it.
I think the real problem is with his/her local social services office. I really thing the information they are giving to treble is incorrect. Medicaid does vary state to state but for the most part, the coverages and elgiblility is the same..... what do you think. I hate stuff like this and want to help treble get to the bottom of it (with some accurate answers).
I'm trying to interpret this one. It's talking about aged people paying a monthly premium; I don't think Treble is aged though <img src="i/expressions/face-icon-small-smile.gif" border="0">. The disability one (second sentence, 1paragraph) would apply but he'd have to have medicare elgibility initially (after 24 months on SSDI). Are you reading this the same or am I missing it.
I think the real problem is with his/her local social services office. I really thing the information they are giving to treble is incorrect. Medicaid does vary state to state but for the most part, the coverages and elgiblility is the same..... what do you think. I hate stuff like this and want to help treble get to the bottom of it (with some accurate answers).
here's some stuff I've found for you treble, maybe it might be a little more helpful than what they are telling you.
Here's the home page where you can find some general information <a target=_blank class=ftalternatingbarlinklarge href="http://www.state.nj.us/humanservices/dmahs/dhsmed.html
">http://www.state.nj.us/humanservices/dmahs/dhsmed.html
</a>
<a target=_blank class=ftalternatingbarlinklarge href="http://www.state.nj.us/humanservices/dmahs/10-49%20MANUAL.pdf">http://www.state.nj.us/humanse...ahs/10-49%20MANUAL.pdf</a> go to page 11. Page 12 covers the medically needy program where you can have income, but they any copays/out of pocket medical expenses offset your income and you can qualify based off of that.
Here's more on the medically needy program <a target=_blank class=ftalternatingbarlinklarge href="http://www.state.nj.us/humanservices/dmahs/10-70%20%20Manual.pdf">http://www.state.nj.us/humanse.../10-70%20%20Manual.pdf</a> start on page 4
<a target=_blank class=ftalternatingbarlinklarge href="http://www.state.nj.us/humanservices/dmahs/10-71%20MANUAL.pdf">http://www.state.nj.us/humanse...ahs/10-71%20MANUAL.pdf</a> Page 32 discusses countable resources/uncountable resources
<a target=_blank class=ftalternatingbarlinklarge href="http://www.state.nj.us/humanservices/dmahs/10-72-Manual.pdf">http://www.state.nj.us/humanse...dmahs/10-72-Manual.pdf</a> More info on financial elgibility. Start on page 28
<a target=_blank class=ftalternatingbarlinklarge href="http://aspe.hhs.gov/poverty/06poverty.shtml">http://aspe.hhs.gov/poverty/06poverty.shtml</a> Federal poverty level guidelines
Good luck!
Here's the home page where you can find some general information <a target=_blank class=ftalternatingbarlinklarge href="http://www.state.nj.us/humanservices/dmahs/dhsmed.html
">http://www.state.nj.us/humanservices/dmahs/dhsmed.html
</a>
<a target=_blank class=ftalternatingbarlinklarge href="http://www.state.nj.us/humanservices/dmahs/10-49%20MANUAL.pdf">http://www.state.nj.us/humanse...ahs/10-49%20MANUAL.pdf</a> go to page 11. Page 12 covers the medically needy program where you can have income, but they any copays/out of pocket medical expenses offset your income and you can qualify based off of that.
Here's more on the medically needy program <a target=_blank class=ftalternatingbarlinklarge href="http://www.state.nj.us/humanservices/dmahs/10-70%20%20Manual.pdf">http://www.state.nj.us/humanse.../10-70%20%20Manual.pdf</a> start on page 4
<a target=_blank class=ftalternatingbarlinklarge href="http://www.state.nj.us/humanservices/dmahs/10-71%20MANUAL.pdf">http://www.state.nj.us/humanse...ahs/10-71%20MANUAL.pdf</a> Page 32 discusses countable resources/uncountable resources
<a target=_blank class=ftalternatingbarlinklarge href="http://www.state.nj.us/humanservices/dmahs/10-72-Manual.pdf">http://www.state.nj.us/humanse...dmahs/10-72-Manual.pdf</a> More info on financial elgibility. Start on page 28
<a target=_blank class=ftalternatingbarlinklarge href="http://aspe.hhs.gov/poverty/06poverty.shtml">http://aspe.hhs.gov/poverty/06poverty.shtml</a> Federal poverty level guidelines
Good luck!
erm, in my prevous posts, I ment the one that covers everything.
I get medicade and medicare mixed up constantly, no matter how many times I hear the diffrence. lol
Thanks for the links julie. I'll check em out once im back from the DMV.
Getting my AZ lisence changed to a jersey one.
They won't give my family any car insurance at all until I do. >_>
I get medicade and medicare mixed up constantly, no matter how many times I hear the diffrence. lol
Thanks for the links julie. I'll check em out once im back from the DMV.
Getting my AZ lisence changed to a jersey one.
They won't give my family any car insurance at all until I do. >_>
treble,
i have been in your situation and i know that it is scary. first off, as you've said, MANY drug companies offer assistance programs to people with NO insurance or with very limited incomes. is ultrase all you are on?
sounds like you are getting a lot of good information about what government assistance is out there for you. if you haven't already, i would immediately educate yourself about all of your possibilities. maybe you could meet with a disability counciler? you sound like a good candidate for ssi/ssdi.
as for your parents, i don't understand -- it sounds like you are saying that they are pushing you to work even though it is making you sick!? that can't be in your best interest. if you are "costing them money" either way (working or not), then i say, quit your job, get healthy, apply for govt programs, and then, when you have your needs covered, think about working part time or whatever you can.
good luck!
laura
i have been in your situation and i know that it is scary. first off, as you've said, MANY drug companies offer assistance programs to people with NO insurance or with very limited incomes. is ultrase all you are on?
sounds like you are getting a lot of good information about what government assistance is out there for you. if you haven't already, i would immediately educate yourself about all of your possibilities. maybe you could meet with a disability counciler? you sound like a good candidate for ssi/ssdi.
as for your parents, i don't understand -- it sounds like you are saying that they are pushing you to work even though it is making you sick!? that can't be in your best interest. if you are "costing them money" either way (working or not), then i say, quit your job, get healthy, apply for govt programs, and then, when you have your needs covered, think about working part time or whatever you can.
good luck!
laura
Julie, I need to ask you something.
Well, more of a favor really... since you're really good at information finding.
Beth is telling me about a disabled child form. It's a new jersey law, that if your child, of 18 or older, is unable to work and get insurance, that you can put them back under their parents coverage.
Now, my mother denies that this exits up and down, and beth is telling me it's for real, and my dads afraid to mess with the insurance company, because it may cause problems with his job.
If this is the real deal though, then I can go in under this, not have to work the full time, stop working now (time to work on my health finally!!!), and get SSDI all the easier!
Should it not be true though, then I have no choice other then to tough it out full time until I get sick and lose it, again. Then I can go back in under COBRA for another 18 months, and attempt to get SSDI during that, well my parents (they offered) cover my COBRA payments.
Well, more of a favor really... since you're really good at information finding.
Beth is telling me about a disabled child form. It's a new jersey law, that if your child, of 18 or older, is unable to work and get insurance, that you can put them back under their parents coverage.
Now, my mother denies that this exits up and down, and beth is telling me it's for real, and my dads afraid to mess with the insurance company, because it may cause problems with his job.
If this is the real deal though, then I can go in under this, not have to work the full time, stop working now (time to work on my health finally!!!), and get SSDI all the easier!
Should it not be true though, then I have no choice other then to tough it out full time until I get sick and lose it, again. Then I can go back in under COBRA for another 18 months, and attempt to get SSDI during that, well my parents (they offered) cover my COBRA payments.
Treble, I'll help you look into it. It might take me a few days, but I'll email the NJ insurance commissioners office today, and call them if I haven't heard back by Tuesday. If it is a law in NJ (as it is in many states) and I find the written law with the ins. commissioners assistance it should make a difference for you.
I'm sorry you are meeting so much opposition from your parents. Have you sat down and had a frank talk with them about all of this, how you feel, your health problems, long term complications of working yourself so hard with a chronic disease, fear of getting sick again and getting laid off.... Maybe separate it from the talks you have about ins. coverage and a job. Just ask them if you can all talk. Might help, might not, but if they aren't willing to call the ins. company and add you then no information I find is going to help you.
But sure, I'll do that and hopefully I'll get something so you can show your parents.
I'm sorry you are meeting so much opposition from your parents. Have you sat down and had a frank talk with them about all of this, how you feel, your health problems, long term complications of working yourself so hard with a chronic disease, fear of getting sick again and getting laid off.... Maybe separate it from the talks you have about ins. coverage and a job. Just ask them if you can all talk. Might help, might not, but if they aren't willing to call the ins. company and add you then no information I find is going to help you.
But sure, I'll do that and hopefully I'll get something so you can show your parents.
<a target=_blank class=ftalternatingbarlinklarge href="http://www.cmwf.org/usr_doc/Collins_riteofpassage2006_649_ib.pdf
">http://www.cmwf.org/usr_doc/Co...assage2006_649_ib.pdf
</a>
According to this article (page 8) New Jersey has a law that went into effect May 2006 that requires most insurers to cover dependents to age 30.
">http://www.cmwf.org/usr_doc/Co...assage2006_649_ib.pdf
</a>
According to this article (page 8) New Jersey has a law that went into effect May 2006 that requires most insurers to cover dependents to age 30.