Waiting for MediCARE....

What is the name of your state? Michigan

Now that my father has been approved for his Social Security Disability - we have to wait another 16 - 17 months for MediCARE to kick in.

Would anyone know if there is any way that he can get MediCARE sooner than the 24 month waiting period, if his health situation is bad, and he has no way of getting the medical attention that he needs, and cannot afford to pay out of pocket?

I'm asking, because my father has no way of getting health insurance ANYWHERE. He does not qualify for MediCAID, and even if he did, he couldn't afford the "spin-down". And no health insurance company will insure him with his diabetes, neuropothy, emphysema, etc...

I just didn't know if MediCARE took into consideration certain people's situations.

Any replys are greatly appreciated.
Thanks!
- Kari

The only cases I've heard of with Medicare kicking in sooner then the 24 months is A...when the decision took extrememly long to make and B...when they have a terminal illness, otherwise you simply have to wait. Trust me I do realize this. We pay for all my husband's doctor appointments and medicines out of our pocket.

You said on your other thread:

karihager1982 said:

Medicare he will get after two years of his disability.

Is there a limited amount of money/assets that you can have in order to get approved for Medicaid??? He did have roughly $50,000 in savings, but with no income, and having to spend money to keep things going (electric, gas, groceries, etc...), it has dwindled down.

Thanks for all of your replies, you are all very helpful!

- Kari

Click to expand...

He is going to have to use that $50,000 for his medical care.

There are other possibilities, If he does daily testing, there is the cost of those supplies, regular visits to the endocrinologist cost about $80 per visit and if he manages his diabetes well he may only need to go a few times a year. Check into low cost clinics or county health plans.

The back payments from SSDI may cover his expenses.

Look into the possibility of having him on your insurance as a secondary dependent on your health plan, if allowed.

Does he belong to AARP, there may be some group plan he can get through them.

By quiting his job rather than going out on disability or retiring may have kept him from having coverage, was he offered COBRA? Was he mentally competent when he made the decision to just quit? Now that he has been approved for SSDI, is there any recourse through his former employment, is there any link of any of his illnessess to his former work?

Not to add to your problems, but . . .

Please keep in mind that even when your dad becomes eligible for Medicare, it is not the be-all and end-all of insurance policies.

First of all, Part A is free. He has to pay for Part B which will reduce his SSD check by $66.60 per month - not a fortune: but neither are SSD checks. Part B is optional - please don't make the mistake of declining immediate enrollment: there are several possible repercussions if he does not enroll right away; one of which can be a higher premium when he does enroll.

Secondly, there are just so many expenses Medicare alone does not cover - and I'm not speaking only of prescriptions now, although they are THE major consideration. And while the vast majority of healthcare professionals accept Medicare, that does not mean they do not bill for what Medicare does not pay. Trying to orchestrate the healthcare of someone so compromised as to qualify for SSD, to ensure that they are seen and cared for ONLY by those caregivers who "settle" for Medicare allowances is like herding cats: one always slips by: an anesthesiologist; a pathologist; a radiology group. . .The bills can be substantial - and even the small ones add up.

The new Medicare prescription "coverage": that is another decision to be made. Whether it is right for your dad will depend on his yearly prescription costs. Another option are prescription discount cards offered through drug manufacturers. The disadvantage to these are the way the programs are administered. Lots and lots and lots of paperwork for doctors' offices - and many are loath to comply with it - and it's not a "one shot" deal: the paperwork continues, on and on, as long as you are in the program. Check the Social Security Disability website for a link to determine what prescription program will best suit your needs. Some states administer their own prescription programs for disabled individuals or senior citizens. Connecticut's "ConnPACE" is probably the best in the country. Many states with high rural populations have no programs. Except for Rx coverage purchased directly through Medicare - or enrolling in the most expensive Medigap level policy - virtually all these are needs-based: your dad will not qualify with assets of $50,000.

You would be wise to start evaluating these "MediGap" supplemental insurances well in advance, as most companies have an "open enrollment" period of 6 months following Medicare eligibility. If Medicare participants do not elect Medigap coverage in the open period, there can be problems getting coverage later - including the inability to enroll in the level of coverage desired and higher premiums. There are - I believe - 6 or 7 levels of supplemental coverage policies. Coverage has nothing to do with who you purchase from, but rates do vary some from company to company. The highest level is the only one that covers prescriptions. It also effectively covers the better part of the average SSD check: the monthly cost is phenomonal: I recently had a client quoted $468 per month for the highest level of coverage. You and your father will have to determine which level is sufficient for his particular situation but keep one thing in mind: the patient with no supplement to Medicare pays $800 out of pocket each and every time he or she is admitted to the hospital - and that's just for starters.

Some of the best guidance - and plain talk - about Medicare is available free through seminars at Senior Centers. There is also a booklet published yearly called "Medicare and You: 200X". It's almost completely incomprehensible.

I realize all this is not wonderful news. But so many people who struggle for long periods with no insurance; people who think their healthcare problems are going to be solved once they reach eligibility, receive an awful reality check along with Medicare coverage. Unfortunately, it's way too late for the kind of financial planning that could have protetcted your Dad's assets. And more than likely that much of his lifesavings will go towards saving his life until Medicare does finally "kick" in - pun intended.

I wish you the best of luck and the strength to endure what you have to endure.