Guest guest Posted February 20, 2004 Report Share Posted February 20, 2004 Hi Everyone, Just wanted to let everyone know that I am back in transplant. I am now Regional Practice Administrator for liver, kidney, and pancreas transplant. I missed all of you and know that you have continued your outstanding work. What a wonderful resource you all are!!!!!! I have a question for the group: I have a patient who was transplanted in October '03 and has run out of benefits for everything; i.e., hospitalization, medications, etc. We are going to apply for Medical Assistance in his state; however, he may not be eligible for those benefits. He did not have Medicare at the time of transplant. If the patient is eligible for Medicare in two years (for disability, not age) will Medicare cover his immunosuppression medications? Any advice you can offer will be greatly appreciated. Thanks and have a great day. Arlene Gatto Albert Einstein Medical Center Philadelphia, PA >>> Leona.Moseley@... 2/19/04 3:50:18 PM >>> I know we discuss this issues a lot. Our patient had his kidney tx May 2003. He had a living donor and applied for Medicare after the tx. He has been medically retired on disability since 1983. His medical insurance is from his former employer (federal government). He can keep the insurance as long he pays the insurance premiums. Medicare became effective May 03. To date Medicare or insurance will not determine who is primary. So his post medical care cost is not getting paid. Would you be so kind to share who you think is primary or know how to get a final answer. Thanks for your input. . LEONA JOYCE MOSELEY,SR. PSR OU MEDICAL CENTER ADMITTING & TRANSPLANT FINANCIAL SERVICES PHONE # FAX # E-MAIL ADDRESS: Leona.Moseley@... BE AN ORGAN DONOR Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2004 Report Share Posted February 20, 2004 Hi Arlene, Just wanted to let everyone know that I am back in transplant. I amnow Regional Practice Administrator for liver, kidney, and pancreastransplant. [(Aguiar, )] Welcome back & congrats on the new position! Ihave a question for the group:I have a patient who was transplanted in October '03 and has run out ofbenefits for everything; i.e., ospitalization, medications, etc. Weare going to apply for Medical Assistance in his state; owever, he maynot be eligible for those benefits. He did not have Medicare at thetime of transplant. If the patient is eligible for Medicare in twoyears (for disability, not age) will Medicare cover hisimmunosuppression medications?[(Aguiar, )] No. If he wasn't at least entitled to Medicare coverage @ the time of the tx (for example, he was having a pre-emptive living donor kidney or was in the 90 HD waiting period or Social Security deemed him disabled retro far enough to have still met the 2yr disability waiting period before the tx date), then there's no entitlement for immuno coverage once he does have Medicare. IF CMS does decide to go ahead & lump the immunos w/other Rx's into the proposed Medicare Part D Rx Benefit in 2006, then he might be eligible for coverage, but it would be in accordance with the coverage levels proposed for all drugs. I'm not sure when that decision will be made, though, & it certainly won't help you today, I know-sorry :-( J. Aguiar Beth Israel Deaconess, Boston Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2004 Report Share Posted February 20, 2004 Welcome back to transplant! Does that mean we'll see you in Miami in May? Re: New Question Hi Everyone, Just wanted to let everyone know that I am back in transplant. I am now Regional Practice Administrator for liver, kidney, and pancreas transplant. I missed all of you and know that you have continued your outstanding work. What a wonderful resource you all are!!!!!! I have a question for the group: I have a patient who was transplanted in October '03 and has run out of benefits for everything; i.e., hospitalization, medications, etc. We are going to apply for Medical Assistance in his state; however, he may not be eligible for those benefits. He did not have Medicare at the time of transplant. If the patient is eligible for Medicare in two years (for disability, not age) will Medicare cover his immunosuppression medications? Any advice you can offer will be greatly appreciated. Thanks and have a great day. Arlene Gatto Albert Einstein Medical Center Philadelphia, PA >>> Leona.Moseley@... 2/19/04 3:50:18 PM >>> I know we discuss this issues a lot. Our patient had his kidney tx May 2003. He had a living donor and applied for Medicare after the tx. He has been medically retired on disability since 1983. His medical insurance is from his former employer (federal government). He can keep the insurance as long he pays the insurance premiums. Medicare became effective May 03. To date Medicare or insurance will not determine who is primary. So his post medical care cost is not getting paid. Would you be so kind to share who you think is primary or know how to get a final answer. Thanks for your input. . LEONA JOYCE MOSELEY,SR. PSR OU MEDICAL CENTER ADMITTING & TRANSPLANT FINANCIAL SERVICES PHONE # FAX # E-MAIL ADDRESS: Leona.Moseley@... BE AN ORGAN DONOR Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2004 Report Share Posted February 20, 2004 Welcome Back Arlene. now i know we are moving ahead with the program. At 10:41 AM 2/20/2004, you wrote: >Hi Everyone, >Just wanted to let everyone know that I am back in transplant. I am >now Regional Practice Administrator for liver, kidney, and pancreas >transplant. I missed all of you and know that you have continued >your outstanding work. What a wonderful resource you all are!!!!!! I >have a question for the group: >I have a patient who was transplanted in October '03 and has run out of >benefits for everything; i.e., hospitalization, medications, etc. We >are going to apply for Medical Assistance in his state; however, he may >not be eligible for those benefits. He did not have Medicare at the >time of transplant. If the patient is eligible for Medicare in two >years (for disability, not age) will Medicare cover his >immunosuppression medications? Any advice you can offer will be greatly >appreciated. Thanks and have a great day. >Arlene Gatto >Albert Einstein Medical Center >Philadelphia, PA > > >>> Leona.Moseley@... 2/19/04 3:50:18 PM >>> > I know we discuss this issues a lot. Our patient had his kidney tx >May >2003. He had a living donor and applied for Medicare after the tx. He >has >been medically retired on disability since 1983. His medical insurance >is >from his former employer (federal government). He can keep the >insurance as >long he pays the insurance premiums. Medicare became effective May 03. > To >date Medicare or insurance will not determine who is primary. So his >post >medical care cost is not getting paid. >Would you be so kind to share who you think is primary or know how to >get a >final answer. >Thanks for your input. . > > >LEONA JOYCE MOSELEY,SR. PSR >OU MEDICAL CENTER >ADMITTING & TRANSPLANT FINANCIAL SERVICES >PHONE # >FAX # >E-MAIL ADDRESS: Leona.Moseley@... >BE AN ORGAN DONOR > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 20, 2004 Report Share Posted February 20, 2004 I would love it!! I hope to see all of you soon. Take care. >>> a.Summa@... 2/20/04 11:29:16 AM >>> Welcome back to transplant! Does that mean we'll see you in Miami in May? Re: New Question Hi Everyone, Just wanted to let everyone know that I am back in transplant. I am now Regional Practice Administrator for liver, kidney, and pancreas transplant. I missed all of you and know that you have continued your outstanding work. What a wonderful resource you all are!!!!!! I have a question for the group: I have a patient who was transplanted in October '03 and has run out of benefits for everything; i.e., hospitalization, medications, etc. We are going to apply for Medical Assistance in his state; however, he may not be eligible for those benefits. He did not have Medicare at the time of transplant. If the patient is eligible for Medicare in two years (for disability, not age) will Medicare cover his immunosuppression medications? Any advice you can offer will be greatly appreciated. Thanks and have a great day. Arlene Gatto Albert Einstein Medical Center Philadelphia, PA >>> Leona.Moseley@... 2/19/04 3:50:18 PM >>> I know we discuss this issues a lot. Our patient had his kidney tx May 2003. He had a living donor and applied for Medicare after the tx. He has been medically retired on disability since 1983. His medical insurance is from his former employer (federal government). He can keep the insurance as long he pays the insurance premiums. Medicare became effective May 03. To date Medicare or insurance will not determine who is primary. So his post medical care cost is not getting paid. Would you be so kind to share who you think is primary or know how to get a final answer. Thanks for your input. . LEONA JOYCE MOSELEY,SR. PSR OU MEDICAL CENTER ADMITTING & TRANSPLANT FINANCIAL SERVICES PHONE # FAX # E-MAIL ADDRESS: Leona.Moseley@... BE AN ORGAN DONOR Quote Link to comment Share on other sites More sharing options...
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