Re: Denied Medical assitance.

[Guest guest]

Has anyone that has applied for medical help through programs within your

state ever been denied? We just got notice for our youngest who has CF but

our oldest who has CF and hydrocephalus I haven't heard yet so I am wondering

if she has been excepted. They said you can appeal. Does anyone thing it is

worth it will it help? or is it a waste of time? Also I was wondering how

others handle pharmacies. Most pharmacy nowadays want the money up front they

are not willing to wait for your insurance money. We just found out that our

girls are positive again for psuedomonos. They want them to use Tobi this

time and I remember we used it once and it was more expensive then the

collistin. How do people come up with $6,000.00 for a months supply of

medication? Especially around Christmas. Deb A

[Guest guest]

Hi Deb,

just a thought about the pharmacy. You are for sure one of their

better customers. And interest rates are very low at the moment. I

bet that their margin from the TOBI is at least 1000$ and if they

have to wait a month for the money from the insurance company it will

cost them 15$ (3% from 6000 for 30 days).

I don't spent more than 2000$ a year at my pharmacy so far, but when

I asked them for a donation for this years Great Strides, they gave

700$!

I would ask the pharmacy about the upfront payment and if they don't

agree would go to another one (Grandmom Bev, how do you handle such

things?)

Peace

Torsten

P.S. You asked about the delivery of the dry powder TOBI. I don't

know, but assume it will be similar to the asthma inhalers.

> Has anyone that has applied for medical help through programs

within your

> state ever been denied? We just got notice for our youngest who has

CF but

> our oldest who has CF and hydrocephalus I haven't heard yet so I am

wondering

> if she has been excepted. They said you can appeal. Does anyone

thing it is

> worth it will it help? or is it a waste of time? Also I was

wondering how

> others handle pharmacies. Most pharmacy nowadays want the money up

front they

> are not willing to wait for your insurance money. We just found out

that our

> girls are positive again for psuedomonos. They want them to use

Tobi this

> time and I remember we used it once and it was more expensive then

the

> collistin. How do people come up with $6,000.00 for a months supply

of

> medication? Especially around Christmas. Deb A

[Guest guest]

Talk to your Social worker at your C.F. clinic about medical assistance.

Once you're approved they can never take it away from you because your child

will be considered as having C.F. the rest of they're life. It's a chronic

genetic disease.

from P.A.

[Guest guest]

Deb

Good question no one who works can't have 6 g a month for meds any time.But

with the medical assistent please fight at the begininig we didn't qualify

for anything so after 9 months we got some medicaid for only 9 months better

than nothing so by march 2002 I will start the paperwork again and try to

qualify.And will fight to the end unless we hit the lotto but fat chance with

all the meds hardly no money for lotto tickets jejejej. Anyway good luck and

fight .

PS try CHIP I don't know your state but try everything

Debbie mom to Sharon 16 ncf, 10 ncf & 2 wcf

[Guest guest]

Oh I forgot won't you contact the makers of Tobi. I use to get Pulmonyze for

free with the patient assistant program .So try it might get it free.

Debbie mom to Sharon 16 ncf, 10 ncf & 2 wcf

[Guest guest]

I want though so much trying to prove to them them cf has no cure. In there

hand book at the social worker office there is something in there about it i

forgot the number it is, But my S.W. at the hospital told me about it. And

you are right no cure means that there insurance can not be taking from them

and theycan not be denied. My oldest is 20 yrs. old and she still had it.

patty

[Guest guest]

In a message dated 12/10/2001 11:53:26 PM Eastern Standard Time,

gdattig@... writes:

<< Also I was wondering how

others handle pharmacies. >>

I know pulmoyzme gives " scholarships " ...Contact manufacturers of the

" biggies " ...maybe Grandma Bev can help...

Also, Dept. of Health in your State might have a program for families with

Chronically ill children try that, Also ask the nurse or social worker at

your CF Center...sometimes (ours was GREAT!) they can turn you on the other

resources that people in your area use.

Good Luck......We got the pulmoyzme through the scholarship when was

first diagnozed because our coverage was awful.

Good Luck.....

Rosemary in New York with three children with CF - they are 11, 9, 5.......

I coined the phrase " BREATHE DAMMIT "

[Guest guest]

I knew that these laws varied from state to state but was unaware that other

states could take your card away from you. The way our social worker put it

was that no one in the U.S. could have it taken from them. She said that if

they try to take it from us then I should contact her because they couldn't

do this.

from P.A.

[Guest guest]

Unfortunately, this is not true in every state. It is true in

Pennsylvania but in the past someone from one of the southern states,

alabama maybe, was having severe problems and was in the midst of losing

their house because of their medical expenses and the fact that they

could not get medical assistance in their state. These programs vary

widely from state to state. Pennsylvania happens to be a very good state

in this regard. The law putting this into affect in Pennsylvania

occurred only within the past few years and was put into place by Tom

Ridge (now the head of homeland security for the US).

On Tue, 11 Dec 2001 08:35:05 EST ck570@... writes:

> Talk to your Social worker at your C.F. clinic about medical

> assistance.

> Once you're approved they can never take it away from you because

> your child

> will be considered as having C.F. the rest of they're life. It's a

> chronic

> genetic disease.

> from P.A.

>

>

[Guest guest]

Torsten,

Thanks for the advice and the information on the dry Tobi. Deb A

[Guest guest]

,

That is who I talked to she is the one who steered me in this direction. We

have never been excepted before I am just trying to get in and we have been

denied. Deb A

[Guest guest]

Debbie,

What is CHIP? Deb A

[Guest guest]

Debbie,

Our insurance will pay for our medication especially now that we are at the

end of the year it is just that the pharmacies will not wait until you get

the money from your insurance company they want the money NOW and with two

girls with CF it really adds up. Rosemary how do you do it with three? Deb A

[Guest guest]

But how do you get excepted in the first place? Deb A

[Guest guest]

It Children's Health Insurance Program

I 'll send you the web site

Debbie mom to Sharon 16 ncf, 10 ncf & 2 wcf

[Guest guest]

oh what state who are in?

Debbie mom to Sharon 16 ncf, 10 ncf & 2 wcf

[Guest guest]

In a message dated 12/12/2001 11:46:02 AM Eastern Standard Time,

gdattig@... writes:

<< What is CHIP? >>

It goes with DIP - ha ha

I am silly today - I am starving....

Rosemary in New York with three children with CF - they are 11, 9, 5.......

I coined the phrase " BREATHE DAMMIT "

[Guest guest]

In a message dated 12/12/2001 11:47:38 AM Eastern Standard Time,

gdattig@... writes:

<< Rosemary how do you do it with three? >>

I have good insurance - good --- we have AETNA and they cover our

prescriptions and are great to us! I am probably the only one who likes them

but to date we haven't had problems and have our own Case Manager.

Rosemary in New York with three children with CF - they are 11, 9, 5.......

I coined the phrase " BREATHE DAMMIT "

[Guest guest]

Hi

I have had the same conversation at our clinic. Once you are covered you are

covered.

Mom to Elliot

10mths wcf

[Guest guest]

You can order your C.F. in the classroom at digestivecare.com

[Guest guest]

Rosemary,

Our insurance pays for our med.'s to it is just that the pharmacy's want

there money NOW and it take about 4 weeks for it to be process through our

insurance. Deb A

[Guest guest]

In a message dated 12/14/2001 9:20:19 AM Eastern Standard Time,

gdattig@... writes:

<< Our insurance pays for our med.'s to it is just that the pharmacy's want

there money NOW and it take about 4 weeks for it to be process through our

insurance. >>

Never heard of that....can you change pharmacy's? talk to insurance company?

Sign a release stating you will cover it if insurance doesn't especially if

you are POSITIVE insurance will cover it?

Rosemary in New York with three children with CF - they are 11, 9, 5.......

I coined the phrase " BREATHE DAMMIT "

[Guest guest]

Rosemary,

I have checked other pharmacy's they are all the same here. Deb A