Re: Medical Coverage

[Guest guest]

just call 1-800-506 3725 between 8 am and 8pm to apply for assistance in

paying for medication . This program is for the uninsured who cannot afford

their meds. cathy from ma

[Guest guest]

Enbrel has a very good sponsorship program. If your daughter has insurance, and

she has a co-pay, Enbrel also has co-pay assistance. This is a great company.

If your daughter is on other medications (often those with PA have depression

and chronic pain issues), most of the companies have sponsorship programs.

Check into each and every one of them. I am sponsored by three companies. I

did have sponsorship from Enbrel for co-pay assistance but then lost my job and

so I'm now seeking complete sponsorship. I don't know how much money your

daughter makes. I think she can get assistance of some type if she makes $12 or

less an hour. As far as SSDI, I am currently in the process of applying for

disability since the PA has more or less rendered me disabled due to the loss of

use of my fingers and hands, as well as hip and back pain. Does your daughter

have any other issues, like fibromyalgia (most often accompanies PA and RA) or

depression or ADD?, and if so, does she

have problems working a full time job. Does she miss alot of work because of

the PA? I was diagnosed with PA when I was 35 and the symptoms began

interferring with my ability to hold a job at 45 and now at 55, I can't continue

working any longer. These conditions are considered disabilities for SSDI. Hope

this helps a little bit.

glass_wolfe <nancy@...> wrote: Any one out there having the same

problem as my daughter?

At the age of 9 she was diagnosed with psoritiac arthritis.

Because of my income at the time she did not qualify for Medicade but

she did however qualify for a program called TEFRA which is based on

the same things as Medicade. All her meds and Dr.'s visits were covered.

At the age of 19 she will no longer qualify which will be on Dec.

23rd, 2006. I went to the DSS office in my town to get her new

coverage as an adult only to be told that she would not qualify for

it. She has to be deemed disabled by Social Security to get any help

with her meds and Dr. bills. So... we fill out the paper work only to

be turned down by S.S. which was no surprise to us really. She is a

full time college student and a part time worker. Because of the

Methotrexate and the Enbrel she is taking once a week she is able to

funtion and work and go to school. But the cost of the Enbrel is a

little more than $400.00 a week and with no help from our government

her meds will soon have to be stopped, as no one I know could afford

that kind of weekly meds. bill.

We were basicly told that she needs to quit working, and if she no

longer has her meds then she might be deemed disabled.

What can we do to get her coverage she needs without stopping her meds??

We are in the process of trying to get in touch with the makers of

Enbrel to see if maybe they would give the medicine free of charge? (

Wish us luck!)

Is there anyone out there that knows of other programs that would be

able to help a young woman that is trying to help herself? She just

wants to work and funtion like any other 19 year old.

Thank you.

Glass_wolfe

Kathy

__________________________________________________

[Guest guest]

I am becoming more and more familiar with the system. What state are

you in? If your daughter has worked at all, she may qualify for state

disability. Federal disability typically denies you the first time but

will probably go through the second or third time. And it will be

retroactive back to the first time you applied. So keep doing it. Too

bad there wasn't anyone to fill you in on this earlier so you could

have started th process last year and been ok this year. I have been in

touch with the United Way foundation and they gave me lots of contacts

in my area. Give them a call. Hope all goes well. Social Services won't

know about many of the agencies that can help you so you'll have to

research on your own. Best wishes. -Betz

[Guest guest]

I want to first say I'm NOT endorsing this company. I just found it

today. I don't know if it will be helpful to you or how good it

really is. This isn't insurance. It's a company that has

negotiated lower rates with healthcare providers. You pay the

provider the negotiated rate. It's called AmeriPlan. If anyone has

any experience with them, I'd appreciate input. What I understand

is that there are no pre-existing conditions since it's not

insurance. For a family it's $60/mo for medical, dental, and

vision. For dental and vision only (and it includes glasses and

braces) it's $20/mo I think. I have military insurance, meaning

excellent coverage. I don't have any coverage for braces and

glasses, though, and I was considering getting just that. Again, I

need to get more information, so please do NOT take this as me

recommending it. I'm only bringing it to your attention in case it

can help. You can access their provider search at

www.ameriplanusa.com. I'm thinking of signing up as a business

which would give me the dental plus coverage for free, which is the

only coverage that would benefit us. I have to do alot more

reading, though, before I connect myself in any way to them.

Gael

>

> Any one out there having the same problem as my daughter?

> At the age of 9 she was diagnosed with psoritiac arthritis.

> Because of my income at the time she did not qualify for Medicade

but

> she did however qualify for a program called TEFRA which is based

on

> the same things as Medicade. All her meds and Dr.'s visits were

covered.

> At the age of 19 she will no longer qualify which will be on Dec.

> 23rd, 2006. I went to the DSS office in my town to get her new

> coverage as an adult only to be told that she would not qualify for

> it. She has to be deemed disabled by Social Security to get any

help

> with her meds and Dr. bills. So... we fill out the paper work

only to

> be turned down by S.S. which was no surprise to us really. She is

a

> full time college student and a part time worker. Because of the

> Methotrexate and the Enbrel she is taking once a week she is able

to

> funtion and work and go to school. But the cost of the Enbrel is a

> little more than $400.00 a week and with no help from our

government

> her meds will soon have to be stopped, as no one I know could

afford

> that kind of weekly meds. bill.

> We were basicly told that she needs to quit working, and if she no

> longer has her meds then she might be deemed disabled.

> What can we do to get her coverage she needs without stopping her

meds??

> We are in the process of trying to get in touch with the makers of

> Enbrel to see if maybe they would give the medicine free of

charge? (

> Wish us luck!)

> Is there anyone out there that knows of other programs that would

be

> able to help a young woman that is trying to help herself? She

just

> wants to work and funtion like any other 19 year old.

>

> Thank you.

>

> Glass_wolfe

>

[Guest guest]

Have you tried contacting the company that produces enbrel to see if

they have a patient assistance program?

>

> Any one out there having the same problem as my daughter?

> At the age of 9 she was diagnosed with psoritiac arthritis.

> Because of my income at the time she did not qualify for Medicade

but

> she did however qualify for a program called TEFRA which is based on

> the same things as Medicade. All her meds and Dr.'s visits were

covered.

> At the age of 19 she will no longer qualify which will be on Dec.

> 23rd, 2006. I went to the DSS office in my town to get her new

> coverage as an adult only to be told that she would not qualify for

> it. She has to be deemed disabled by Social Security to get any

help

> with her meds and Dr. bills. So... we fill out the paper work only

to

> be turned down by S.S. which was no surprise to us really. She is a

> full time college student and a part time worker. Because of the

> Methotrexate and the Enbrel she is taking once a week she is able to

> funtion and work and go to school. But the cost of the Enbrel is a

> little more than $400.00 a week and with no help from our government

> her meds will soon have to be stopped, as no one I know could afford

> that kind of weekly meds. bill.

> We were basicly told that she needs to quit working, and if she no

> longer has her meds then she might be deemed disabled.

> What can we do to get her coverage she needs without stopping her

meds??

> We are in the process of trying to get in touch with the makers of

> Enbrel to see if maybe they would give the medicine free of charge?

(

> Wish us luck!)

> Is there anyone out there that knows of other programs that would be

> able to help a young woman that is trying to help herself? She just

> wants to work and funtion like any other 19 year old.

>

> Thank you.

>

> Glass_wolfe

>

[Guest guest]

My advice is to keep applying for SSD AND SSI. Hardly ANYONE is accepted on

their

first try. But you know it takes 5 to 6 months under normal circumstances, but

it doesn't

cost to anything to apply, so I would keep trying.

Jk

-------------- Original message --------------

From: " glass_wolfe " <nancy@...>

> Any one out there having the same problem as my daughter?

> At the age of 9 she was diagnosed with psoritiac arthritis.

> Because of my income at the time she did not qualify for Medicade but

> she did however qualify for a program called TEFRA which is based on

> the same things as Medicade. All her meds and Dr.'s visits were covered.

> At the age of 19 she will no longer qualify which will be on Dec.

> 23rd, 2006. I went to the DSS office in my town to get her new

> coverage as an adult only to be told that she would not qualify for

> it. She has to be deemed disabled by Social Security to get any help

> with her meds and Dr. bills. So... we fill out the paper work only to

> be turned down by S.S. which was no surprise to us really. She is a

> full time college student and a part time worker. Because of the

> Methotrexate and the Enbrel she is taking once a week she is able to

> funtion and work and go to school. But the cost of the Enbrel is a

> little more than $400.00 a week and with no help from our government

> her meds will soon have to be stopped, as no one I know could afford

> that kind of weekly meds. bill.

> We were basicly told that she needs to quit working, and if she no

> longer has her meds then she might be deemed disabled.

> What can we do to get her coverage she needs without stopping her meds??

> We are in the process of trying to get in touch with the makers of

> Enbrel to see if maybe they would give the medicine free of charge? (

> Wish us luck!)

> Is there anyone out there that knows of other programs that would be

> able to help a young woman that is trying to help herself? She just

> wants to work and funtion like any other 19 year old.

>

> Thank you.

>

> Glass_wolfe

[Guest guest]

Is there anyone out there that knows of other programs that would be

able to help a young woman that is trying to help herself? She just

wants to work and funtion like any other 19 year old.

Try the Patient Access Network. Since she is 19 and works part-time

as well as going to college, she would need to provide them with a

copy of her income tax statement. They review the finances and offer

assistance to pay with various meds, including Enbrel.

Another option would be to see if you or your wife can add her onto

your insurance as a dependent, during your employer's open

enrollment (which is usually between November and December each

year.) Even though she works part-time and goes to college, if you

help her with at least half of her finances, you can claim her as a

dependent on YOUR taxes and on your health insurance. The insurance

company may require a note from the college saying she is a full-

time student, but once they have this proof, most insurance

companies will cover adult children as dependents while they are

full-time students until they are around 23 years old or so. (I

know, my 23 year old was covered under my health plan till this

year, and my 21 and 19 year olds are still covered.) If you don't

have a good prescription plan with your insurance (mine is awful, I

have to pay 25% of the cost of my Enbrel each month, which is about

$300-400 a month) this may not be a great option though.

Take care.

[Guest guest]

I do not have medical coverage either,I am fighting Social Security

right now, I'm on my first appeal. I am on MTX and Enbrel. I get my

Enbrel thru the company. Just let me tell you, that you will have to

jump thru their hoops to comply with their restrictions. If you and

she can bear through that, then it will be worth it, trust me. It is

a foundation that covers the enbrel actually and at first they didn't

tell me that there was a waiting list for an opening in the

foundation. I was told that I had been approved financially wise to

recieve the medicine, but I had to wait for an opening and they

didn't know how long that would be. Luckily I didn't have to wait

long..about 2 weeks.

Also try www.pparx.com you can search for all medications and put in

some info to see if she might be eligible to get them at a discount

or free.

I wish you and your daughter all the luck in the world. Keep plugging

away at social security,,take it as far as you can,,get a laywer if

need be,usually if you don't win then you don't owe them anything.

And good luck with the Encourage Foundation (Enbrel)

>

> Any one out there having the same problem as my daughter?

> At the age of 9 she was diagnosed with psoritiac arthritis.

> Because of my income at the time she did not qualify for Medicade

but

> she did however qualify for a program called TEFRA which is based on

> the same things as Medicade. All her meds and Dr.'s visits were

covered.

> At the age of 19 she will no longer qualify which will be on Dec.

> 23rd, 2006. I went to the DSS office in my town to get her new

> coverage as an adult only to be told that she would not qualify for

> it. She has to be deemed disabled by Social Security to get any

help

> with her meds and Dr. bills. So... we fill out the paper work only

to

> be turned down by S.S. which was no surprise to us really. She is a

> full time college student and a part time worker. Because of the

> Methotrexate and the Enbrel she is taking once a week she is able to

> funtion and work and go to school. But the cost of the Enbrel is a

> little more than $400.00 a week and with no help from our government

> her meds will soon have to be stopped, as no one I know could afford

> that kind of weekly meds. bill.

> We were basicly told that she needs to quit working, and if she no

> longer has her meds then she might be deemed disabled.

> What can we do to get her coverage she needs without stopping her

meds??

> We are in the process of trying to get in touch with the makers of

> Enbrel to see if maybe they would give the medicine free of charge?

(

> Wish us luck!)

> Is there anyone out there that knows of other programs that would be

> able to help a young woman that is trying to help herself? She just

> wants to work and funtion like any other 19 year old.

>

> Thank you.

>

> Glass_wolfe

>

[Guest guest]

I applied for SSI and SSD about 6 years ago and appealed for 2 years,

until my lawyer said that is wasn't worth trying to go any further.

>

> My advice is to keep applying for SSD AND SSI. Hardly ANYONE is

accepted on their

> first try. But you know it takes 5 to 6 months under normal

circumstances, but it doesn't

> cost to anything to apply, so I would keep trying.

> Jk

>

>

[Guest guest]

I really feel for those of you in the States. I am off work with full pay and

if I am found not able to go back, I will get paid my normal salary, tax free,

the rest of my life.

I know, I know..... you really didn't want to hear that!

Ontario

[Editor's Note: It helps that your country has to pay virtually nothing for

national security since your neighbor to the south essentially assures you of

your freedoms and in effect provides your national defense. This is a statement

of fact and not a political statement. The US government spends more on

fighting a war that the many of its citizens believe is of dubious value than in

finding cures for the diseases that are destroying the lives of millions of its

own people. Canada's value systems are light years ahead of those in the US in

the view of many of us. JMO. Kathy F.]

[ ] Re: Medical Coverage

I applied for SSI and SSD about 6 years ago and appealed for 2 years,

until my lawyer said that is wasn't worth trying to go any further.

[Guest guest]

, I do want to hear this, thank you. My neighbor is Canadian and I agree

with Kathy that your value system is ahead of us here in the USA. I am not

sure if Kathy's statement is political or not, but I am not sure how we are

providing for Canada's national defense. Is there a treaty, that is not mutual?

Long live Canada.

[Editor's Note: Hi, , long time no see. I did not mean my statement in a

political way. A very significant portion of the US budget goes towards defense

which means that Canada, with whom we do have a mutual defense treaty (it has

sent troups to Iraq, for example) and we are both members of NATO, does not have

to spend money protecting its 3000 mile border from an aggressive neighbor, nor

does it have to fear incursion from other enemies. It knows the US would, of

our own selfish necessity, come to Canada's defense if it faced foreign

invasion. Canada does, of course, need to protect the land inside its borders

and it does have a miliary force, but it is much smaller than it would need if

the US were not its immediate neighbor. Many Canadians readily admit that not

having to spend much on defense is a big part of why it is able to spend more

money on humanitarian care. Kathy F.]

<fortheluvofgoldens@...> wrote: I really feel for those

of you in the States. I am off work with full pay and if I am found not able to

go back, I will get paid my normal salary, tax free, the rest of my life.

I know, I know..... you really didn't want to hear that!

Ontario

[Editor's Note: It helps that your country has to pay virtually nothing for

national security since your neighbor to the south essentially assures you of

your freedoms and in effect provides your national defense. This is a statement

of fact and not a political statement. The US government spends more on fighting

a war that the many of its citizens believe is of dubious value than in finding

cures for the diseases that are destroying the lives of millions of its own

people. Canada's value systems are light years ahead of those in the US in the

view of many of us. JMO. Kathy F.]

[Guest guest]

For ....that's just one attorney's opinion. Don't let one

person persuade you to throw in the towel unless you can afford to do

that. Call United Way and get a list of resources in your area. I

imagine that your health has declined over the past 6 years so you

may have a shot at it now. And , thank you for your

compassion. I love my country but lately it's been so hard just to

get access to the money that I've been giving out of my paycheck for

29 years now. We have a great country yes...but we are not taking

care of our own and I don't see it changing anytime soon. Before I

was disabled, I had no clue as to what a disabled person needed so

the Social Services and Disability systems were of no concern to me.

I never noticed the people who limped in the supermarket. I never

thought about what a person may have endured that week in their

personal life if they seemed tense or a bit rude in the checkout

line. I never looked at a Mom with her children in tow and wondered

if she was able to pay her rent that month. I think differently now.

But our government officials will more than likely not ever find

themselves in the financial position that I am in so it may never

become an important issue to them. Alas, that is human nature. When

one of their family members dies of Aids or is hit by a drunk driver

then those issues become important to them generally. We just don't

usually have the capacity to " get it " unless we've lived it. I

understand all of this and in some ways I am cutting them a break by

saying that I believe that their lack of personal experience in the

area of poor health and lack of funds to pay for medications and food

is at the root of their inefficiency in managing our nations health

care problems BUT regardless, the reality is that this is one area

where our great country has not stepped up to the plate. Do I want to

hear it??? Well lately I DO hear it ringing in my head over and over.

I pray that we get it together down here and sock some of the efforts

and funding that goes into taking care of the rest of the world into

taking care of our own citizens first. This is what I pray. And I

commend you for realizing what a gift you have. We all need to do

more of that and having said that, I'm going to sit here and come up

with five things I am thankful for as a US citizen even though I'm

not happy about our health care system (or lack of). -Betz

>

> I really feel for those of you in the States. I am off work with

full pay and if I am found not able to go back, I will get paid my

normal salary, tax free, the rest of my life.

>

> I know, I know..... you really didn't want to hear that!

>

>

> Ontario

>

> [Editor's Note: It helps that your country has to pay virtually

nothing for national security since your neighbor to the south

essentially assures you of your freedoms and in effect provides your

national defense. This is a statement of fact and not a political

statement. The US government spends more on fighting a war that the

many of its citizens believe is of dubious value than in finding

cures for the diseases that are destroying the lives of millions of

its own people. Canada's value systems are light years ahead of those

in the US in the view of many of us. JMO. Kathy F.]

>

>

> [ ] Re: Medical Coverage

>

>

> I applied for SSI and SSD about 6 years ago and appealed for 2

years,

> until my lawyer said that is wasn't worth trying to go any

further.

>

>

[Guest guest]

I really do not want to get into anything political, I was only stating that our

country is way ahead of yours in health care, and I pray so much that things

would change for all of you. Our healthcare system is not perfect, believe me.

Many Drs. are leaving here to go to the States for better pay, leaving our OR

rooms unattended.

Ontario

Re: [ ] Re: Medical Coverage

, I do want to hear this, thank you. My neighbor is Canadian and I

agree with Kathy that your value system is ahead of us here in the USA. I am

not sure if Kathy's statement is political or not, but I am not sure how we are

providing for Canada's national defense. Is there a treaty, that is not mutual?

Long live Canada.

[Editor's Note: Hi, , long time no see. I did not mean my statement in

a political way. A very significant portion of the US budget goes towards

defense which means that Canada, with whom we do have a mutual defense treaty

(it has sent troups to Iraq, for example) and we are both members of NATO, does

not have to spend money protecting its 3000 mile border from an aggressive

neighbor, nor does it have to fear incursion from other enemies. It knows the

US would, of our own selfish necessity, come to Canada's defense if it faced

foreign invasion. Canada does, of course, need to protect the land inside its

borders and it does have a miliary force, but it is much smaller than it would

need if the US were not its immediate neighbor. Many Canadians readily admit

that not having to spend much on defense is a big part of why it is able to

spend more money on humanitarian care. Kathy F.]

[Guest guest]

Thank you Betz, great post.

Ontario

[ ] Re: Medical Coverage

For ....that's just one attorney's opinion. Don't let one

person persuade you to throw in the towel unless you can afford to do

that. Call United Way and get a list of resources in your area. I

imagine that your health has declined over the past 6 years so you

may have a shot at it now. And , thank you for your

compassion. I love my country but lately it's been so hard just to

get access to the money that I've been giving out of my paycheck for

29 years now. We have a great country yes...but we are not taking

care of our own and I don't see it changing anytime soon. Before I

was disabled, I had no clue as to what a disabled person needed so

the Social Services and Disability systems were of no concern to me.

I never noticed the people who limped in the supermarket. I never

thought about what a person may have endured that week in their

personal life if they seemed tense or a bit rude in the checkout

line. I never looked at a Mom with her children in tow and wondered

if she was able to pay her rent that month. I think differently now.

But our government officials will more than likely not ever find

themselves in the financial position that I am in so it may never

become an important issue to them. Alas, that is human nature. When

one of their family members dies of Aids or is hit by a drunk driver

then those issues become important to them generally. We just don't

usually have the capacity to " get it " unless we've lived it. I

understand all of this and in some ways I am cutting them a break by

saying that I believe that their lack of personal experience in the

area of poor health and lack of funds to pay for medications and food

is at the root of their inefficiency in managing our nations health

care problems BUT regardless, the reality is that this is one area

where our great country has not stepped up to the plate. Do I want to

hear it??? Well lately I DO hear it ringing in my head over and over.

I pray that we get it together down here and sock some of the efforts

and funding that goes into taking care of the rest of the world into

taking care of our own citizens first. This is what I pray. And I

commend you for realizing what a gift you have. We all need to do

more of that and having said that, I'm going to sit here and come up

with five things I am thankful for as a US citizen even though I'm

not happy about our health care system (or lack of). -Betz

[Guest guest]

I have worked for a University for 27 years. I have paid into the Long Term

Disability fund from day one. I was on sick leave, with full pay for 6 months

and then LTD kicks in.

Ontario

Re: [ ] Re: Medical Coverage

, I do want to hear this, thank you. My neighbor is Canadian and I

agree with Kathy that your value system is ahead of us here in the USA. I am

not sure if Kathy's statement is political or not, but I am not sure how we are

providing for Canada's national defense. Is there a treaty, that is not mutual?

Long live Canada.

[Editor's Note: Hi, , long time no see. I did not mean my statement in

a political way. A very significant portion of the US budget goes towards

defense which means that Canada, with whom we do have a mutual defense treaty

(it has sent troups to Iraq, for example) and we are both members of NATO, does

not have to spend money protecting its 3000 mile border from an aggressive

neighbor, nor does it have to fear incursion from other enemies. It knows the

US would, of our own selfish necessity, come to Canada's defense if it faced

foreign invasion. Canada does, of course, need to protect the land inside its

borders and it does have a miliary force, but it is much smaller than it would

need if the US were not its immediate neighbor. Many Canadians readily admit

that not having to spend much on defense is a big part of why it is able to

spend more money on humanitarian care. Kathy F.]

[Guest guest]

Betz, that was a terrific post. I also never really thought about health and

disability coverage until I wound up in this place where I really need both. I

am lucky enough that copays aren't an issue for me, but if I couldn't get

prescription coverage -- yikes. I don't care how much money you're making, $30k

a year for humira once a week isn't affordable for anyone.

Something has to change in this country, because we're basically throwing people

with chronic illnesses to the wolves until they're 65 and qualify for Medicare,

and that's just not right.

[ ] Re: Medical Coverage

For ....that' s just one attorney's opinion. Don't let one

person persuade you to throw in the towel unless you can afford to do

that. Call United Way and get a list of resources in your area. I

imagine that your health has declined over the past 6 years so you

may have a shot at it now. And , thank you for your

compassion. I love my country but lately it's been so hard just to

get access to the money that I've been giving out of my paycheck for

29 years now. We have a great country yes...but we are not taking

care of our own and I don't see it changing anytime soon. Before I

was disabled, I had no clue as to what a disabled person needed so

the Social Services and Disability systems were of no concern to me.

I never noticed the people who limped in the supermarket. I never

thought about what a person may have endured that week in their

personal life if they seemed tense or a bit rude in the checkout

line. I never looked at a Mom with her children in tow and wondered

if she was able to pay her rent that month. I think differently now.

But our government officials will more than likely not ever find

themselves in the financial position that I am in so it may never

become an important issue to them. Alas, that is human nature. When

one of their family members dies of Aids or is hit by a drunk driver

then those issues become important to them generally. We just don't

usually have the capacity to " get it " unless we've lived it. I

understand all of this and in some ways I am cutting them a break by

saying that I believe that their lack of personal experience in the

area of poor health and lack of funds to pay for medications and food

is at the root of their inefficiency in managing our nations health

care problems BUT regardless, the reality is that this is one area

where our great country has not stepped up to the plate. Do I want to

hear it??? Well lately I DO hear it ringing in my head over and over.

I pray that we get it together down here and sock some of the efforts

and funding that goes into taking care of the rest of the world into

taking care of our own citizens first. This is what I pray. And I

commend you for realizing what a gift you have. We all need to do

more of that and having said that, I'm going to sit here and come up

with five things I am thankful for as a US citizen even though I'm

not happy about our health care system (or lack of). -Betz

[Guest guest]

Betz, I'm pulling for you big time, hoping your meds will do the trick and stop

your eye

troubles, FAST! You need someone to help you with those forms. They are

impossible

even for people with good eyesight! In my city there's a group called

" Volunteer Mobile "

that matches willing volunteers with the needs of various people.

You are sadly correct in saying that we don't know what other people go through

until we

get there ourself. It seems so often that there's a presumption that you are

trying to pull

something on " The System " when you try to claim disability. Years ago, before

I became a

teacher, I was a medical social worker working with geriatric patients. One of

my jobs was

to act as a liason with various agencies, trying to interpret a patient's

medical needs, to

facilitate the flow of papers, help find funding for meds, you name it. It was

rewarding

sometimes, frustrating most of the time because it seemed so futile. I decided

that my

next job would be with young, healthy people, so that's how I ended up in

school forever.

You also nailed the problem on the head, saying " this is one area where our

great country

has not stepped up to the plate. " We have squandered so many resources with

nothing to

show for it. I am indeed making a political statement. With all that our

country has, we

ought to be able to do more for our own when there is true need. Yet when

Clinton

tried to push an agenda for National Health Coverage years ago, she was trounced

by

vested interests in maintaining the status quo. I don't know, but highly

suspect that our

government officials have the most excellent health care available and are in no

position to

empathize with those who do not.

Here's hoping that in the future, Americans will demand a " safety net " for those

who need

it. And here's hoping that you will be doing better. Your " one-eyed Jack "

comment made

me laugh so hard my sides hurt!

Lucia

> [ ] Re: Medical Coverage

>

[Guest guest]

Hi Jaye,

Don't even think that medicare is a bargain. You cannot exist on medicare

alone. You must

also buy a suppliment and that is where you must be VERY careful or it could

cost you

more big time. I joined Kaiser here in California, the care is good and the

co-pays are

ok, but I only pay a fraction of the cost that other insurance companies charge.

The only

way you can really save on your drugs is to apply for hardship assistance. It

took them

most of this year to catch up with mine that I applied for last year. I now pay

$2. for

a 3 month supply instead of $20. Whenever you are dealing with an insurance

company

read carefully and ask many questions, especially about medicare.

Janet in Ca

-------------- Original message --------------

From: Jaye Eldridge <jayesails@...>

> Betz, that was a terrific post. I also never really thought about health and

> disability coverage until I wound up in this place where I really need both. I

> am lucky enough that copays aren't an issue for me, but if I couldn't get

> prescription coverage -- yikes. I don't care how much money you're making,

$30k

> a year for humira once a week isn't affordable for anyone.

>

> Something has to change in this country, because we're basically throwing

people

> with chronic illnesses to the wolves until they're 65 and qualify for

Medicare,

> and that's just not right.

[Guest guest]

Don't even think that medicare is a bargain. You cannot exist on

medicare alone. You must also buy a suppliment and that is where

you must be VERY careful or it could cost you more big time.

SO true! My father in law is 94 and has Medicare and a supplement.

But he still pays quite a bit some times for his meds. I believe

this happens when he is in the " donut hole " gap that so many

Medicare supplement plans have.....his policy seems to have him pay

the first $250 a year on his pills out of pocket. Then up until he

hits around $2000 in medication costs, he just pays a copay for his

pills. But once he hits around $2000, from then until he's reached

$5000 in medication costs he has to pay every single cent himself.

After $5000 then the Medicare supplement kicks in again and at that

point it pays everything, he doesn't even have to pay a copay. Most

Medicare supplement plans have a similar " donut hole " gap; the

amounts where it kicks in and out may be slightly different but it

works the same way. Dh has Medicare because he is disabled due to

seizures....he is currently now taking FOUR different

anticonvulsants. I didn't even bother to sign him up for a Medicare

supplement plan because there is NO WAY we could afford copays and

any sort of donut hole gap....I keep him covered through my

employers insurance. Even Humana is pretty awful though when it

comes to injectable meds (I have to pay 25% of the cost of the med,

which for Enbrel OR Humira OR Remicade runs to between $300-500 a

month) or copays. He can't take Dilantin, it doesn't work for

him....but they keep sending us letters ( " have you considered a

cheaper medication for your health issues? " ) and charge pretty stiff

copays for his seizure meds too.....we end up paying around $200 a

month for everything for him. Luckily I have a Flexible Spending

Account at work, and contribute the maximum ($2400 a year), which

helps defray the cost for HIS copays. But WITHOUT insurance, I hate

to think.....his pills cost about $1000 a month for EACH one if we

had to pay out of pocket for them. My cousin lives in Norway (she

married a Norwegian guy)....which has its problems in health care

such as long waiting lists for procedures and seeing specialists and

stuff....but at least when she or her kids are sick, they are paid

for the time they need off school or work and their medicines or

other health care is provided to them. (They pay through the nose

for it though, I believe she said the income tax across the board

over there is around 15% or everyone's income, plus their sales tax

is just awful too.)

[Guest guest]

Thanks for the encouragement and understanding Lucia! Love Betz

[Guest guest]

I am little young for this (33), but NYS has the epic

program for medicare eligble citizens and it was a

godsend for my late aunt. I am not sure if other

states have simular programs, but it is worth

investigating.

Greg

--- cameronparkmom@... wrote:

> Hi Jaye,

> Don't even think that medicare is a bargain. You

> cannot exist on medicare alone. You must

> also buy a suppliment and that is where you must be

> VERY careful or it could cost you

> more big time. I joined Kaiser here in California,

> the care is good and the co-pays are

> ok, but I only pay a fraction of the cost that other

> insurance companies charge. The only

> way you can really save on your drugs is to apply

> for hardship assistance. It took them

> most of this year to catch up with mine that I

> applied for last year. I now pay $2. for

> a 3 month supply instead of $20. Whenever you are

> dealing with an insurance company

> read carefully and ask many questions, especially

> about medicare.

>

> Janet in Ca

>

> -------------- Original message --------------

> From: Jaye Eldridge <jayesails@...>

>

> > Betz, that was a terrific post. I also never

> really thought about health and

> > disability coverage until I wound up in this place

> where I really need both. I

> > am lucky enough that copays aren't an issue for

> me, but if I couldn't get

> > prescription coverage -- yikes. I don't care how

> much money you're making, $30k

> > a year for humira once a week isn't affordable for

> anyone.

> >

> > Something has to change in this country, because

> we're basically throwing people

> > with chronic illnesses to the wolves until they're

> 65 and qualify for Medicare,

> > and that's just not right.

>

________________________________________________________________________________\

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[Guest guest]

In a message dated 06/12/2006 01:12:59 GMT Standard Time, nancy@...

writes:

Is there anyone out there that knows of other programs that would be

able to help a young woman that is trying to help herself? She just

wants to work and funtion like any other 19 year old.

Hi ,

I'm sorry your daughter is struggling so much with this. Unfortunately I

couldn't have offered advice as I am in Scotland but hopefully someone here will

have been able to as you asked that question at the beginning of December. (I'm

way, way behind as usual.)

Take care,

[Guest guest]

, my heart goes out to you. My husband, who is a doctor,

suggested you send this letter to your congressman immediately. Write

in big letters: " IMMEDIATE ATTENTION " on the envelope. I heard that

this years budget was cut, even further, the dollars for medicare/

medicaid and other programs that would help people in this medical

emergency situation.I say, except for the grace of God, there go I.

What is wrong with our country? We used to care for situations like

these. That is why God has blessed our nation. When we stop caring and

helping, I worry about God removing his blessing from us to get us

back to the basic teaching of love and compassion for humanity. I hope

your son, and you, find help very soon.

Sincerely, Connie

[Guest guest]

I just turned on C-Span after I sent the last message...they are

conducting a hearing on the cuts made to Medicare and Medicade...at

this very hour.

[Guest guest]

,

Is there a no ha clinic in your area that offers free care? Technically,

community health centers that are funded by the govt cannot turn people away

based on their innability to pay. I will check out some community health centers

in your area and give you their name and number to call.

Sent via BlackBerry by AT & T

medical coverage

Hi everyone,I hope you are all feeling the best you can at this time.

I have medical coverage with SSI,because I am totally disabled,but my

24 year old son,who was working full time at a good job with

insuranc,was fired from that job because he took off 8 days sick with

active ulcerative colitis, and ankylosing spondilitis.He called in

everyday for 5 days, then his boss told him to bring in a drs note

when he comes back.He went back in a total of 8 days with a drs

note.The boss fired him because he didn't call those last 3 days.He

says he abandon the job. So,now he has no way to pay for drs and

meds.I don't know what to do for him, and he sure doesn't either.He

applied for unemployment and social security and medicaid.All

denied.I know it isn't supposed to be done,but I have shared some of

my meds that I know are the same that he takes.But since I have had

my colon removed,I don't have to have the meds for the ulcerative

colitis.He is so skinny and needs to be seen by a dr, but he hasn't

got the money to pay for it.He has huge bills already from the

hospital and dr visits.Does anyone out there know of a way he can get

any help for this? It is crazy that they don't consider a young male

as having health problems that somehow would be covered.Especially

from getting fired after working almost 3 years at this one job, and

not taking any other time off from work.He will be loosing his

housing at the end of this month,so he will be homeless too.Were I

live is like an assisted living complex,so he can't move in with me.

I don't know where to turn, and he is too sick to go out and search

himself.I am getting more sick myself from worry.Being sick and

disabled and trying to help my son that is so sick too is really a

difficult thing for me,as well as for him.He has no idea what he is

in for,especially without medical care.If anyone can head us in the

right direction,I know there is a way out there somewhere.We really

need prayer as well as a hint of how to get him to get medical care.

Thank you everybody,I sure am glad you are out there and that I can

reach out to those who know the delima and the disease. D.

in Oregon