I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: paddbear0000 on August 22, 2007, 02:32:32 PM
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Okay, I was just reading the topic on Joe enjoying his disability too much and am very confused. I'm starting a new topic so the other one doesn't go completely off topic. I had recently read some information on another website (KidneyTimes.com I think) about dialysis coverage. It was talking about how most kidney patients are eligible for MedicAid and use that with or without private insurance. I thought I had it figured out, but after reading the 'Joe' topic, I guess I don't have it figured out. Is it true you are deemed 'disabled' and given disability as well? Some were also mentioning social security too. How is that involved? I guess I'm more than a little scared about how we're going to afford my dialysis once the time comes. Since moving to Ohio, my employment has been shaky and less than desirable due to the economy. I was unemployed for over a year when we first moved here, was then employed for 6 months until layoffs because they couldn't afford to keep us, was again unemployed for 2 months, then employed for 3 months (and laid-off for the same reason as before) and am once again unemployed. As a result of this and having just paid for our wedding, we are BROKE and barley scraping by. Thank god I have insurance through my husband's company now! Now my problem is, according to my social security benefits review I received around my birthday, I don't even qualify yet for SS. Would someone please explain to me how disability and SS are involved and what may happen in my situation (not being eligible)? I'm so lost at this point and terrified of our financial future!
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There are a couple things. None of which should be confused with Social Security Retirement.
Social security disability (SSDI) --If you become disabled and have enough work credits one can qualify for Social Security Disability. The amount from SSDI is based on work history income. Most recent work history I do believe.
Then there is Supplemental Security Income (SSI)-- If one does not have enough work credits to get Social Security Disability then they will qualify for SSI, which is a set amount they will pay out. Also some states also supplement this check.
One may get SSDI but it may be a very low amount due to limited work history, if this amount falls below a certain threshold then they can also collect a partial SSI check.
If one collects SSI it usually is an automatic qualification for Medicaid because SSI income is so low.
If one is on SSDI and their income is below a certain level they can also get a program called QMB (qualified medical beneficiary) to pay their Medicare premiums, Medicare copayments (the 20% of approved Medicare costs) and yearly Medicare deductibles and their part d drug premiums. There is also a second tier income level that will help people pay a portion of drug costs if their income level is too high to get QMB.
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My head is spinning! Wow! Thanks for the info. Now does a spouse's income have any affect on any of this?
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once you start dialysis you will qualify for medicare. once you apply it will take 4 months to kick in. the dialysis center will usually write-off the cost of treatments until then, so don't panic if you receive a bill. Medicare pays 80%, that's 80% of the allowable charges not 80% of the approximately 65 thousand the center will bill. you are only responsible for the 20% of the allowable charges, they can't bill you more. when you apply for medicare you should also apply for ssi and ssdi. since you are married and living with your husband the ssi amount will be based partially on his income. however you only need $1 of ssi to qualify for medicaid. ssdi as big steve said is based on your total work history in all states. if your income is below a certain point (for me it's 14,000, caus i'm not married) the government gives you extra help. they cover my medicare part b premiums, my part d premiums. it takes time to get all this set in place, but don't worry, it will work out. each state is a bit different, you'll just have to do some research. the social worker at your center can help. but be proactive, because despite what they think they don't know it all.
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Go to the social security website. It will answer alot of your questions. You can apply for social security online--very easy. I did it one night and got a phone call the very next morning to verify a few facts. I printed the medical release forms off their site, gave them signed to s.s. office. They did the rest. Keep asking questions--someone here will have answers!
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Thanks for the help. My husband is the financial "genius" in the family, so I will let him read everything and be my adviser when the time comes! ;D Hopefully he doesn't have a heart attack when he sees it all!
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I have SSI and it sure was a process!~ I had to go in front of a judge and explain why I should get it- I was like 14 at the time. I just said that so many ppl abuse the system and I am actually in need of SSI- due to my Spina Bifida, etc, and that it isnt fair that I had to actually go through the process twice- the judge agreed with me!
I also now have medicaid and medicare- which can be a pain since sometimes one claims the other needs to pay, etc.
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I am glad the judge ruled in your favor Karen :2thumbsup; I see so many people frauding the system it is pathetic, and the ones who really need it get nothing :banghead; Grrrrrrrrrrrrrrr >:(
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In 1999, I received SSI and SSDI since I didn't have hardly any work credits. So I qualified for SSI (very little amount..). I was on my mother's HMO since I qualified for being disabled. I also got Medicare.
This time around, in 2004, I went out on short term disability with my employer, so I had my HMO and getting income from short term disability. Once I was on that for so long, I started long term disability, then I applied for SSDI and once I started getting that, my long term disability checks stopped. I did not get SSI due to getting too much money on SSDI. I do however get 3 SSDI checks, 1 for me, and 1 for each of my children. It comes in my name on their behalf, since I have primary custody of them, if my ex had it I would not get SSDI for them. Let me just say that my total SSDI is not enough to survive on... and if it weren't for my parents letting me live with them and only paying 200/mo rent, I would probably be homeless... the government expects you to live on nothing, its very sad.
As for insurance, I have Medicare (A and B) and a Blue Cross and Blue Shield medicare supplement, so I have no co-pays in the hospital, or at any doctor office, or outpatient center. My Medicare pays 80% my supplement pays the 20%. I also pay no premiums or anything due to my income.
I also have a prescription drug plan through Medicare Part D, and the one I have, I don't pay any annual premiums or basically no out of pocket costs for me, b/c I qualify for low-income help. Also, since my medicines are so expensive, I reach all my limits in January and have no co-pays after January. The co-pays I do have in January are only $5 and $2, so I'm loving my prescription coverage.
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My question is: Even though I work, can I still get SSDI? Disability? Someone says yes, but then I read somewhere else that no, you have to have not worked for 6 months, at least!! Just who can do that??? I work to get the insurance to pay for the dialysis, and it ends up being all I do, most days.
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I was still working when I applied. ESRD has special provisions with SSDI. Being on dialysis or transplant list are will make you qualify. I had no problem and was approved in 3 months time. Even on SSDI, you can work part-time. SS has a good website that gives all the information. Keep good records. They will want to know why you can't continue to do the job you do now. I wish everyone had as easy a time as I had.
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I had the opposite luck. Social Security would not approve me because I was working full-time. I was only working 3 days a week but the other 2 days were sick days. They told me I had to quit first. But, I probably got someone who didn't know. You are at the mercy of the idot you get.
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So much info. ??? ??? ??? ??? ???glad you guys share with us.
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That's why I am so confused. I applied once, back in January/February, and when the person called on the phone and asked if i worked in December, I said yes, she said you don't qualify and hung up. LIterally. My SW is no good, as far as pushing for SSDI for me. And working full time and trying to keep my house and myself together leaves no time or energy for much else.
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The information I got from Social Security Admin about working and getting SSDI, is you can only make xx.xx amount of money and still get your SSDI, I am 98% sure they told me that the x amount is 500.00/mo. Although it might be different in another state or on a person to person basis.
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I think you are right Angela. Not sure about the exact dollar amount.
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The information I got from Social Security Admin about working and getting SSDI, is you can only make xx.xx amount of money and still get your SSDI, I am 98% sure they told me that the x amount is 500.00/mo. Although it might be different in another state or on a person to person basis.
I thought it was $900.00 ???
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From the Social Security website.
Trial work period—The trial work period allows you to test your ability to work for at least nine months. During your trial work period, you will receive your full Social Security benefits regardless of how much you are earning as long as you report your work activity and you continue to have a disabling impairment. In 2007, a trial work month is any month in which your total earnings are $640 or more, or, if you are self-employed, you earn more than $640 (after expenses) or spend more than 80 hours in your own business. The trial work period continues until you have worked nine months within a 60-month period.
Extended period of eligibility—After your trial work period, you have 36 months during which you can work and still receive benefits for any month your earnings are not “substantial.” In 2007, earnings of $900 or more ($1,500 if you are blind) are considered substantial. No new application or disability decision is needed for you to receive a Social Security disability benefit during this period.
Expedited reinstatement—After your benefits stop because your earnings are substantial, you have five years during which you may ask us to start your benefits immediately if you find yourself unable to continue working because of your condition. You will not have to file a new disability application and you will not have to wait for your benefits to start while your medical condition is being reviewed to make sure you are still disabled.
Continuation of Medicare—If your Social Security disability benefits stop because of your earnings, but you are still disabled, your free Medicare Part A coverage will continue for at least 93 months after the nine-month trial work period. After that, you can buy Medicare Part A coverage by paying a monthly premium. If you have Medicare Part B coverage, you must continue to pay the premium. If you want to end your Part B coverage, you must request it in writing.
Work expenses related to your disability—If you work, you may have to pay for certain items and services that people without disabilities do not pay for. For example, because of your medical condition, you may need to take
a taxi to work instead of public transportation. We may be able to deduct the cost of the taxi from your monthly earnings before we determine if you are still eligible for benefits.
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Thanks BigSky, that's exactly what i needed to know :2thumbsup;
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We have the smartest people here! It is nice to know that someone always finds an answer to a question. Thank, BigSky :thx;
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This is SOO complicated! My head is swimming!!! :o
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Explain to me how can one live on 900 dollars a month? Where does the government think we live, a third world country? This is not even a house payment for most of us!
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Exactly kit.... I an't even live on what they pay me now... but I also can't just go out and get a job that pays less than what I am getting now either... if I can't live on what i am getting now how could I possibly live on less.. Goverment. :thumbdown;
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What is the alternative? Working full-time while on dialysis is very physically demand on the body. Kitkatz, you are the exception. Or be like Zach and own the company.
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I worked full-time before I lost my lisence and car.
I'm not on dialysis now.. so i have a time limit on how long I can continue getting SSDI..... countdown....
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So I got these two questionnaires in the mail from social security saying they need more information to determine eligibility. One of them is about physical and mental activity - No problem, pain in my butt to explain myself when I have a chronic condition but, no problem. The second one is work history, 15 years back which is piratically my entire working life - The problem here is I don't remember the exact order and even if I did when I had the interview at the local office WE WENT THROUGH ALL OF THIS ALREADY. Why are they subjecting me to this? I am so aggravated (treatment day) with these formalities, at the office they had the dates and I just had to fill in the blanks, now I am simply frustrated. :rant;
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George, anything I can do to help? Hope you got some rest today. Let me know if I can do anything.
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Feeling your frustrations and stresses over the incompetent of SSA. What the hell is going on with them?
They already had your info. when u were there. Why are they sending you the papers to fill out ??? ??? ???
Take ur. time and sort it through. Take care my friend.
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... at the office they had the dates and I just had to fill in the blanks, ...
Can you call that office and ask them to fax or mail you a copy of that?