I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Medicare/Insurance => Topic started by: tbarrett2533 on March 10, 2011, 10:03:13 AM
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Hello everyone :)
I am hoping that this information will help someone who was in the same situation I was in when I found out that I would be on dialysis.....
I was paying $456.00 a month for my health care premium through my employer (this was just for a single person (me) and just health, not dental, vision etc) my co-pays were sky high for meds and doctor visits (between $25-50 each) So on average (between meds, co-pays, dialysis co-pays (3 times a week at $25.00 a shot) I was spending well over $1000.00 a month on healthcare, which by the way I was so sick (still am) and struggling to go to work (still am) I was only able to work about 30 hours a week and barley doing that. As a result of this I was forced to leave my residence and my sense of freedom and independence and go live with family so I decided to look into getting some help...... I searched and learned of a program offered through my local DSS which is called:
The medicaid buy in program for the working disabled.......
In short: I had to go to DSS, fill out the application, sit through the interview, then the worker sent my application to a review committee in Albany (where it sat waiting for at least 3 months, until I called Sen. Nozzilio and begged for his help in pushing my application along, which once the Senator called on my behalf I had my approval and medicaid the very next day) :yahoo;
Now b/c I am part of this program DSS not only pays my $456.00 a month healthcare premium, I have Medicaid too (also pending medicare which they will also pay)
I now have NO co-pays for anything!!!!
Please I urge each and everyone of you who are struggling with insurance issues (regardless of what state you live in) to please research your options.....
There is no reason why someone who is sick and in need of a life saving treatment have to worry or wonder how they will ever be able to pay for it!!!! This disease robs you of so many other things that life has to offer....... It should not have to "rob" you in other ways
I just recently moved back into my own apartment and gained my sense of freedom and independence back!!! :cheer: :2thumbsup;
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What is the income limit for this program?
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For a single person (which is what I am b/c i don't have a family and live alone) I can earn up to 75k a year, family or married couples I know is a little bit higher, just ask your local department of social services. I also know that if you do a google search for 'medicaid buy in program for the working disabled' websites will pop up that are loaded with information.
Good luck :)
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Thanks for the information, it's good to know that there are options out there if need be. It never would have occurred to me to look into anything concerning DSS because I would have thought the income limit would have been much lower. Thanks again for sharing :2thumbsup;
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TBarrett, I am so glad that things have worked out for you. But I have to point out that nothing about this is FREE.
NY State is in a HUGE crisis when it comes to Medicaid and we all need to be aware that the money is coming from somewhere. We are getting ready for some serious cuts and it is going to be a rough ride financially for everyone. People are going to be asked to dig deep when it comes to their treatments, and yes, even dialysis will be affected. We are already seeing HUGE spend downs. Paratransit is the first dialysis related service that is being reduced.
We are going to have to fight for anything that we can get.
The link for NY State DSS and the Medicaid Buy in is: http://www.health.state.ny.us/health_care/medicaid/ldss.htm
For NY City: http://home2.nyc.gov/html/hra/html/directory/public_health.shtml
A warning of what is to come:
http://www.nytimes.com/2011/03/13/opinion/13sun1.html?_r=1&scp=2&sq=medicaid&st=cse
Medicaid and the N.Y. Budget: Sensible Cuts, and Little Political Flak
New York’s Gov. Andrew Cuomo has achieved a significant political and budgetary victory getting the state’s powerful health care providers and its major health care workers’ union to agree to live within a strict Medicaid spending limit for the next fiscal year and accept a slow rate of growth after that.
Medicaid costs are a quarter of the state’s operating budget, and this agreement is an important step toward closing a projected $10 billion deficit.
The governor’s Medicaid Redesign Team — which was dominated by health care providers and public officials — agreed to hold state spending on the major portion of Medicaid to $15.1 billion next year, well below the $18 billion originally projected. They also agreed to hold future growth to a 10-year rolling average of medical inflation. That is a very stringent standard.
Over a recent five-year stretch, the state’s share of Medicaid spending grew by an adjusted rate of more than 6 percent a year; medical inflation has been increasing by about 4 percent. If the team can’t find the savings, the state will step in to make it happen.
The redesign team approved dozens of proposals to cut spending, all of which have been incorporated into Mr. Cuomo’s budget or related legislation. The Legislature, which must enact a final budget by April 1, should adopt most of the recommendations. They are sensible and necessary. We urge lawmakers to force out a misguided cap on malpractice awards — a provision engineered by hospital leaders that would deprive many injured patients of fair compensation.
The biggest immediate savings in the plan would come by cutting payments to providers and managed care companies. Those cuts would be mitigated by subsidies to help failing safety net hospitals, nursing homes and clinics to restructure, merge with more solvent institutions or close in an orderly fashion. Still, there is a risk that people in some poor neighborhoods may find it harder to get care.
The plan would place new burdens on some of the state’s most vulnerable citizens — the poor, the sick, the elderly. But for the most part they were protected from substantial harm. There would be no change in eligibility standards to force people off the rolls and no wholesale elimination of benefits previously offered.
Instead, there would be narrowly tailored reductions. Right now, patients who need rehabilitative services like physical, occupational or speech therapy have no limits on the amount of care they can receive. The new budget would limit them to 20 visits in a 12-month period. The goal is to reduce excessive utilization. But 20 visits might not be enough for some badly disabled patients, and an efficient monitoring process will be needed.
Home care visits for housekeeping services would be limited to eight hours a week in New York City, placing more of a burden on families. Reimbursements to fee-for-service dentists would be cut, making it harder for patients to find a dentist who will take them.
Medicaid patients would also be asked to pay a bit more in co-payments. Right now they pay $3 for a clinic visit or a brand-name drug. That would rise to $3.40. Right now, they pay $25 for a hospital stay. That would rise to $30. The increases seem modest, but any co-payments carry the risk of discouraging some poor people from seeking care they really need.
The package contains many sound reforms, including greater use of managed care and other forms of care coordination. If done well, those steps should lower costs and, one hopes, improve treatment.
One of the biggest changes in this process is political. For years hospitals and health care workers have used their clout in Albany — and high-priced advertising campaigns — to ward off cuts and reform. Mr. Cuomo pre-empted them, first by threatening to wage his own advertising campaign against them and then by inviting them to join his Redesign Team.
Now instead of battling the governor, the Greater New York Hospital Association and Local 1199 of the Service Employees International Union, representing health care workers, have together initiated an advertising campaign praising his leadership and urging the Legislature to give him what he wants.
It was smart to bring these key players into the effort to find ways to cut spending quickly and a real coup to get them to accept very tight spending limits. But Mr. Cuomo must be careful not to give them a disproportionate say going forward in reshaping the state’s health care system. Officials need to give patients’ advocates a stronger voice. The only patients’ advocate on the redesign team abstained from approving the package.
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thank you so much for the information.... :thx; I am well aware of cuts being made and where :) (I am a caseworker for a profit company), I for one will be one of those people who will advocate for myself, and not take no for an answer!!!
there is no reason why ANYONE in this country should have to go hungry, or be homeless etc. b/c they are working to pay their healthcare bill!!!
A much better approach at cutting spending (in my opinion) would be to look at the people who don't have jobs & are sucking medicaid dry and have been for generations!!