Medicare and Obamacare

[ladyhawk526]

I live in Indiana and have had Medicare for years and have a secondary insurance through my husbands employment.  His company is shutting down and we will lose our insurance.  I am almost done with all the testing required to get on the transplant list.  I have to have a secondary insurance to get on the list.  I called Obamacare and discussed my issue with them.  (The person I talked with was not very informative).  They said they could not help me.  So my question is can I have obamacare and Medicare?  Or should I just apply for Medicaid?   

[Simon Dog]

You don't get medicaid unless you are dead stone broke, and your spouse will only be allowed to keep something around $119k.   

[nursey66]

You probably would need to buy a part B supplement and part D for meds. I don't think you can get on obamacare if eligible for Medicare . Your part B supplement should pickup what's not covered by original Medicare. You shouldn't have to pay any penalties if you go right from private ins to full Medicare. The same thing happened to us when I retired, as my husband was using my ins to pay what Medicare left ,usually 20%  that can be a huge $$$ if you are on dialysis.  Or any surgery , hospital, dr visits.

[Vt Big Rig]

I have the same problem. My wife will be done this summer and I will need a supplement. I am told they are not available in Indiana to those under 65. We will try to use a cobra on her insurance . Talk to your social worker about NKF help for a policy or cobra from your husbands company.

[Michael Murphy]

Going to NKF for help in insurance payments is a great idea the money comes from NKF but is donated by the dialysis company.  The dialysis company is not allowed to pay for your insurance. So the NKF is away around that prohibition you need to speak to your centers Social Worker.  In addition Fresinius has insurance experts that will help you navigate through insurance rules to find the best solution.

[Zach]

Actually, it's the American Kidney Fund (AKF) not the National Kidney Foundation (NKF) that can perhaps offer patient assistance.

http://www.kidneyfund.org/patient-programs/

The American Kidney Fund leads the nation in charitable assistance to dialysis patients, helping more than 84,000 patients pay for health insurance premiums and other treatment-related expenses in 2014. Our HelpLine provides health information and resource referrals to patients in English and Spanish. Programs for children include summer enrichment activities and the annual Calendar Kids Art Contest.

If you are a patient who is in need of treatment-related financial assistance, speak with your dialysis center social worker about submitting an application to AKF.

Have questions about our financial assistance programs, the status of an application, or related matters? Call the American Kidney Fund's Patient Services department at 1.800.795.3226Call: 1-800-638-8299, or email patientservice@kidneyfund.org.   

Health Insurance Premium Program (HIPP)
http://www.kidneyfund.org/patient-programs/hipp/
All applications for the Health Insurance Premium Program (HIPP) must be submitted online via our Grants Management System (GMS).

Through the Health Insurance Premium Program (HIPP), the American Kidney Fund pays Part B Medicare, Medigap, commercial, and COBRA premiums for dialysis patients who have insufficient income and savings. These premium payments allow patients to continue their health insurance coverage, enabling access to physician care and medical treatment.

HIPP serves as a “last resort” source of financial assistance. Last year, 71,500 dialysis patients in the United States were able to maintain their insurance coverage thanks to grants from HIPP. If you have any questions, do not hesitate to contact our Patient Services Department at patientservice@kidneyfund.org or 1.800.795.3226.

[Michael Murphy]

Zach thank you that's the second time  I made that mistake I keep confusing the National Kidney Foundation ( Which has a bunch of kidney centric apps for iPads and iPhones. )With the American Kidney Fund since you were kind enough to point out my error previously I will try to do better in the future.

[Zach]

Zach thank you that's the second time  I made that mistake I keep confusing the National Kidney Foundation ( Which has a bunch of kidney centric apps for iPads and iPhones. )With the American Kidney Fund since you were kind enough to point out my error previously I will try to do better in the future.

Hi Michael,
Too many alphabet city names to remember.
CMS, ESCO, KDOQI, and PCORI just to name a few.
We need a list to keep them all straight. 

Regards,
--Zach
 

[Hootie]

If you are on Medicare due to ESRD and below 65, you can buy a supplemental policy to pay the other 20% that Medicare does not pay. We have Plan f with AARP (United Health Care) along with a Part D drug plan with same company. Both are the best as recommended by two different insurance brokers. The Plan F is not cheap but it is a bargain  compared to other plans. We have been very pleased. As other said Obamacare does to work with Medicare.

Dialysis companies want you to  stay on private insurance as long as you can, as their reimbursements are much better with private insurance. As one person told me  they "do a happy dance" every time  someone walks in with private insurance. They will work to get support from the organization mentioned above to keep you on private insurance. From what I can tell their finance person's core job is to do just that.

[Vt Big Rig]

I have been told this is not available in Indiana.

[Shaks24]

It looks like Indiana has legislation in the works to mandate Medigap for under 65. At this time it looks like they do not force the issue on the state approved medigap insurers. The only thing you can do is try to call them and see if they will issue you a policy in one way or another. It would probably be pricey but here is a list of the companies that sell medigap in Indiana. You may have already tried this. Good luck.

http://www.in.gov/idoi/files/Supplements_in_Indiana_revised_8-13-15.pdf

[iolaire]

It looks like Indiana has legislation in the works to mandate Medigap for under 65. At this time it looks like they do not force the issue on the state approved medigap insurers.

This is a very important point, when someone say's "Obama Care" they really mean "My state's implementation of the Affordable Care Act" subject to all the local politics. 

Someone in my clinic came to VA from CA and I've overheard the staff telling him that our coverage is much worse than what he had in CA.