medicare question for my situation

[sullidog]

Hey all,
I just have a medicare question. It may be better answered by medicare but here it is.
I'm on medicare for disability other then my dialysis, I'm on it for my blindness as well. My question is since I will have medicare for life do to my other disability, will my transplant drugs when I get one will they be covered for life rather then the 36 months?

[MooseMom]

I highly doubt it, but that's just me being cynical.  Doesn't make me wrong, though.  Interesting question.  Like I suggested to another poster, have you checked out Beth Witten's posts on www.homedialysis.org?  She is a licensed social worker who can probably answer your question.  Go to the forum and ask.  And then let us know what she says.
http://forums.homedialysis.org/

[Annig83]

I don't believe that they are.  You have two seperate claims.  Since your transplant drugs are not related to your blindness, they will probably only provide for the 36 months.  Here is their website, it may answer your question?  However, I would definitely call Medicare... they are surprisngly nice and answer these questions on a daily basis.   
http://www.medicare.gov/navigation/medicare-basics/understanding-claims/understanding-claims-overview.aspx

[Bill Peckham]

No they are, they will be.


Just as if you had Medicare due to age if you qualify for Medicare due to disability then you are covered for all Medicare benefits subject to paying premiums and copays.

[MooseMom]

No they are, they will be.


Just as if you had Medicare due to age if you qualify for Medicare due to disability then you are covered for all Medicare benefits subject to paying premiums and copays.

Are you sure about this?  I hope you are right, but as Annig said, I'd have thought they'd be treated as two separate claims.  Are you saying that if you get a transplant after age 65 and have qualified for medicare due to age, you get your transplant drugs paid for for life?  Can you show us something from medicare that addresses Sullidog's question?  I'd love to see this in writing.  Thanks!

[Bill Peckham]

I don't understand the confusion. People over 65 do not have to contend with the 3 year rule. Neither do people with Medicare due to disability. I can't think of what to show you because it is fundamental to the program. Medicare is health insurance, if you qualify for it, it pays for kidney transplants and immunosuppression.

You can qualify for Medicare due to age, disability or ESRD, there aren't separate programs, it's the same Medicare. If you have Medicare due to disability then you have the same Medicare benefits as everyone else with Medicare.

EDITED TO ADD: People who qualified for Medicare solely due to ESRD, loose their coverage three years after a transplant because they loose access to Medicare. It isn't that immunosuppressant drugs are some special category of health care, it's strictly a question of qualifying for Medicare.

[MooseMom]

OK Bill...that is simple enough and great to know.  Thanks for the explanation!

[rsudock]

Man if only I was old or had another problem I wouldn't have to worry about this 3 month period...oh well something to look forward to in old age. Thanks for the info Bill!!

xo,
R

[Meinuk]

Sullidog, it is simply a question of which part of medicare will cover your transplant meds.

Part B will cover them for the first 36 months after transplant, and then when you revert to your disability coverage, your Part D will cover them.  Just make sure that you have a good Part D to cover your meds. (The same happens when you age into Medicare at 65)

Since you are already covered by Medicare, there may be some questions, but a call to your medicare regional office should clarify everything.

It is VERY important that you know the enrollment periods for Part D and any of the other medicare plans.  Here is a GREAT online tool for looking at what is offered:

https://www.medicare.gov/find-a-plan/questions/home.aspx

You should have a good Part D plan in place because Part B ONLY pays for immunosuppresives.  All other meds are processed through Part D. (anti virals etc).

[Lillupie]

OK, I can understand what Bill is saying. The thing is Medicare runs out ONLY because we (not me) with a transplant are NO longer considered as disabled.
 If he is blind, totally, You cant expect him to work, like you would me (if i could ever get a kidney). ESRD or no ESRD does not take away his blindness. Sullidog, Im sorry you have both.

Lisa