Is there any pre-dialysis financial assistance?

[paddbear0000]

I was wondering if there is some sort of program to help pay for kidney failure related expenses before starting dialysis? After 4 months of covering my medical expenses, my insurance company has NOW decided to inquire as to whether or not I had insurance prior to starting on their policy 4 months ago. They have a pre-existing clause of 1 year, which I somehow managed to get around until this point. Since I didn't have insurance for 4 years beforehand, I am in serious danger of losing coverage for the next year. Being that my GFR is at 19, I'm terrified that before the year is up, I will need to start dialysis. There is no way we are going to be able to afford all the doctor visits and Rx's before I even qualify for Medicare, etc. Any suggestions? Help!

[Romona]

You could try some of the kidney foundations. I remember searching some that had assistance programs. If I can find the website where I found them I will PM you.

[goofynina]

Romona, if you could please post the websites here so we (and future members) can read the info.  Yes, the National Kidney Foundation does help but when i tried to get help there was so much red tape to go through, we were just going to try to raise the money on our own and they said it was illegal     So just be prepared for lots of red tape and some hoops to jump through, maybe a couple of hurdles and if you reach the finish line, dont be surprised if you have to attempt a high jump, lol 

[Romona]

http://www.aakp.org/
I just checked this one. It looks like dialysis and transplant help. It does mention medications. I don't know if it would help since paddlebear0000 isn't on dialysis yet.
I don't know if I posted it right.
A renal social worker might be able to help more. I'll search some more later. Like Susie said there will be hoops to jump through. I know I have seen more places with fiancial assistance for renal patients.
There is a group that helps with raising funds for transplants. I'll have to find that one. I think by searching the state that you live in would be a good place to start.




http://www.kidneyfoundationofcentralpa.org/grants/home.aspn dialysis. This one is in Pennsylvania and provides grants for people in their area.

[goofynina]

Thank you for that info Romona,  your Social Worker may have a better clue of how to find financial aide for you also   Good luck and please let us know what you find out 

[Black]

I was wondering if there is some sort of program to help pay for kidney failure related expenses before starting dialysis? After 4 months of covering my medical expenses, my insurance company has NOW decided to inquire as to whether or not I had insurance prior to starting on their policy 4 months ago. They have a pre-existing clause of 1 year, which I somehow managed to get around until this point. Since I didn't have insurance for 4 years beforehand, I am in serious danger of losing coverage for the next year. Being that my GFR is at 19, I'm terrified that before the year is up, I will need to start dialysis. There is no way we are going to be able to afford all the doctor visits and Rx's before I even qualify for Medicare, etc. Any suggestions? Help!

IF you find yourself without insurance:

Contact every drug company about their drug plans for people without insurance.  Go to the main web site for the drug manufacturer and see if they have their own program.  Do a google search for "free medication" for some other places to start searching.

Ask your docs for 1) free samples, 2) change to cheaper generics when available, 3) change to a different drug made by a different company which has a drug assistance program.

Also ask your doc if they will give a discount for not having to file insurance.  (Or a discount for paying cash/check at time of service.)

Ask the office staff at every office you visit if they have any applications for financial assistance.

Some hospitals have their own assistance programs and will provide free or discounted in hospital and out-patient services such as radiology, lab, surgery.  Ask if they have any Hill-Burton funds available.

Look for a "not-for-profit" dialysis clinic.  They will be the best bet for not trying to collect what Medicare won't pay.

Start ASAP to gather copies of your latest income tax return, paycheck stubs,  a list of all of your assets, a list of all of your bills, copies of your last three bank statements..  Any time you apply for assistance your are probably going to need those.

Mike and I made it without insurance for over 15 years, and the health care costs those last 2 years before he started dialysis could have been VERY expensive.  Fortunately, we got huge price breaks from the hospital (free), his neph (-25%), his radiologist (-75%), his anesthesiologist (-50%), his surgeon (-50%), medications (most were free, few generic) and because I am his spouse many of my medical bills were covered as well.  We just asked and then submitted the paperwork.  I suggest starting with the hospital if you owe them for anything.  After we qualified there everything else was easy to get.  The radiologist accepted a copy of the approval letter from the hospital as proof that we couldn't pay and wrote off 75% of what we owed.

[paddbear0000]

I was without insurance for the last 4 years (minus the last 4 months) and am familiar with all of the drug company programs and stuff. I also used to participate in a hospital assistance program. The BIG problem with that was that I had to go to their clinic and be seen by resident doctors (students) and the 2 I saw were complete idiots and I was teaching them everything about diabetes. When one of them FINALLY decided to tell me my kidneys were failing, he told me I needed to start dialysis or get a transplant immediately! My creat at the time was only 3.0! I knew that was wrong. He completely threw me and upset me to no end. I REFUSE to go back there ever again, for my health's sake. They are completely lacking in knowledge in both diabetes and kidney failure. The other problem is now that I'm married, my husband's income disqualifies me for everything. No one seems to care that, even tho he makes fairly good money, by the time the mortgage, utilities, food, gas and especially my medical bills are paid, we have nothing left! They just care about what your paycheck says.

I'll check out everyones suggestions and let you know what I find out. Thanks!

[thegrammalady]

when you do start dialysis it will take 4 months from application for medicare to kick in. the dialysis center usually writes off charges if you don't have insurance.  like black said most drug manufacturers have programs for free drugs. you have a bit of research to do, but things can work out.

[Lulu]

I am pre-dialysis as well and am losing my insurance before I go on dialysis.  Besides just generally freaking out, I have been doing a lot of research . I have medicare part A (hospital) because I got my disability approved. Even if you don't have disability (which only gives you medicare part A until you start dialysis) you can still get medicare the first month you start dialysis. Here's how...a little known loophole.... If you do home dialysis, either kind, PD or Hemo, you are automatically enrolled in Medicare when you do your first day of dialysis training (training is done in clinic). The enrollment is retroactive to the first day of the month you start your HOME (key word) training in. So, here's how to get your access point covered by medicare before you have it....talk to your surgeon's office and let them know that your medicare will be retro-effective so that the access surgery is covered. Make sure that you get your surgery done the beginning of the month (ideally the 2nd day of the month) and schedule your training for home dialysis at the clinic on the 26th of the month. You can change the day's to suite, but the main point here is that you have to have you access surgery done and start the first day of your home training within the same month. Your access point needs time to heal so thus the three weeks between. All of the medicare paperwork is filled out your first day of training. All of this is above par, it is just most docs steer toward in-clinic dialysis. I am sure the reason is somewhat financial.  Anyways, for all the details here's the link for the Center for Medicare and Medicaid Services publication on Medicare Coverage of Kidney Dialysis and Kidney Transplant Services. Please keep in mind that you only need Medicare Part A and Part B to cover the dialysis and transplant and transplant immunosupppresant drugs. I am going through this process as we speak and hope this info helps you. Remember to be your own advocate...Don't let the Docs fool you. They know this stuff too, but would rather bill an insurance company full tilt instead of waiting for a medicare payment. Anyways, here's the link.

http://www.medicare.gov/Publications/Pubs/pdf/10128.pdf

 

[paddbear0000]

Wow! Thanks for the information Lulu! Hopefully it won't come to this, but it's good to know. Boy, you sure have to jump through hoops nowadays just to get some help.

[okarol]

Go to: http://www.akfinc.org/ The American Kidney Fund is our nation's #1 source of direct financial assistance to kidney patients, and is a leader in providing education to those with and at risk for kidney disease.
Direct financial assistance programs are offered by the American Kidney Fund to needy dialysis and kidney transplant patients nationwide. For further information about these and other programs please call the Patient Services Department toll-free at 1-800-638-8299 or contact the social worker at your dialysis center.

More info about Medicare and Medicaid and other programs is listed here: http://goldbamboo.com/topic-t2810-a19630.html

[Stacy Without An E]

We have an amazing social worker at my clinic.  She started about a year ago and replaced a rather dingy women that had no idea what she was doing.  She was searching for programs to help Dialysis patients and found that the National Kidney Fund will help with your Medicare co-pay.  Since I work, my co-pay is anwhere from $200-$300 every two months.  As someone who doesn't make a boatload of money (it's a falacy that radio people are rich) I bring her my statement every time I receive one.  It's been a real blessing when you're living paycheck to paycheck.


Ask your Social Worker or go to www.KidneyFund.org.