State or Gov assistance?

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windhover
Regular Member


Date Joined Oct 2008
Total Posts : 28
   Posted 12/18/2008 3:10 PM (GMT -7)   
 Anyone  had  esp  with this? I work  fulltime  60k a  yrs  job have  Blue Cross ins.......Since  Cindy  was  diagnosed with ESLD  we  are now owing bout 15k in copays.........can we  get any help???
  So far  2 paracentesis, 2 blood  transfusions, endo  withh banding, 10 dr visits  16 lab visits, 3 CTs,  3 mental hea;th....an  it  goes  on  not  to mention the  drugs  and  travel.........?? Should  I  go  an   seeek  help?
 

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 12/18/2008 5:33 PM (GMT -7)   

Windhover, you can try for Medicaid, but you are probably over-income.  I would suggest you contact financial services at the hospital where your wife is being treated, to see if they have some type of charity program that could pick up what Blue Cross doesn't cover.  If not, I'm sure they would let you work out a payment plan that you can live with.  Is your wife on your insurance?  Medicaid will also pay for a transplant, whereas Medicare doesn't.  But again...your income might disqualify you.  Has she applied for SSD or SSI?  When approved, she will either get Medicare or Medicaid, though for Medicare there is a 2-year wait from the time she applied for SSD. 

Here's something else I know from experience:  If all you can pay on each medical bill is only a dollar or two a month, they cannot turn it over to debt collectors or in other ways harrass you for the money, as you are showing willingness to pay.

Hope this helps.
Hugs,
Connie
 
"But that was yesterday, and I was a different person then."
 
Alice in Wonderland, Lewis Carroll


Butterflythree
Veteran Member


Date Joined Oct 2007
Total Posts : 954
   Posted 12/18/2008 6:25 PM (GMT -7)   
Connie, Could it be possible that you mean Medicaid doesn't pay for transplants and Medicare does? The Medicare website says that they will cover transplants under certain conditions and when done at approved facilities.
Butterflythree
 
There is always hope!


hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 12/18/2008 9:24 PM (GMT -7)   
Hmm.  I thought it was the other way around.  Will check more thoroughly.  I do know that Medicaid pays for transplants for pediatric patients.

Hugs,
Connie
 
"But that was yesterday, and I was a different person then."
 
Alice in Wonderland, Lewis Carroll


mer
Veteran Member


Date Joined Aug 2008
Total Posts : 613
   Posted 12/18/2008 9:35 PM (GMT -7)   
Hello all! Medicaid also pays for transplants. Of course you have to qualify to receive medicaid. My hubby is on medicaid, and that is why we are on the transplant list...they are covering his medical expenses. It was a long journey, but he had to qualify through the state (we are in TX) and be medically disabled, and then we had to qualify w/ the income for his SSI. He is too young to qualify for Medicare (he's 47), so Medicaid is who picked him up.

Unfortunately, if your income is too high, you usually will not qualify for SSI...however, some states allow a "spend down" of expenses, etc that get you into the income range that will qualify you for medicaid once you have been deemed medically disabled.

Hope that helps some.....

Mer

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 12/18/2008 9:44 PM (GMT -7)   

Mer, thanks for the additional info.  I just went to both Medicare and Medicaid's sites.  Medicaid does pay for transplants at approved transplant centers.  Medicare pays "under certain conditions," but doesn't state what those conditions are, or whether they cover all expenses 100%.  It does seem that as of '99, in FL, Medicaid HMO plans will not pay for transplants, but regular Medicaid will.  I know when I first went to Mayo, I had both Medicare and an HMO Medicare supplement.  I had just signed up for the supplement.  I found that Mayo does not take HMOs of any kind (for any type of treatment there) so I stopped enrollment in the HMO. 

If one qualifies for Medicaid financially, it's best to go that route.  I remember my brother-in-law in OK didn't qualify for Medicaid due to their assets (a small farm) and he had to wait the 2 yrs. for Medicare...and got his transplant just in the nick of time.  This was some years ago, and I had forgotten that it was Medicare that paid for his transplant


Hugs,
Connie
 
"But that was yesterday, and I was a different person then."
 
Alice in Wonderland, Lewis Carroll


okielady
Regular Member


Date Joined Sep 2007
Total Posts : 77
   Posted 12/18/2008 10:10 PM (GMT -7)   

Windhover,  my husband has Blue Cross Blue Shield Oklahoma.  He actually got it in July, before we found out in August that he had Hep C and had a transplant in October.  That was an interesting time trying to prove that we didn't know about a preexisting condition, but quite literally we didn't know.  I don't know about your policy, but we never have had that much copay through out all this time.  Check to see if your providers are in their system and try to talk to the insurance company.  I'm sure all states are different.  So far we only had one doc come in that wasn't in the system and fortunately it was just a one time thing.  They paid for Jerry's entire transplant.  The main thing that would come back on us to pay would be part of the private room expense, as they only pay partial on that.  My prayers are with you and your family.

Helen


hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 12/19/2008 1:42 PM (GMT -7)   
Helen, my gosh you guys were lucky!  Also in how quickly from diagnosis to transplant!  I'm sure the insurance went over the medical records with a fine-tooth comb looking for indication of previous knowledge of the hep C.  smilewinkgrin
Hugs,
Connie
 
"But that was yesterday, and I was a different person then."
 
Alice in Wonderland, Lewis Carroll


okielady
Regular Member


Date Joined Sep 2007
Total Posts : 77
   Posted 12/19/2008 4:57 PM (GMT -7)   

Connie,  We were blessed to get the transplant, but it seemed in 2 months we went from half sick to being on life support for over a week and as the transplant surgeon stated he had one foot all ready crossing over to the other side.  He wouldn't have made it thru the nite.  Our surgeon fought for that liver, as it was supposed to go to someone else, but he asked the other surgeon if his patient would be alive tommorrow as Jerry wouldn't have been.  Talk about a roller coaster ride this disease is definitly that.  He worked Aug 6th on a Monday in 2007, went to the doctor on Tuesday and went down hill fast from there.  We were diagnosed on Aug 13th and transplanted on Oct 17th.  Miracles do happen.  We have had an extra year and we are going to get thru Christmas if I have to give him mouth to mouth.  We are having a decent day today, so I do count my blessings.

Helen

 


windhover
Regular Member


Date Joined Oct 2008
Total Posts : 28
   Posted 12/19/2008 6:27 PM (GMT -7)   
Glad  you  got  your  transplant  so fast.........ope  all goes well..............Glad Blue  Cross  did  so well with you  perhaps  the will with us.........
 

hep93
Elite Member


Date Joined Jul 2005
Total Posts : 12014
   Posted 12/19/2008 9:20 PM (GMT -7)   
Helen, that is quite a story.  God Bless that surgeon!  Though it was a close call, your experience gives hope to many here.

Hugs,
Connie
 
"But that was yesterday, and I was a different person then."
 
Alice in Wonderland, Lewis Carroll

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