Adjusting to new life

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carolinemc

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May 31, 2010
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kansas city, mo
Well, here I am at it again. This time,. adjusting to new life with medicare. Can't get medicaid yet, since I still have to go through the backpay. Was more than I was expecting and can't buy up a lot of stuff. But I will be alright. Just new and will be trying the medicare out on Monday when I go for my mammogram. Hate it, I call it the boobie squeeze. LOL!. I will keep you all update as I navigate this new world I am in now.
 

Protimenow

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Aug 10, 2010
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Medicare is helpful. Medicaid might not be all that helpful. I have the California version of Medicare -- between me and my wife, we get a few dollars too much Social Security to avoid a 'share of cost,' and the share of cost guidelines are, shall I say, 'unrealistic.' They take a total of our Social Security income, subtract a little over $900 (what they think our monthly cost of living is), and came up with a MONTHLY SHARE OF COST more than $1600. WHO THE HELL CAN LIVE ON $900 a month? In California? It's bizarre.
Unfortunately, the supplements cost a lot of money, too, so we're stuck avoiding health issues and getting by with Medicare only, or hunting for doctors who won't charge a deductible.

I may be able to get Medicare to buy me a meter - but I don't really need one. Medicare apparently pays for lab tests. I don't know about your mammogram.

Good luck sorting out your new insurance situation.
 

carolinemc

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Joined
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Messages
717
Location
kansas city, mo
Medicare is helpful. Medicaid might not be all that helpful. I have the California version of Medicare -- between me and my wife, we get a few dollars too much Social Security to avoid a 'share of cost,' and the share of cost guidelines are, shall I say, 'unrealistic.' They take a total of our Social Security income, subtract a little over $900 (what they think our monthly cost of living is), and came up with a MONTHLY SHARE OF COST more than $1600. WHO THE HELL CAN LIVE ON $900 a month? In California? It's bizarre.
Unfortunately, the supplements cost a lot of money, too, so we're stuck avoiding health issues and getting by with Medicare only, or hunting for doctors who won't charge a deductible.

I may be able to get Medicare to buy me a meter - but I don't really need one. Medicare apparently pays for lab tests. I don't know about your mammogram.

Good luck sorting out your new insurance situation.
You do know that medicare comes from federal, not state. I too have found it hard with having the back pay from SSDI to get Medicaid(from the state). I was not charged a co-pay for the mammogram, but I will find out soon on the bill. Still a whole new world for me. I will keep everyone in the know as I get through this new stuff to me. Different than when my mother was alive and was on it. A lot has changed. And no one can live on $900 a month nowhere in this country. And I agree about the supplements, the cost are outrageous. My mother had to ignore those 20% of the medical bills, no money to pay. You keep hanging in there also. One day they will change it for the better, till then, we are stuck with what we have.
 

Protimenow

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California
Yes. I'm aware that medicaid is a state program. However, a lot of the money that goes to states to fund medicaid still comes from the Federal government.

I'm still trying hard to get work so that this is no longer an issue. In California, we have Medicare Advantage programs -- basically, HMOs, that cover most of the costs but may still have deductibles and you have to go to contracted providers. There are questions about quality of care for these programs, and the lack of choice is a problem for my wife.
 

btlRickas01

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May 2, 2015
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Chicago western suburbs
Thanks so much for sharing your experiences with Medicare. I'll be turning 64 in a few months and I'm dreading having to choose between Medicare and Advantage, not to mention the other parts. I've been on ACA since 2015 when I had my aortic valve replaced. It paid well but the deductibles and cost are getting out of hand. I've been using HMOs since then, if I would have had a broader network I would have used a different hospital/surgeon back then.
 

Protimenow

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I was fortunate. When I had my aortic valve surgery, I had a good job with great benefits. I was able to get a very good surgeon (perhaps, at the time, one of the most experienced in AVR). Nine months later, I was no longer in that job (this company was self-insuring -- maybe, in a wierd way, they didn't like having to pay so much out for me.

If I had to wait for Medicare to get surgery, I may have been out of luck. I don't think I'd be able to get a surgery like this today.
 

carolinemc

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kansas city, mo
I was fortunate. When I had my aortic valve surgery, I had a good job with great benefits. I was able to get a very good surgeon (perhaps, at the time, one of the most experienced in AVR). Nine months later, I was no longer in that job (this company was self-insuring -- maybe, in a wierd way, they didn't like having to pay so much out for me.

If I had to wait for Medicare to get surgery, I may have been out of luck. I don't think I'd be able to get a surgery like this today.
You would still have surgery, Medicare does not have to decide if you have a bypass surgery or not. It is just that it only pays 80% of the medical bill, you are still responsible for the 20% medicare does not pay. It is nice having medical insurance that pays for all it the surgery and the hospital stay. But you would not be put on a list or wait for months for surgery on Medicare. You might if you were in another country. Hugs for today.
 

carolinemc

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Messages
717
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kansas city, mo
Thanks so much for sharing your experiences with Medicare. I'll be turning 64 in a few months and I'm dreading having to choose between Medicare and Advantage, not to mention the other parts. I've been on ACA since 2015 when I had my aortic valve replaced. It paid well but the deductibles and cost are getting out of hand. I've been using HMOs since then, if I would have had a broader network I would have used a different hospital/surgeon back then.
It is sad how things have turned out with medical health insurance and it will not get better till we have a President with a heart of gold and see that we need a system for all people, equal and fair to all ages, abilities or disabilities. I am so used to HMO. Hugs for today.
 

marvsehn

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Jan 23, 2016
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Location
Lynchburg, VA
I waited till 65 and medicare kicked in. The Dr was on me for years to get it done. I have an aortic mechanical.
ACA was a nightmare, my wife is still on for one more year at full cost, about $14,000 premium and $6500 deductable before any coverage.
Over the years I also paid 100s of thousands into medicare so it is not free either.
I have great Drs at Duke and life is good.
My total bill for my surgery etc was about $45k, paid by medicare and the supplement.
 

Protimenow

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California
No, Carolinemc, I would NOT have surgery. Not without something to cover the 20% that Medicare doesn't pay. Right now, I can't afford supplemental insurance - perhaps if I KNEW that I would have to have surgery, and could afford the supplement, I'd have the surgery.

Without a good supplement, I'd S.O.L.

---
A president with a 'heart of gold' would be great to have -- but we'd also need a Congress that would enable that president to do good things. The current Congress would block any 'heart of gold' plans. (The insurance lobbies are way too strong, and many legislators are way too weak).
 

Agian

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Adelaide, South Australia
If you're waiting for a politician to come along with a heart of gold, you may as well bank on the second coming.

When America gained its independence, the awe the British reserved for their king, was reflected in the way the Americans viewed their Presidents... Then Bill Clinton and li'll Elvis came along. LMAO
 

carolinemc

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Messages
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kansas city, mo
No, Carolinemc, I would NOT have surgery. Not without something to cover the 20% that Medicare doesn't pay. Right now, I can't afford supplemental insurance - perhaps if I KNEW that I would have to have surgery, and could afford the supplement, I'd have the surgery.

Without a good supplement, I'd S.O.L.

---
A president with a 'heart of gold' would be great to have -- but we'd also need a Congress that would enable that president to do good things. The current Congress would block any 'heart of gold' plans. (The insurance lobbies are way too strong, and many legislators are way too weak).
You may not have a choice when your life depends on it. No one cam fix medicare right now, not even the new congress. If you do go have surgery, you may have to do what I and millions of Americans have done for many years, ignore the bills you cannot pay. I can't afford the supplement insurance either.
My own mother was on SSDI for many years, on medicare and could not pay for a hospital bill, three hand surgeries, cause SSDI does not pay enough for medical expenses.
So hopefully you may never have to have surgery, but if you do, do not say cause you have only medicare and have to pay the 20% I can't have OPH, cause you will regret those words. Never say you can't cause of Medicare. Hospitals do get right-offs on the bills you cannot afford to pay. And it does not go against your credit score these days.
So keep doing what you are doing and just remember, you cannot be denied a life saving surgery because you cannot afford the 20% that Medicare does not pay. Just go for the surgery if it comes up. Never deny yourself medical care. Promise me, I went through this with my mother and soon myself. Good luck in care of the heart and other health issues and hugs for today. I am also a type 2 diabetic, onset from OPH. Do what you have to and remember the state has medicaid that can help also.
 

carolinemc

Well-known member
Joined
May 31, 2010
Messages
717
Location
kansas city, mo
If you're waiting for a politician to come along with a heart of gold, you may as well bank on the second coming.

When America gained its independence, the awe the British reserved for their king, was reflected in the way the Americans viewed their Presidents... Then Bill Clinton and li'll Elvis came along. LMAO
I have dealt with Medicare on the one side, my mother had it, and seen the crazy changes of the years. It is sad when they, the politicians keep chipping away at the benefits that people do need. And it would be nice of we did get a President that could bring back the way Medicare used to be years ago, but those days are gone. Not when there are politicians and Presidents who do not stand with the people need help the most. The only real change is that now you can have Medicare and Medicaid( if you have no property and $2,000.00 or less in the back per month). I am trying the dwindle the backpay I got from SSDI to qualify for Medicaid. It will be months before I can do that, LMAO. And no kids to worry about. And I loved Bill Clinton, for he was a different person for the people, till more changes came after him. No more politic talk, I will get angry.
You have a great day, sorry I get carried away. Hugs for today.
 

Protimenow

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California
I'm not sure about political talk here. Unfortunately (?) I've got a house with some equity in it. If we have surgeries and don't pay, liens against the house will probably eat whatever equity we have in this house. Although I'm driving a 17 year old car that my daughter gave me, and trying to get by on Medicare and freelance work that doesn't come as much as I'd like it to, Medicaid has been made so that it's unusable for regular stuff. Unless it's a real emergency, or we find a doctor who doesn't require the deductible, we're (my wife and me) running almost like we have NO medical insurance.
Yes, hospitals write some things off -- but only after their vultures do what they can to find bones to pick clean.
So, for the two of us, unless it's something that seems emergent, we just bear the pain and discomfort. (Remember - Social Security, Medicare and Medicaid are socialist programs -- we can't have THOSE can we?)
 

tom in MO

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Jan 17, 2012
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MO USA
If you're waiting for a politician to come along with a heart of gold, you may as well bank on the second coming.

When America gained its independence, the awe the British reserved for their king, was reflected in the way the Americans viewed their Presidents... Then Bill Clinton and li'll Elvis came along. LMAO
Politics and insulting other countries is not the purpose of this board.

To set you right, the American president is not held in awe like the british queen. We get rid of our leaders at least every 8-years. Our president is not the head of our state religion, like the queen is. Not sure of who "li'll Elvis" is, but that's probably an insult to the "King of Rock and Roll" as well.
 

Agian

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Adelaide, South Australia
Tom, where's the insult? They asked Washington if he wanted to be king. That's all people knew at the time.
Your comments indicate you don't like being compared to the British. Fair enough. But if you look at the back of Australian coins... you guessed it. So if my comment was meant as an insult, it would be hypocritical.

As for politics, I don't know what you're talking about. Li'll Elvis is what Clinton called his... , which I am pretty sure was apolitical. I suspect he liked Elvis so much, he named it after him.

I'm a big Elvis fan too, aka the 'king of rock and roll', but I don't revere him the way the British revere their monarch, or the way the abovementioned gentleman revered his genitalia. So, when you say that I was 'probably' insulting him as well, you seem to be flailing to find something to criticise me about.

I find it fascinating the way you grafted your own political views onto an allegation I was insulting your country. I guess I am entitled to opinions, as long as they're the right ones. I suspect you might have led it 'slide' if I 'insulted' your current president. I won't be voting in your elections, so please don't blame me for any results.

Happy to engage in further 'debate'. You'll lose. I'm probably a bigger fan of your country than a lot of your compatriots. So, save your faux rage for someone else.
 
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