ESRD AND MEDICARE

[kerjekvincent]

I have kidney failure and on dialysis and recently got my medicare ins. I was on hemodialysis but now I have switched to PD. Up until last month I had my EGHP, now they have offered me COBRA which costs around 500 dollars/month. I don't think I can afford that amount. What other ways are there to help me pay for the 20% that medicare does not cover as it appears I do not qualify for Medicaid or other state help as my wife earns over the limit and I am disabled and unemployed.

 

[mattspits]

Hello,

Unfortunately, I have no experience with ESRD and Medicare. I do know that there are supposed to be plans designed for Medicare recipients with ESRD. If you have not done so already be sure to contact 1-800-MEDICARE to ask them what options are available to you.

 

[ShirleyP]

Hello kerjekvincent,

Congratulations on getting PD, I hope it goes well. I know the feeling about original medicare. What state are you in? How old are you? I'm assuming you are not 62 yet? Otherwise a Medicare Senior Advantage plan worked great for me my first three years of PD. Unfortunately, because of some funny business, my Nephrologist told me to get my affairs in order as I was no longer responding to treatment and that she wasn't going to refer me for Hemodialysis, since it was her opinion (no image study) that I would not have an adequate artery for a permanent. I had to ask my primary for an ultrasound, which found one in my upper left arm. They put a temp cath in my chest and pulled the PD cath out. Shortly after that, looking at my EHR, I noticed a diagnosis from that day stating 'mechanical disorder of Peritoneal Dialysis Catheter', so it wasn't me that failed it was the catheter. An they felt it wasn't necessary to tell me. I was having my doubts about their commitment to my health. I compared my 2010 EHR to my 2012, there are dates missing under allergies. It's a Renin-Angiotensin System reaction to an ACE inhibitor (Lisinopril) on the same date I had an accept risk stroke during a carotid angiogram. And the same reaction to all ACE inhibitors is listed about 3 weeks later. This would be a 3 week long Acute Kidney Failure (near complete kidney atrophy). So they were responsible for my ESRD. Well I wasn't about to stick around and started looking for a new senior advantage plan. Well to my surprise, negligence is not a medicare approved reason to leave one plan for another. My plan provider had paid for everything and now I had come up with 20% for original medicare. I also suddenly made $7 dollars to much a month in Soc Sec (my only source of income) which made me have a $386 out of my pocket share of cost with my MediCaid monthly coverage. W

While probably not an option for you, I had to financially destroy myself and get under the federal poverty limit. The share of cost went away and everything else was now covered. After a year on Hemo, I'm finally back on PD with my new Original Medicare provider.

I got really good information from my California 'SHIP' program worker. Each state has one. I'd start there.

ShirleyP