Medicare changes

[chrisroski]

Just thought I would give a heads up to the PALS out there that have Medicare. I recently had to change where I get my formula from because Medicare did not accept the company I had. Apparently, they are bidding on these companies, and if they don't make the bid, Medicare will not use them. Friday, I got a call from the company who,provides my compression vest they can no,longer serve me. Medicare will not pay for the machine because I have a Cough Assist Machine as well. My doctor feels that vest, neb and cough assit all help to keep the excessive muscus down, since I have Bulbar ALS. The company told me they are sending me a form to,try to appeal the decision. I am assuming this all has to do with the new Health Caree Reform, which if this how it's going to work is not going to be good for PALS or anyone on Medicare . If you have a second insurnace company you may be ok, I have supplemental insurance to cover the 20% Medicare does not cover. Just thought I would,pass along in case people start getting calls also. Hope this doesn't turn out to be another fight for PALS, maybe they feel since we have a death sentence, why bother. Lets hope not.

 

[Nikki J]

Hi sorry for all the frustration. Medicare rules have been changing and getting tougher for years so I don't know this is directly related to health care reform. I hope your supplemental helps often they won't cover things that Medicare does not. For example aside from a welcome physical Medicare does not cover physicals only a so called wellness check which is different. If a person has a physical neither Medicare or supplemental will pay.
Keep working on the appeal sometimes you have to appeal more than once
Good luck
Nikki

 

[penny1]

My husband earned his wings in June 2011. My understanding of how medicare works is that they take the cost of DME and divide it by 10. That is the monthly rent, after 10 mths you own it. I know the vest cost is twice that of a cough assist. If push came to shove you could continue payment on the DME that had the fewest payments left or was less costly per mth. Not perfect but you may be close to owning some of this equipment. I donated his pwr chair, hoyer, neb, cough assist and vest to our local ALS. Hope this info will help someone keep the DME that is needed. Stay strong, live each day, love like there is no tomorrow. Penny

 

[Barbie]

Penny, that is how I ended up owning my Hoyer lift.

I also read recently that Disability is in much worse shape that medicare, and they think they may have to start reducing payments by 20-25% as early as 2016.

 

[Bad Balance]

This is scaring me...

 

[Uptown]

Penny, that is how I ended up owning my Hoyer lift.

I also read recently that Disability is in much worse shape that medicare, and they think they may have to start reducing payments by 20-25% as early as 2016.

Barbie, I am curious where you heard this. I can find nothing pertaining to this on the SSA website and have heard there will be no decreases but the COLA will be suspended or ended. Please elaborate!

Thanks.

 

[jellis86]

There are many reports about the ailing SS and SSDI. Google ssdi reduction 2016 and the top few are the best. Although alarming numbers, the fund will always maintain payouts since SS has been part of the general fund since the early 70s. However, it will add significantly to the national debt unless something is done to fix the system.

Social Security Board of Trustees: No Change in Projected Year of Trust Fund Reserve Depletion

 

[jellis86]

Post went to mod

Google ssdi reduction 2016.....about the 6th link down is from the SS administration website

 

[Uptown]

Thank you! I read it and I still don't see Congress reducing benefits. Money has been borrowed and reallocated for many years and now there is more retirement the funds are extremely low. Assuming disability and retirement go up as the boomers age, it may require borrowing t interest to pay back what was used elsewhere. I think it is more likely to raise retirement age than reduce current benefits.

Here's another article from a lawyer further down on the google results. I concur with this analysis.

wardharper: Will SSDI benefits be reduced in the future?

 

[Barbie]

What I find so irritating is SS and SSDI is such a needed program and so important--but many in the general population have the mistaken idea that most people are scamming the system and it is easy to get. There are people out there that want to cut the program and would be happy...

 

[Nighthawk]

What I find so irritating is SS and SSDI is such a needed program and so important--but many in the general population have the mistaken idea that most people are scamming the system and it is easy to get. There are people out there that want to cut the program and would be happy...

You are right

A LOT of people out there scamming the System and...collecting SSDI benefits even when they are NOT really disabled as many of us here are.

No wonder why the whole System is going bankruptcy.
Many young people who can still work hard but...they rather sit in a couch at home while collecting SSDI benefits. That enrages me.


Grrrr.