- Joined
- Nov 5, 2009
- Messages
- 14,256
- Reason
- Lost a loved one
- Diagnosis
- 00/0000
- Country
- US
- State
- WA
- City
- Seattle
Like Nikki's sister, my husband was not eligible for any federal benefits or coverage due to lack of work credits (in his case, due to the Marfan he was born with). There is no way around that of which I am aware.
I am assuming you already have dependent coverage on a group plan, which will cover essentially the same services as does Medicare -- private plans typically follow Medicare guidelines with a few riffs. And, unlike traditional Medicare (as opposed to Medicare Advantage or Medicare + a supplement), your group plan likely has an out-of-pocket maximum.
There will be differences in copay levels and deductibles, of course, depending on plan design, but covered services and equipment will not be fundamentally different. They might even be slightly better.
When Larry was first diagnosed, a hospital staffer advised a divorce so he could get more benefits. We didn't.
Larry was on private insurance (usually my COBRA, a few months of individual coverage) throughout the ALS years until the last few months, when he turned 65, but even then he had to pay a Part A premium in addition to what others pay. Our private coverage paid for his power chair, hospital bed, suction machine, home PT, etc. with the same caveats as Medicare. We borrowed his Hoyer from the ALSA and self-paid for used BiPAPs.
I built a relationship early with an RN case manager, which was invaluable in getting equipment more quickly. You can call any private plan that bears primary medical risk for your care, and ask to be assigned a case manager.
Best,
Laurie
I am assuming you already have dependent coverage on a group plan, which will cover essentially the same services as does Medicare -- private plans typically follow Medicare guidelines with a few riffs. And, unlike traditional Medicare (as opposed to Medicare Advantage or Medicare + a supplement), your group plan likely has an out-of-pocket maximum.
There will be differences in copay levels and deductibles, of course, depending on plan design, but covered services and equipment will not be fundamentally different. They might even be slightly better.
When Larry was first diagnosed, a hospital staffer advised a divorce so he could get more benefits. We didn't.
Larry was on private insurance (usually my COBRA, a few months of individual coverage) throughout the ALS years until the last few months, when he turned 65, but even then he had to pay a Part A premium in addition to what others pay. Our private coverage paid for his power chair, hospital bed, suction machine, home PT, etc. with the same caveats as Medicare. We borrowed his Hoyer from the ALSA and self-paid for used BiPAPs.
I built a relationship early with an RN case manager, which was invaluable in getting equipment more quickly. You can call any private plan that bears primary medical risk for your care, and ask to be assigned a case manager.
Best,
Laurie