My Photo
Name:
Location: Vero Beach, Florida, United States

My name is Pat and I live in Florida. My skin will never be smooth again and my hair will never see color. I enjoy collecting autographs and playing in Paint Shop Pro.,along with reading and writing. Sometimes, I enjoy myself by doing volunteer "work" helping celebrities at autograph shows. I love animals and at one time I did volunteer work for Tippi Hedren's Shambala Preserve.

Friday, January 23, 2009

The Older Generation

Ok, so.. you youngsters are going to tune this post out, and that's ok.  But just remember one thing... no matter how impossible it seems to you now, one day, with luck, you will be old.   Sound like a depressing post?  Yep. It is.

It has to do with Social Security and the healthcare you get after age 65 which is called Medicare. And I need some help if anyone happens to know how..

In my case the first thing to remember is I have to live on 650.00 a month.  Sound impossible?  It is.  IF my brother hadn't taken me in and if David hadn't let me stay here I have no idea where I'd be.  Ok, nuff said on that note.. just remember when I discuss the medical care that I am trying (for obvious reasons) to keep it as low in cost as possible and yet get as much for the bucks as I can.

So here's the gist:  Medicare is something you are awarded for reaching age 65 to help with your medical care.  Key word: help.  It is not by any means all that you need!  Medicare will pay 80% of your doctor visits and 80% of any hospital stay.  That's all. AND.. it is NOT free.  This will cost you (at this time) approximately 97.00 a month.  (start subtracting:  650.00 minus 97.00 equals 553.00)  and it is taken out of your Social Security before they mail you your check.

Now, one must find two more things.  One, called a supplemental insurance or medigap. Either of these will cover most of the 20% of your doctor visits and most of the 20% of your hospital visits... each still having some sort of co-payment on your part.  Generally it means you still have to pay about 30.00 per doc visit and at least 100.00 a day for 7 days in a hospital .  You'd be amazed at what isn't covered at all, let alone partially!  (in this I would like to keep my copays to about 25.00 and no more then a total of 800 for a hospital stay at 100 or so a DAY ..NOT a deductible of 800. in which even if you were there only 2 days you would have to pay the 800.)

The second thing you must find is another place to sell you drug coverage for your medicines.  Which isn't easy finding one that you have (again low co-payments) and or low deductibles and or  unlimited amounts.  Get that?  you want low co pays, and or low deductibles (some start out that you have to have spent 1,000 or more before they even begin) and not least you don't want a fixed amount so that they stop paying after you have spent X amount.  (example:  Pays UP TO 2,700. a year after that you are on your own)  I can tell you right now.. my brothers medicines, if he were not totally disabled, would have cost nearly 2,000 a month!  ONE MONTH!  So don't kid yourself that, "oh wow, I'll never use 2,700 a month on meds"... it can happen to you!

I am so utterly confused .  Each day I give a new try to be on the web to find my answers because I HAVE to know what I am buying by the end of the month.  At this point I feel so overwhelmed that when I pull up a website.... I look at it and begin to cry.   I never, never, never understand insurance of any kind.. so that's where my panic begins.  I don't know anyone in New Jersey who ,whet thru this, and found what they needed so that I could ask and have them say, well this is what I got, what it covers, and how much it cost so I could say... that sounds good and just call and do the same thing without reading hundreds of things and getting so lost that I just give up.

Every now and then I kid myself into thinking I actually understand one or two of them, but if I am right they would cost me a total of about 400.00 a month.  wanna deduct that from my 650?  Pretty simple...  it would barely leave me enough for co pays!!  Remember those?!  I have to have enough left for the CO PAYS!!  hello?!

So.. ok.. if you know someone who recently went thru this and found what they think is a good solution  (trying to keep the total price to  no more than 300, including the medicare part of 97.00, please, have them contact me!!)

I'm sorry to have put you through this post, but in case you didn't recognize it.. I am in such a state of nerves over this that I am not even sleeping more than 2 hrs a night! Desperate is desperate..

Ok.. I am done whining.. 

 

27 Comments:

Blogger animewookie said...

The fact that you have been put in this position is a travesty.
I don't know if you've tried this site yet but maybe it will be of some help to you. Theres an 800 number so perhaps you can talk to a real live person.
http://www.state.nj.us/health/senior/ship.shtml

7:40 AM  
Blogger cj said...

I was going to ask if there wasn't some sort of senior advocate in your area that could help you. Maybe that's what anime's link is.

Check it out and I'll be praying for you!

cjh

7:52 AM  
Blogger Donna said...

That's downright scary. Thanks for itemizing things, because I had no idea what to expect from Medicare. Of course Cliff is working now, and says he intends to keep working as long as he can. But let's be realistic here: He won't live forever, and he may not always be ABLE to work.

8:49 AM  
Blogger DesLily said...

animewookie: I'll check it out but I have to say.. i dread even opening a website anymore, it's like a switch inside of me flips and no matter how easy a read I just don't get it anymore... i think i've just gotten too much information without understanding any of it totally, which is what is needed!

hi cj: thanks. my fear (and I feel like I know this without a doubt) I will take anything just to be able to stop thinking about it.

donna: the longer you can put it off the better! eventually they may have to make it easier to figure it all out. My problem is I am at the stage where no matter what i choose it will be wrong or use up what little money I have faster than my mind can wrap around it... right now i need someone to say this is what you will take and this is what it will cost and this is what you pay and make the choice for me.. it sure can't be any worse than what i will choose on my own

8:57 AM  
Blogger Astaryth said...

I had a friend go thru something similar a couple of years back.... She said AARP helped her figure some stuff out. I'm sure they have a website. Maybe they could help you? Man, this really sucks. I hope you figure it out.

9:12 AM  
Blogger DesLily said...

Hi JJ: oh yeah it sucks lol..
I have AARP on my list "to call". my x sister in law has them and I may take exactly what she has only because I can't decipher all the shit I've been reading enough to know that somewhere I can get what I need at a cheaper price..and trust me every 10. saved helps!
All the places have good things.. problem is price and what they offer ..or don't offer. Many have "deductibles" (no can do that) many cut you off after a certain amount and leave you dangling and many have high co pays.. none seem to help the guy who doesn't have much to spend. If you are fairly well off you can get the best of the best, be covered 100% with little to no deductibles and unlimited time etc. As always, the rich can be covered the poor pay out what little they have until they have nothing.

9:18 AM  
Blogger DesLily said...

By the way.. i really don't expect an answer to my problem I just had to get it off my chest and let anyone who reads my blog know where my head has been, since it does reflect on everything I say and do.. so take it all with a grain of salf folks!

9:19 AM  
Anonymous Anonymous said...

This is a very difficult decision for you. Do you belong to AARP? I do, I have the AARP medical supplement Plan F, it's about 120.00 a month, there are no deductibles and with Medicare almost no co-pays. I've not had to pay for any medical visits or treatments this past year.

I also have the AARP Preferred RX plan which is about 28.00 a month and I pay between 7.00 and 30.00 co-pays for prescriptions.

Sometimes Walmart and your drugstores will have plans for medicines that can help you out.

The people at AARP are really helpful, check out their website and maybe give them a phone call.

This has really helped my husband and me, we are both on Medicare and SS.

Good luck, Alice in Arizona

9:26 AM  
Blogger I'm mostly known as 'MA' said...

I will just turn 65 in March and have signed up for medicare as directed. I'm working right now but hope to retire next year. The money needed for health care is astounding. Everyone says AARP is the best and cheapest way to go but I've not had to go that route yet as I'm still working. I'm beginning to wonder if retirement will ever come. Donna sent me over here to see you. Good Luck

9:35 AM  
Blogger DesLily said...

hello Alice, and thanks! yes I plan to call AARP next week, I wanted to put this out here and see what othres have done. I don't belong to any "senior" things where people sit around and say, "well I did this and got that" which would be a bigger help than websites that leave you questioning you sanity after a while with no one to ask question to!

hello Ma! I know I'm not a big commentor but I've read Donna's blog from the beginning when I learned about journals! lol.. the thing that scared me with AARP was the fact that my x sisterinlaw pays 181.00 and 38.00 for her medigap and drugs coverage at aarp plus there's still the 97.00 for medicare itself. That's 316.oo! and of course you still have all your copays! that's not cheap for many of us! I do realize the actual cost of things so understand why it all costs so much... but unless you are fairly well off or own nothing and have no savings account to get on medicaid (not medicare) you are basically screwed to paying out money you need to eat with!.. I wish I knew the answers because things will only get worse I can't imagine what our kids will go through in just another 20 yrs or so!

9:43 AM  
Blogger madcobug said...

Sending you an email Pat. Hugs, Helen

10:39 AM  
Blogger Pamela said...

Of course, the physicians are required to have someone in their staff who understands all this stuff, too.

We have a Senior Center in town -- Usually there are a few experts hanging around there that help others.

I wish I was there to give you a big hug -- and maybe rub your neck or something. Anything to get your to rest, sleep etc. Stress is not our friend!

11:04 AM  
Blogger DesLily said...

Pam: and I'd let you rub my neck and back! LOL LOL I've already asked the staff at my doctors and checked out what they "recommended" and I wasn't happy with what I found.
I don't know if the lack of sleep is just this or not..honestly haven't slept well in months sometimes I go to bed at 10 and back awake for the rest of the night by 1...I stay laying down in the dark but nada. sometimes I take excedrin pm and it helps but the minute i stop taking them it's back to normal... sigh. well.. at least my gums don't itch!

11:09 AM  
Blogger Celeste said...

One thing you need to check with is your state medicaid office. For lower income( and your income DOES meet it in GA) you can get medicaid to cover you in addition to medicare. I am not sure about everything else in your finances. They take certain things into account but it is worth a try.

11:20 AM  
Blogger DesLily said...

Celeste: thank you for your comment.. i was on medicaid some time ago for a while and I know I can't go on it now. Actually the SS amount is enough to keep me off.. also though, not alot, you can't have almost nothing in savings.. you know how ridiculous that is when one bad sickness can wipe out thousands of dollars?!! so if you try to put anything away to help yourself you can't get on medicaid.

11:49 AM  
Blogger Cath said...

We moan and groan about the NHS in the UK but really we ought to be ashamed of ourselves for doing so. No one in this country has problems like yours getting healthcare, although certain cancer drugs can be hard to obtain. Remember my brother being in hospital last year? He was in there for 10 weeks and had a major op. Paid nothing. The fact that you have this horrendous problem to deal with is shameful. We have the Citizens Advice Bureau over here who help people to sort these problems, perhaps there's a US equivilent? I hope you can manage to sort it out, Pat, and wish there was something I could do to help.

12:17 PM  
Blogger DesLily said...

Cath: wow.. so, how long do I have to live in England to be covered? lol... do you want to know the REALLY SCARY part?.. there are many people here in America a lot worse off than I am!... blows your mind eh?!

12:33 PM  
Blogger Nymeth said...

Unfortunately I can't say anything helpful, but I wanted to let you know I'm keeping my fingers crossed that you manage to find a way to sort things out soon.

4:17 PM  
Blogger Kathy said...

If you can stand one more comment about this Pat ...

... Contact a senior services agency in your area. Here we have an agency called North Shore Elder Services. They will either have someone on staff to help you or will point you in the right direction.

Also, it helps to network with other seniors (I know, I know) in your area and you can do that by going to your senior center. There should be one somewhere in the area.

I know my sister has her Medicare A & B now, but she also has a supplemental insurance through an independent insurance agency ... $44.00 a month for her prescription coverage and low co-pyas. But she's in Maine. I'm only pointing that out, because there are things out there ... they just are not easy to find.

Remember too that you may qualify for some type of assistance for daily living. Food stamps, medicaid, etc. Take advantage of what's available to you ... while it's still available.

Also ... if you find yourself in the hospital with a large hospital bill staring you in the face ... do not hesitate to speak the finance department. All hospitals who receive Federal $$$ must provide some free care and discounted care to patients ... even a discount can help.

But we all know you aren't going to find yourself there any time soon.

Hugs. Kathy

9:34 PM  
Anonymous Karmyn R said...

I think the insurance companies intentionally make it difficult to understand. That way you might just shrug your shoulders and blindly choose one.

I truly hope the new administration can help fix the problems of health care!!!

9:34 PM  
Blogger Anne said...

Donna sent me this way. I do know that IF you require medications, there are a few organizations that supply them for FREE if your income is low enough and it sounds like yours is. WWW.needymeds.com is ONE website. There has to be some type of senior advocates in your area. Also agency that does medical billing in your area can help you with you bills. They can be jewels for the most part. Don't give up and don't accept no or we can't do that for an answer. YES, you can! Good luck. Our son who is only 34 is on Medicare. He was on medicaid and now is on both. He is mentally (bipolar) disabled. You can own things to do this. Lots of times they need to be placed in a trust. Actually a good legal aide person could help you too. Anne

1:06 AM  
Blogger Ladytink_534 said...

I haven't got a clue. So sorry you're going through this though :(

4:52 AM  
Blogger Ladytink_534 said...

Hey, thought you'd get a kick out of this. A guy on YouTube is going around to older stars and getting their life story through interview including talking about their movie or TV work (be warned, it's very long).

Here's Fess Parker's interview (first part)

5:10 AM  
Blogger DesLily said...

nymeth: thanks anyway

thanks Kathy.. I'm far from the only person feeling like I am or going thru this I already know i can't get medicaid by am researching aid for drugs.

Karymn: I totally agree. They have their own language and then you are supposed to understand it... that and "small print"

Anne: thanks for coming by. My brother was totally disabled and on both also. no one in their right mind would trade places with anyone who gets free medical care in this country.

nope no youngun would tink :o).. I'll check out Fess Parker!

6:47 AM  
Blogger Debi said...

Oh DesLily, I am just so damn sorry. The stress must be overwhelming! I wish I had some helpful advice, but I'm afraid I'm clueless. But I wanted you to know I'm thinking about you, and hoping like crazy that you find a solution that will really work!!!

7:49 AM  
Blogger DesLily said...

debi: it's looking like I'll take something from aarp.. problem is you never realize what insurance of any kind WON"T cover until you get that rejection notice of "this is not covered"... no one can predict what will be needed. That and while they do list what is covered your mind cannot come up with all the "well what doesn't it cover answers"..

7:53 AM  
Blogger Sugar said...

i get medicare & have for yrs, i get 750. a month. have to learn to cut a lot of corners & do without a lot of things.
as for medicare, it does pay 80% of dr & hosp, they helped me in choosing (well, actually they chose for me) an insur to fill in the gap...it pays the other 20% of ye dr & hosp bills. no co pay there. i have a $1.00 copay for each medicine (& i take lots of meds, expensive ones too).
so, you'll get help with your medical, just ask for it & check things out if it isn't what you want, before you sign up.
good luck,
sugar

11:52 AM  

Post a Comment

Links to this post:

Create a Link

<< Home