What To Do ESRD?

[somarco]

http://www.medicare.gov/Publications/Pubs/pdf/10128.pdf

Medicare is health insurance for the following people:
People 65 and older ■■
People under 65 with disabilities ■■
People any age with ■■End-Stage Renal Disease (ESRD) (permanent kidney failure requiring dialysis or a kidney transplant) - pg 7 in above linked document

 

[VaDwayne]

Just take all this info, tell her to go to the local security office (I would go in person rather then call, my clients always have better luck that way) and inform them of the situation.

If memory serves right, ESRD and ALS (Lou Gehrig's) are 2 chronic conditions that you do not need to wait the customary 2 years for Medicare to start.

You are 100% correct on the ESRD. I am not sure about the Lou Gehrig's disease because I've never met anyone with it.

In Franks post above, it mentions benefits start 4 months after treatment begins, which is a fact, but most people have been in treatment long before they get Social Security, which means as soon as they become eligible for Medicare coverage(immediately), they will qualify, if it's been the 4 months.

I don't know this because I am an agent, I know this from family experience. And if I remember correctly, they backdated and paid for those 4 months too.

 

[Bob_The_Insurance_Guy]

I found this on their website:

[FONT=Verdana, Helvetica]If you (or your spouse) did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you are under age 65, you can get Part A without having to pay premiums if:[/FONT]

• [FONT=Verdana, Helvetica]You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months. (Note: If you have Lou Gehrig's disease, your Medicare benefits begin the first month you get disability benefits.)[/FONT]
• [FONT=Verdana, Helvetica]You are a kidney dialysis or kidney transplant patient.[/FONT]

She is on Kidney Dialysis. So, she is eligible for a Medicare Supplement, or just a Medicare Advantage.

Still confused, and can't get a human being at Medicare.

 

[somarco]

can't get a human being at Medicare

Could be a good reason . . .

 

[VaDwayne]

I found this on their website:

[FONT=Verdana, Helvetica]If you (or your spouse) did not pay Medicare taxes while you worked, and you are age 65 or older and a citizen or permanent resident of the United States, you may be able to buy Part A. If you are under age 65, you can get Part A without having to pay premiums if:[/FONT]

• [FONT=Verdana, Helvetica]You have been entitled to Social Security or Railroad Retirement Board disability benefits for 24 months. (Note: If you have Lou Gehrig's disease, your Medicare benefits begin the first month you get disability benefits.)[/FONT]
• [FONT=Verdana, Helvetica]You are a kidney dialysis or kidney transplant patient.[/FONT]

She is on Kidney Dialysis. So, she is eligible for a Medicare Supplement, or just a Medicare Advantage.

Still confused, and can't get a human being at Medicare.

Let me clarify..

1. Tell her to talk to Social Security NOW(super important) ,to get her on disability social security ASAP

2. When she gets SS, she will get part A FREE, she will need to enroll in part B

3. When she has part A and B, she will qualify for a med supp during her open enrollment period which she can begin enrolling 3 months before the month of her 65th birthday .THERE WILL BE NO HEALTH QUESTIONS ASKED!!!

4. MA is not an option as the only turn down for a MA is ESRD, to the best of my knowlege.

That's it! It's not the rocket science like the forum guru's make it out to be.

I hope that helped..

Something else to remember, her part B Medicare will pay the majority of the drugs she will be using for dialysis.

 

[somarco]

Correct me if I am wrong (as if I have to invite that), but the ESRD seems to be a "qualifying" event irrespective of age.

 

[VaDwayne]

Correct me if I am wrong (as if I have to invite that), but the ESRD seems to be a "qualifying" event irrespective of age.

If I understand your question correctly, you are correct.

Example: If someone is receiving underage SS due to disability, they have to wait 24 months before buying a med supp; ESRD negates that requirement.

 

[Bob_The_Insurance_Guy]

Just found out today that Georgia is not one of the states that offers Medicare Supplement Plans to under age 65 Beneficiaries.

The best we can do for her is put her on SSDI, and have that, in combination with Medicare Parts A and B, be her medical coverage plan until December of 2011.

So, basically, SSDI and Medicare Parts A and B are her medical insurance from January 2011 to December 2011.

 

[VaDwayne]

Just found out today that Georgia is not one of the states that offers Medicare Supplement Plans to under age 65 Beneficiaries.

The best we can do for her is put her on SSDI, and have that, in combination with Medicare Parts A and B, be her medical coverage plan until December of 2011.

So, basically, SSDI and Medicare Parts A and B are her medical insurance from January 2011 to December 2011.

Please read my post above;that is exactly what I said. I am glad you finally got the answer you were looking for, good luck.

 

[sman]

They will be offering them beginning in November.

Just found out today that Georgia is not one of the states that offers Medicare Supplement Plans to under age 65 Beneficiaries.

The best we can do for her is put her on SSDI, and have that, in combination with Medicare Parts A and B, be her medical coverage plan until December of 2011.

So, basically, SSDI and Medicare Parts A and B are her medical insurance from January 2011 to December 2011.