hate alabama medicaid

That is just so wrong... I
That is just so wrong... I guess I shouldn't be complaining when they deny expensive prescriptions for my husband. I am so sorry.
Brenda

Question
What was it that caused the change from SSI to SSDI?

From what I can see that may be the issue. SSI folks get Medicaid while SSDI folks qualify for Medicare after 2 years.

Can you contact the state agency governing insurance and/or social services to see if there are other options available to you?

Hope you find a solution.

Marie who loves kitties

Goldie1 said:

Was going to say the same....
thing as Marie. When you get SSDI, you are eligible for Medicare 2 years after date of diagnosis. Call your local SS office.

Take care,

Ellen

Stage
Thinking that this is only stage 4 because not all cancer patients could get it. Thinking it depends on state and stage.

Kim

That stinks
So sorry, John.

*hugs*
Gail

Question
Can I take the opportunity to try and get a basic understanding of the US system asI feel very ignorant. I understand that taxes vary between state so the level of social welfare and free access to health care vary- is that free access what is called medicaire and how does that vary from medicaide?

My other understanding is that people have private insurance of variable levels that is often provided through their employer. I assume then that if you don't work you only have access to medicaire level treatment but if you have insurance you have access to 'more' or 'better' treatment? Is that correct.

How does this translate for for this group of people here with cancer- does it affect what chemo people have access to or other treatments including surgery, cyberknife, RFA etc?

It is very complex for an outsider to understand as generaly in the UK there is one system that all have access to and only a small private healthcare component (though there are moves towards more private providers that worries me).

If anyone has teh time to do a brief description of the system it would really help me,

steve

steved said:

Question
Can I take the opportunity to try and get a basic understanding of the US system asI feel very ignorant. I understand that taxes vary between state so the level of social welfare and free access to health care vary- is that free access what is called medicaire and how does that vary from medicaide?

My other understanding is that people have private insurance of variable levels that is often provided through their employer. I assume then that if you don't work you only have access to medicaire level treatment but if you have insurance you have access to 'more' or 'better' treatment? Is that correct.

How does this translate for for this group of people here with cancer- does it affect what chemo people have access to or other treatments including surgery, cyberknife, RFA etc?

It is very complex for an outsider to understand as generaly in the UK there is one system that all have access to and only a small private healthcare component (though there are moves towards more private providers that worries me).

If anyone has teh time to do a brief description of the system it would really help me,

steve

Dear Steve
Receiving financial assistance to cover medical costs in the USA is a complicated mess and non-existant for many.

Employer Insurance - who gets it: If you work your employer may have a contract with a private insurer to provide their employees access to insurance. In some cases the employer will pay the cost to cover the employee only and the employee has to pay if they want to cover their dependents and spouse. There are many plans with varing coverage and many different private insurers. So if you change employer, you will likely change your insurance company as well as the amount of coverage. If you work for a small business or are self-employed you are likely responsible to obtain your own private insurance, which is very costly.

State sponsored coverage (Medicaid) is basically some medical coverage for those at or below the established poverty level. The eligibility requirements and what is covered varies by state.

Federal sponsored coverage (Medicare): When you work you actually pay into the Medicare fund...a tax. Generally Medicare comes into play at age 65. Those younger than 65 with certain disabilities can become eligible before 65. The overage is actually in parts. Part A is basically hospital coverage and is "free". Part B is generally for physician costs and you actually have to pay for it. Part D is for perscriptions and you have to purchase that from a participating carrier. There are other "supplemental" plans which you can purchase to help cover costs not covered by Medicare.

There are loopholes in all of this...for instance...a physican or private hospital does not have to take patients who are covered only by state or federal programs. In other words you can be turned away.

None of the coverages are 100%. Each insurer, whether private or government funded, gets to determine what is a reasonable cost for the service. In most cases the coverage is then only 80% of the reasonable cost and there is usually a deductible involved (a certain annual amount you must pay before coverage begins). With private insurance the patient is responsible for the difference between the actual cost and the reasonable cost. With Medicare the physician/hospital have agreed to accept the reasonable cost.

This is generally a quick picture of coverage in the USA and why so many have no insurance at all and why those that do get varying access to the services they need.

As I said, our medical coverage is a mess no matter how you slice it, and why even those with some coverage face great financial woes.

Marie who loves kitties

Lovekitties said:

Dear Steve
Receiving financial assistance to cover medical costs in the USA is a complicated mess and non-existant for many.

Employer Insurance - who gets it: If you work your employer may have a contract with a private insurer to provide their employees access to insurance. In some cases the employer will pay the cost to cover the employee only and the employee has to pay if they want to cover their dependents and spouse. There are many plans with varing coverage and many different private insurers. So if you change employer, you will likely change your insurance company as well as the amount of coverage. If you work for a small business or are self-employed you are likely responsible to obtain your own private insurance, which is very costly.

State sponsored coverage (Medicaid) is basically some medical coverage for those at or below the established poverty level. The eligibility requirements and what is covered varies by state.

Federal sponsored coverage (Medicare): When you work you actually pay into the Medicare fund...a tax. Generally Medicare comes into play at age 65. Those younger than 65 with certain disabilities can become eligible before 65. The overage is actually in parts. Part A is basically hospital coverage and is "free". Part B is generally for physician costs and you actually have to pay for it. Part D is for perscriptions and you have to purchase that from a participating carrier. There are other "supplemental" plans which you can purchase to help cover costs not covered by Medicare.

There are loopholes in all of this...for instance...a physican or private hospital does not have to take patients who are covered only by state or federal programs. In other words you can be turned away.

None of the coverages are 100%. Each insurer, whether private or government funded, gets to determine what is a reasonable cost for the service. In most cases the coverage is then only 80% of the reasonable cost and there is usually a deductible involved (a certain annual amount you must pay before coverage begins). With private insurance the patient is responsible for the difference between the actual cost and the reasonable cost. With Medicare the physician/hospital have agreed to accept the reasonable cost.

This is generally a quick picture of coverage in the USA and why so many have no insurance at all and why those that do get varying access to the services they need.

As I said, our medical coverage is a mess no matter how you slice it, and why even those with some coverage face great financial woes.

Marie who loves kitties

Thanks for the outline
Is useful to understand why so many people describe such a variety of issues with it. I would be interested to hear from people as to how this translates on the ground for them receiving cancer care. Really is only for my understanding as interested as a doc that works in a totally different system.

steve