Are you on Medicare? | Arthritis Information

 

I am getting on it in Oct. and I don't have to pay for a secondary plan, they give one to me as I so below the poverty line.

I have been on Medicaid for 6 months and it has been impossible to find a doctor and very few prescriptions are covered.

I would love to hear that things are going to get better once I am on Medicare. Anyone appreciated who has experience with Medicare.

Actually in my state (WV) you would be better off staying on medicaid than going over to medicare.  Medicare pays 80% of your doc visits it's the part D prescription plans that are the pits for RA patients.   I have a 5 deductible after which the insurance company pays up to ,510 in medication costs.  After hitting this cap, I'm in a coverage gap until I reach a total of ,050.   After that they have catastrophic coverage which makes me responsible for only 5% of the total prescription cost.  (compared to the normal 33% for Humira)  

wow Bob, how awful for you. Do you have any other options? That is just terrible!

I feel your pain bob, it is the exact same way for us here (ky). For us medicade is much prefered over medicare. and I find myself being envious of those who have medicade because it covers almost everything. Here the choice between medicade and medicare is always medicade. Sorry to here about your troubles, sending hugs and prayers your way.

jamie

II'm on Medicare and chose a managed care plan through Blue Cross.  It has a prescription drug program comparable to Plan D.  My problem is the medicine coverage.  I get generics for a low copay but very few brand names are covered and if they are, it's at a copay.  The newer arthritis drugs (if covered) are at 35% copay and not affordable for me.  Same thing with two of my drugs for kidney problems....not covered at all and I had protested twice with doctors' statements etc and was refused.  It's just not right and we need some real changes in the system. This is really bad news. I do not know if I will be better off as I was sent a letter saying that I would not have to pay for a supplementary plan because I am so low income. I am just praying it will pay for my prescriptions. It says my copay will be no more than . Most prescriptions are not paid by Medicaid but I am in OR which is in dire straights economically. I was way better off in CA but I need my family. No one expects me to live long so they are helping me to get my affairs in order and they come to visit me which are the highlights of my life. I had an emergency nurse tell me that people in my condition do not usually live longer than five years, my aides and my family are honest with me that I need to get my affairs taken care of. I am not scared but I want to be sure Kelsey and Colton and my dogs are taken care of and my brother gets his money back that he used to pay off my second mortgage and now with the housing market, that would not happenn. I am hoping that Obama wins as he has several plans that will help me.roxy2008-08-12 10:18:51Roxy, I had private insurance before I went on Soc. Sec. Disability. I paid 1600.00 per month for my husband and I for insurance. Now , it is covered by my part B .50 (Ithink) per mo. If you are below poverty line and have Medicaid, you should be covered by Medicare with the Medicaid policy picking up some, if not all of the rest. The exception might be prescriptions. People are telling you that you won't be alive within 5 years?  I'm all for honesty, but if people who are not my doctors, are telling me I'll be dead in 5 years, I'd tell them right where to go.  Of course everyone should have their affairs in order...who knows when our time is up? Positive thinking sure helps as far as I'm concerned.

Medicaid in my state has limits. Like they only pay for 14 doctor visits a year, then you have to pay. I used up my 14 visits within the first 3 months of the year. SUCKS!

Kelstev, People tell me that because my RA has progressed so rapidly and my liver is suffering from all the painkillers, pred. and everything else, antidepressants (now on the maximum for Cymbalta), cholesterol meds, ulcer meds ,,,,,,,,,,,,,, I cannot even keep track. My RD wants me on Orencia but no way can I pay for it, that is why we are trying Enbrel again. I have had one stroke and high risk for another. I do not get hardly any exercise unless I am lucky enough to get a ride and can get in the building to the pool. They use a swing to put me in pool but once in, I feel great - I always overdo and feel it the next several days but it is bliss. I smoke, I want to quit so bad but in a bad flare, I quit caring and smoke or when Kelsey is having a bad day - I end up smoking. Smokes are always available as Kelsey rolls her own and will give them to me. Not good excuses but that is what happens. My bp gets very high when I am in pain. My diet sux as we eat food box donations and my brother brings groceries once in awhile, but rarely fresh stuff.   My family has paid for so many things I cannot ask for more. My brother has had to pay off utilities when they get shut off, he buys me groceries, anyything that breaks in the house, he pays to fix it,he paid off my car, takes Kelsey out and buys her clothes or to lunch to get a break from her sick mom.   My other brother paid off second mortgage on my house - 50 K and bought me a wheelchair. My younger brother has been paying for my oxycontin 0 a month - he does not make a lot of money - so I really have them all strapped. They all see me in such bad condition and I was very suicidal before I got the oxycontin that we had a talk and they agreed I really did not have quality of life. Doctors are frustrated because we are treating the symptoms but I really am not on anything that will put me remission. I pray that I can get back to a quality of life and I hope the wheelchair makes a difference. Someone has to push me but we are going to try to leash my two weimeraners to the front to pull me. I hope that works. If I could cut back on pred,. painkillers, lower blood pressure and cholesterol,, get on a biologic that actually works, less stress and better diet - we will all be more hopeful but my family is pretty much tapped out. Now with the housing crisis I cannot even sell my house. The nurses and doctors main concern are my liver, smoking, high bp with the stroke or internal bleeding from ulcer. Right now things are looking up. I feel like I am closer to getting Enbrel, getting connected to a church that I like the doctrine has helped a lot. They bring me a cd of the sermon every week and pray with me. I would love to go in person but too early in am for my morning pain. I also am hoping that the doctor will help me to get this plan to help pay for the oxycontin. He wants me on morphine, but I hate it. Take morphine, first I get sick, take nausea medicine, then I sleep a very wierd kind of sleep, then I wake up and everything is surreal and swimming. That stops and the pain comes back. The thing that bugs me the most is my brain does not function at all. That is what I have left. You may not know it from my posts but I am very intelligent. I was only two points short of Menses. (Professor nominated me to take the test). I would have passed it if it were not for geometry and my dyslexia.

I have to tell you, strengthening my belief that the spirit lives on (I would like to live as an Oak Tree after I die, maybe overlooking a creek where I could provide a place for birds and other animals food and shelter. That is where I picture my spirit would be happiest - that would be my heaven. Anyway, faith in your spirituality makes such a difference. Thank God I made that call and reached out.

Being very independent to almost totally dependent and a huge burden to your family is not quality of life. I hope it improves but if it does not - I have no problem with letting this body go. It has served me well.

(Hula and I use to talk about this a lot, her progression was very fast like mine, and she felt the same way. She was ready and tired of being trapped in her body. Our body is only a temporary housing for who we really are)roxy2008-08-12 15:07:32Roxy when you say people tell you that you wont be alive in 5 years, are they doctors? my aunt has had extremely bad RA for 40 years without any of the meds we have today. She has survived cancer, suffers with kidney, liver and heart problems, had 3 strokes and her BP has been through the roof, she has outlived a lot of her family who were healthy ,so dont let anyone tell you how long you have left. I read a book about Jane tomlinson who suffered cancer, she was given 4 months to live and then went on to live 12 more years and ran marathons, bike rode across america and did 2 thriathalons.Are you KIDDING me?

"I go to the pool for water therapy once a week. It is absolutely wonderful." then 3 hours later.."I do not get hardly any exercise unless I am lucky enough to get a ride and can get in the building to the pool."

Which is it?  You get in the pool once a week, or you hardly go?  Your lies are catching up with you again.

Go back to your hole.  You are pathetic.  I hardly doubt you are dying.  Get a hobby and some positive thinking and you might be better off.  Geezzz.  And stop talking about pissing in a bowl.  No one wants to hear about that.  Such white trash.

Phats

 

Orencia shouldn't be out of your reach.  I receive help from a supplemental insurance co. to cover my copay.  There were several out there and the Orencia maker themselves also provide drug assistance coverage.  I was not elegible for that since I do have insurance.  Please look into the many organizations available.  I currently use the Healthwell Foundation.  My dr. said that the one that Montel Williams is spokesman for is excellent as well.  Can't remember the name at this time.... [QUOTE=Phatgirl2]Are you KIDDING me?

"I go to the pool for water therapy once a week. It is absolutely wonderful." then 3 hours later.."I do not get hardly any exercise unless I am lucky enough to get a ride and can get in the building to the pool."

Which is it?  You get in the pool once a week, or you hardly go?  Your lies are catching up with you again.

Go back to your hole.  You are pathetic.  I hardly doubt you are dying.  Get a hobby and some positive thinking and you might be better off.  Geezzz.  And stop talking about pissing in a bowl.  No one wants to hear about that.  Such white trash.

Phats

 

[/QUOTE] Well Phats, if you think about it...once a week is not very often to get out for activity. People that can just get up, get dressed, run out the door and do what they want, take for granted many things. I broke my leg one time and I learned quickly how poor facilities are laid out for handicapped people when I had to use a wheelchair to get around my community. I was a private home health nurse to a quadriplegic man for 11 years. I took him to his doctor appts and other errands and found parking, and access to different places of business to be inadequate for a motorized chair. It was difficult for him and he stayed home alot rather than fight access to places he really wanted to go.

Roxy, keep working on improving certain aspects of your health especially the smoking. it really adds to your inflammation and makes your blood pressure and cholesterol levels high. One day at a time. I actually am on a massive dose of prednisone too.  (100mg daily but beginning to taper in 20mg increments soon)  I applied for copay assistance through the Healthwell Foundation they helped me once with Remicade.  I never tried the one Montel is the spokesperson for but it is called PPARx.