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Are You Confused With Medicare Coverage?
In another topic about SSDI, @s-steppins mentions her confusion about Medicare and health options. I have heard many stories of those who struggle with this same confusion. I can relate. Although I have medical coverage through my hubby’s job, my parents are both on Medicare.
Each year plans change, and they must choose a new supplemental plan for health and RX coverage.
PHA offers some excellent resources for insurance coverage. They have one link specifically breaking down the Medicare information. Here is that link. The other resources for medical coverage are well done and helpful, too.
Not that anyone here is dummies, but this Medicare for Dummies is an easy-to-read site that some may find helpful, too.
If you are on Medicare and a supplemental plan, please share your tips with those overwhelmed with navigating the best coverage for those with PH.
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14 Replies
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Thank you so much for this information @jenc.
I was on the phone for a couple of hours this morning seeking help.
This will help a lot I am sure. -
I am on Medicare and so far it has been really good. I have a Cigna HMO which works well in my area. We have really good healthcare available so the HMO has a huge network. I doubt it would work well in a small area because of the network size. I have a large deductible on my Adempas but everything else has been easy. They pay 80% on my Adempas so that is a lot. I have had it for 2 years.
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I’m not on SSDI, but many PH patients have reported that having your doctor list “right heart failure as a result of pulmonary hypertension” is a magic phrase that usually results in automatic approval.
Edit: I just noticed I answered a question that wasn’t asked. I’m unable to delete my comment. For that, I apologize.
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Thanks, @mamabear007, for all of your contributions to this topic. I have had my docs add to my SSD information but never thought of adding the RHF to the diagnosis. That is a great tip.
Also, the waiting period for Medicare, great tip.
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@jenc, hopefully, that information will help somebody here. If not, maybe when somebody comes here asking in a month or a year or so, our members will remember the information and be able to share it. 🙂
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Yes @mamabear007 thank you for making that important point. Sharing what comes to mind here on the forums is likely to help someone eventually, if not now then possibly later.
How is your son doing these days?
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@colleensteele, my son is doing quite well. Still working full time — and last week, he and his wife even took a 3-day fishing trip.
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Hi @mamabear007, so true. We are so thankful for all that you share and others. Any small tip can make a huge difference in someone’s life.
I read the update on your sn. I am so happy to hear that he is doing well. Working full-time is a task in itself. I am grateful that he and his wife had that 3-day fishing trip. Is that deep-sea fishing? Did he grow up fishing, or is this a new hobby for home?
As a kid, I grew up around the water. Boating and fishing were common on the weekends. But as an adult. I tried fishing several times. I cannot sit still, and my hubby says that I talk too much for fishing, LOL
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@jenc, it was a 3-day vacay, fishing on a lake. His father-in-law has a boat, and they used that. This is the first time my son has gone fishing — ever. His wife, on the other hand, has been fishing her entire life. He caught enough for supper (and then some more to take home). I think it was bass.
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Hey @mamabear007, I think that the 3 days fishing on the lake was relaxing. It sounds like they were catching fish, too. That always helps me. But as I mentioned, I cannot keep quiet and don’t usually catch anything, LOL.
It sounds like this may be a new hobby for him. I am certain that his wife gave him all of her secrets to catching a big fish. Was that a long drive for them or nearby? If I had to do a long drive, you would probably find me chilling out on a blanket or lounge chair beside the lake hehe.
I would be the one waiting for all to bring home dinner. Although, I prefer going to the local fish markets. I cannot stand to watch someone gut a fish. That grosses me out now, lol.
Have you enjoyed fishing at some time in your life?
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@jenc, depending on traffic, the trip would’ve taken them 4-5 hours each way. I went fishing off a pier in Key West when I was a kid, but I didn’t catch anything. Still, it was fun.
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LOL, @mamabear007, as a kid, I was OK not catching anything. I am pretty sure that my grandparents told me to be quiet, so I did not run the fish away. Some things never change, LOL.
Oh, Key West is on my list. I still have not made it there. I will take one day.
Thanks for sharing; you are full of valuable information.
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I’m glad you didn’t delete it @mamabear007 because you brought up a good point. It seems there are magic phrases that get the ball rolling in regard to many medical scenarios. It was the same for transplant. Cullen’s right heart failure and placing him on Milrinone were two things that helped bump him up on the list. Thank you for mentioning the power of words!
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You’re welcome, @colleensteele. Something else than many don’t know is that getting on SSDI will qualify someone for Medicare, but there is usually a 6 month waiting period for the Medicare to kick in. Sometimes they make an exception, but I haven’t heard from enough people who got the exception to know what it is.
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