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Last year I received my letter telling me about the increase back in Sept. and since I hadn't heard anything this year......thought I was going to get a break :( Wrong, I received my letter yesterday.
Thank you so much for the post with links. I will review and see how to proceed. Short Term Disability is a program my employer offers. It is part of the FMLA program but for yourself not a family member. I have up to 12 weeks in a rolling calendar available to use. I use sick time or vacation time for the first 5 days and then will receive compensation at a prorated rate weekly but most importantly will keep my benefits and job until I return. I do not know what will happen with me next, but at least I can have some time to make a clear, educated decision based on the way my health is without the stress of having to go to work everyday and adding more stress.
to apply for social security disability (SSD):
Supplemental Social Security Income (SSI)
Benefits for people with disabilities:
Information on mental claims for disability:
Susan, I don't know what short term disability is, but you can apply for social security disability, and if you get accepted, you automatically get Medicare two years later. They don't only accept physical reasons, but mental as well. This is one of the reasons the application is so long. There are other poverty programs like SSI, Medicaid, food stamps, etc. Personally, I went on SSD a few years before my transplant, and I am still on it. I am now 64, and have Medicare health insurance and a monthly Social Security check, which isn't enough to live on, but it sure helps. I love the $104 medical insurance. When I went on disability I just called Social Security and they sent me all the forms.
My question is what to do now? I went back to work after kidney transplant 3/29/2010. I was out for 3 weeks to rehab and went back. Now 3 1/2+ years later I am struggling at work. I am a customer service rep at a bank so my job is not physical, but mental. I am longer to do this job between my apathy and the stress of the job itself and the environment. I am 53 years old. I went on short term disability yesterday. I don't know how to proceed. Has anyone gone back to work after transplant to find out later they just don't have the strength to do the job anymore? I would appreciate any information. I carry all the benefits for the family. What will happen to me? Can I get SS? Can I get some government insurance? Thanks! Sue
Very sorry to hear about your troubles with Lincare. With all the political pressure from the conservatives in congress, there have been many changes in Medicare's DME program. Most areas of the country must use the Competitive Bidding Program, which limits who you can go to for your O2 and supplies, but they must service your needs. Medicare says that if you are having any issues getting your oxygen, you are supposed to call 1800Medicare, and they will do something to get you help.
Since you are now near the end of the 5 years, you should be able to switch oxygen providers, and it also sounds like your current provider is not able to fill your needs anyway, so you need to report them to Medicare. Have you tried calling Medicare, or has your doctor come up with any recommendations? If they are not able to help, you should look for another doctor,
More and more companies are converting people away from LOX, since it is so expensive, which is unfortunate, but there's really nothing we can do about it. However, if you really need a very high oxygen flow, your supplier is supposed to help you. I know a couple of people who use over 15 liters when exercising, and they 'T' (or 'Y') tanks together and put them in a rolling cart so they can exercise. I have to admit that I've never heard of anyone needing 30 liters of oxygen. That doesn't sound right. Are you retaining CO2? It sounds like there may be other issues if you require that high a flow.
You should discuss this with your pulmonologist and he should be able to prescribe the needed flow for you, and your supplier is required to fill those needs.
If they won't put you into a transplant program due to your weight, you should also discuss this with your doctor to see how he can help. If the main reason you are not able to lose weight is prednisone, maybe he can take you off all steroids to help you.
If you are not familiar with using a "Y" connector to combine oxygen sources, I put an article on my server with links to photos which should help:
Jay Lackritz - Double Lung Transplant, NYC, May, 2007
In a reversal that followed intense lobbying from the health insurance industry and members of Congress, the U.S. government said it will increase the payment rate for health insurers that offer coverage through the popular Medicare Advantage program.
The Centers for Medicare & Medicaid Services said on Monday it will increase the rate by 3.3% in 2014, reversing a 2.3% cut announced in February.
The turnaround boosted shares of major health insurance companies such as Humana Inc in after-hours trading.
Medicare Advantage provides care for seniors who select to receive their Medicare benefits through private insurance plans. About 14 million Americans are enrolled in the program.
The program has long ensured industry participation by paying more than the cost of the traditional Medicare program for the elderly and disabled. The proposed reduction had followed efforts by the Obama administration to reduce how much money it pays private insurers as an incentive to participate.
In announcing its final rates for 2014 on Monday, CMS said the changes came "after careful consideration of public comments."
"The policies announced today further the agency's goal of improving payment accuracy in all our programs, while at the same time ensuring program stability and preserving beneficiary choice," Jonathan Blum, acting principal deputy administrator for the CMS, said in a statement.
Since the initial rate announcement in February the agency, part of the U.S. Department of Health and Human Services (DHHS), has encountered weeks of heavy lobbying by health insurers, whose share prices dropped sharply on the planned rate cut.
Some insurers hinted they would drop their Medicare Advantage business for 2014 if the government did not back down.
Lawmakers on both sides of the aisle took those concerns on board. More than 160 of them joined an effort to reverse the previously announced rate cut, according to America's Health Insurance Plans (AHIP), which launded Monday's decision.
AHIP has released several lawmaker letters expressing worry about the proposed Medicare Advantage payment cuts, including three last week from bipartisan members of the New York House delegation; the entire Massachusetts House delegation, all Democrats; and six other House Democrats.
"We have concerns that if CMS does not make this adjustment, many Medicare Advantage enrollees in Massachusetts, and across the country, will face higher premiums and fewer benefits," said the Massachusetts delegation's letter, which was addressed to Marilyn Tavenner, acting CMS administrator, and dated March 27.
Earlier in March, a large bipartisan group of senators highlighted the threat of plans potentially exiting the Medicare Advantage market altogether.
Meanwhile "The Coalition for Medicare Choice," which is funded by AHIP and other private insurers, launched a full-throated attack on the proposed cuts through television advertising and social media.
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