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Medical Forum / Diseases and Disorders / Epilepsy / July 2005

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Medical Bills! immadummie

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owlvee - 08 Jul 2005 00:43 GMT
I am getting medical bills from the hospital, of course, from when I was
taken there during my last emergency Grand Mal seizure. I stayed there 3
days or 16 grand plus!!!!)

 I went today for assistance to pay the bills since I haven't worked
for the past 3 years. The lady there mentioned that "medicaid" and
"medicare" would be coming up in my future once my Epilepsy Disability
case was settled.

 She mentioned that I probably "wouldn't" be eligible for one of those
two once I settled my case because my disability check would be too
large (??Duh- I don't know which one she said) and that the other took a
year to start once I settled my disability claim. So I guess I will be
eligible for Medicaid "or" Medicaid, I am not sure which.

My question is "Can someone explain to me or post some links that will
explain to me the difference between 'Medicaid' and 'Medicare'?", as I
don't know one from the other."

Oh, and just out of curiousity, anyone know what all this will do to my
"Non Related Disabled Veteran's" check and "Vietnam VA Benefits" I get
now, once I get my disability case approved????????????????????????

Thanks,
~..~
owlvee
G.Ross - 09 Jul 2005 06:03 GMT
>I am getting medical bills from the hospital, of course, from when I was
>taken there during my last emergency Grand Mal seizure. I stayed there 3
[quoted text clipped - 10 lines]
> start once I settled my disability claim. So I guess I will be eligible
> for Medicaid "or" Medicaid, I am not sure which.

**G* I don't live in the U.S. but until we hear from some people who do, who
understand this, I'll mention some things that are set up in Canada, and
*some percent of these might explain part of this.
(Howdy Dave can explain U.S. Bureaucracy :-<  or correct any assumptions I
make here, since I'm only guessing,  based on how I think parts of the
Canada one do these... )

When I first got Canada Pension, I got one 'large' check that started from
date of 'disability onset' up to current (about 20 months).  *If I had been
below a certain yearly amount as a lump sum I would have been eligible for
another $1000 Pension *Deduction from my Income Taxes  (at that time-- it's
discontinued now).   But since my first check was ~$300.x20 for above almost
2 years, plus my Employer's Insurance was already paying out, my Total 12
month income was too high for that $1000. (Canada) Deduction at tax time.
  Dave might be able to answer this when he's around -- but if your 'gross
income' is above xxx dollars?  a Percent of  That might start to *reduce
amount of money you're eligible for, that pays e.g. Prescription and Medical
costs ??
  If you know someone who's an accountant, and if you may not need the full
dollar amount when it first arrives, there *might be a way to move some of
the 'disability income'  across to a 'retirement fund' (if that's tax
deductible), to reduce this year's total gross income?  I don't know if
U.S.? has similar programs like the Canada Pension and Pension Savings Plans
we have or not.
  I *do remember taking a 'whack'  when I first retired (pre-seizures) and
had to collapse a ~large savings plan from my employer, as part of my
retirement process. (It wasn't something I had a choice about-- because I
was declared 'Disabled'  I had to collapse or Transfer Company-shared
savings plans to an outside bank or account.   *That made it become Taxable
to the Federal Government at tax time (10 months later).  Part of that was
put (non-deductible) to pay down our Mortgage.
  The reduced mortgage payments saved enough expenses to pay the Tax Bill
that became due 10 months following above retirement. /

   I know Dave, plus some others who used to post here, can translate what
you were told at top and below, into 'plain language'....  In Canada it's
something strange like your Gross Income from all sources per year x 16% or
18% -- and if that amount is above a certain amount in one Calendar Year it
reduces the total Disabled Amount payable for that year.  The *next year,
unless you had to carry some of that large income forward, then you might be
**eligible for both types of income the Second year and beyond.
   (Never under-estimate a bureacracy and hoops they might create, while
they don't realize effect it can have on our lives, while it doesn't matter
to them !!  :-<  ) Dave or a couple of other people in U.S. who've done some
of this might have a translation for you and how to reduce any unnecessary
delays in getting any payments started.   Sometimes it's quicker to get an
agency to help (if a local Ep. Association does stuff like that as part of
their mandate, for example).
 Some of them might also have a U.S.  Government Website link, that might
have interpretation bulletins wrt.  taxation of citizens, that would explain
that for you.
  But I got my forms and 'record of employment'  from my employer (needed
to show how many years I contributed to government plans here), and was able
to get the forms filed near where I live.   My first check (Canada again)
started about 10 weeks later once it was approved, but was back-dated to
'date of onset'  that my Doctor had completed.
  **Note also, when you finally get approved, that you're likely insured
(then) for any receipts you have for those expenses you mention above, that
you've **already paid. There's probably an 800 number or www address where
you can get Forms to add those expenses onto, and where to mail them once
the paperwork you have underway is done?   Dave might know about that too.
You might need a 'retirement number' or 'insurance number'  to put with any
claims to speed up processing when the initial stuff is done.   (more below)
/

> My question is "Can someone explain to me or post some links that will
> explain to me the difference between 'Medicaid' and 'Medicare'?", as I
[quoted text clipped - 3 lines]
> "Non Related Disabled Veteran's" check and "Vietnam VA Benefits" I get
> now, once I get my disability case approved????????????????????????

**G* IF I were setting it up, for the U.S.,  *I would have separated
Veteran's Benefits from the Calculations I talked about earlier,  and these
latter payments would not be included in a calculation of total income, or
'reduction amounts' calculated, if any applied to your annual income.  I
think *again, that's what Canada does for our Military People, wrt.
pensions and compensation after they are set as 'retired' here.   (The only
fellow I knew who was in the Liberation of France, has moved to warmer
climes in Western Canada.  )    G./

> Thanks,
> ~..~
> owlvee
Dave ©¿©¬ - 09 Jul 2005 07:09 GMT
Howdy!

If you qualify for Social Security Disability it works pretty much the same
way.

They determine a set monthly amount due to you.

Your first check will give you a lump sum that covers everything from the
date of your initial application to the current month.

I believe that the lump sum goes back to a maximum of 7 years. I know that I
didn't get everything because my initial application had been 10 to 15 years
previous to my acceptance. Still I got a good chunk.

For the sake of easy arithmatic, lets say that you will qualify for $500 per
month.

For the sake of example, lets say that you first applied exactly 5 years
ago.

That would mean that your first check would be:

$500/month * 12 months/year * 5 years = $30,000.

MedicAid (from the state) won't help you until you only have 2 or 3 thousand
left!

When you get your disability you will be enrolled in MediCare, which will
cover major medical expenses such as doctor's bills, testing and hospital
stays,

BUT
You will have to pay your own pharmacy bills until you've piddled your lump
sum down to a couple of  thousand.

Signature

Dave ©¿©¬

http://www.howdydave.com

> >I am getting medical bills from the hospital, of course, from when I was
> >taken there during my last emergency Grand Mal seizure. I stayed there 3
[quoted text clipped - 96 lines]
> > ~..~
> > owlvee
Dave ©¿©¬ - 09 Jul 2005 06:41 GMT
Howdy!

MedicAid is run by the STATE. If you are unemployed you should be eligable
for MedicAid if you have less than $3000 (or thereabouts) to your name. The
amount probably varies somewhat from state to state.

MediCare is run by the Federal Government and you will automatically be
enrolled when you get Social Security Disability.

If you are eligable for MedicAid now, you will be disqualified when you get
the lump sum check for Social Security benifits accrued from the time you
first applied for it until you get the check.if you have more than a set
amount of fluid assets (bank accounts, etc.)

If you are owed a back payment for disability, as soon as you get it you
will be suspended from the MedicAid program until you have nothing left.

One thing to remember...

MedicAid covers pharmacy expenses
MediCare doesn't!

To get the specifics of how MedicAid works in your state, you will have to
do a search on "MedicAid" and your state.

Signature

Dave ©¿©¬

http://www.howdydave.com

> I am getting medical bills from the hospital, of course, from when I was
> taken there during my last emergency Grand Mal seizure. I stayed there 3
[quoted text clipped - 22 lines]
> ~..~
> owlvee
Holly F. Sox, RN, RAC-C - 14 Jul 2005 00:20 GMT
<snip>

>One thing to remember...
>
>MedicAid covers pharmacy expenses
>MediCare doesn't!

Actually, Medicare part D is scheduled to go into effect on January 1,
2006. This is the prescription drug benefit. The rules are
unbelievably contorted in ways that only the federal government could
devise.

Go to www.medicare.gov

It's a fairly user-friendly website with links for beneficiaries and
providers.

Our Medicaid program in South Carolina. SUCKS.

The spend-down amount is $3000, at least for nursing home placement. I
am not sure about the community medicaid.

>To get the specifics of how MedicAid works in your state, you will have to
>do a search on "MedicAid" and your state.

http://www.dhhs.state.sc.us/dhhsnew/index.asp

Holly

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